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Dr. Harold Ridley, Rayner, and the first intraocular lens

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Dr. Harold Ridley, Rayner, and the first intraocular lens

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During World War 2, Dr. Harold Ridley was an ophthalmologist from England who observed that pilots who had shards of plastic in their eyes from shattered cockpit canopies did not experience any inflammation or rejection of the plastic (1).This observation led him to believe that plastic could be used in the eye without causing harm (2).

In 1949, Dr. Ridley performed the first successful implantation of an IOL in a patient who had cataracts removed and is generally credited with inventing the first intraocular lens (IOL) and pioneering the use of plastic in eye surgery (2). The IOL was made of Perspex, a type of plastic, and the first lens was manufactured and distributed by Rayner in 1989 (3). The above image is one of the first designs for the lens and would later be re-modeled multiple times before release (3).

Dr. Ridley's work revolutionized ophthalmology as well as neuroscience by reducing the amount of risk that an object could ensue upon the eye in terms of peripheral neuropathy (2). He has made a significant impact on the lives of millions of people with cataracts and other eye conditions. His advancements continue to make lasting impacts in neuroscience by guiding how plastic can be better used in the eye.

References:
1. Apple, D. J., & Sims, J. (1996). Harold Ridley and the invention of the intraocular lens. Survey of ophthalmology, 40(4), 279–292. https://doi.org/10.1016/s0039-6257(96)82003-0
2. https://rayner.com/wp-content/uploads/2021/12/Invention_of_the_IOL.pdf
3. https://royalsocietypublishing.org/doi/pdf/10.1098/rsbm.2007.0022

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Samuel Sharp's "A Treatise on the Operations of Surgery" highlights how he performs the first intracapsular cataract extraction and more

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Samuel Sharp's "A Treatise on the Operations of Surgery" highlights how he performs the first intracapsular cataract extraction and more

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Samuel Sharp was an English surgeon who is credited with performing the first successful intracapsular cataract surgery in 1747 (1). Sharp believed that removing the entire lens, including its capsule, would lead to better outcomes and improve the patient's vision (1).

Intracapsular cataract surgery involved making a small incision in the eye and then using a specially-designed, spoon-shaped instrument to remove the entire lens and its capsule (1). He performed it on a 13-year-old boy and it was a success, inspiring him to write various texts of surgical procedures (1).

Sharp's significant contributions helped advance the practice of cataract surgery. The book shown above, A Treatise on the Operations of Surgery, is a culmination of the many surgical techniques he had practiced and developed (2). This book, in turn, helped advance many fields of neuro-ophthalmology (2). The book was written in 1825 and today, many of the techniques in the book have been replaced by modern techniques, but it remains an important part of the history of ophthalmology and neuroscience (2).

References:
1. Hubbell, A A. “Samuel Sharp, the First Surgeon to make the Corneal Incision in Cataract Extraction with a Single Knife: A Biographical and Historical Sketch.” Medical library and historical journal vol. 2,4 (1904): 242.1-268.
2. Kirkup J. Samuel Sharp and the Operations of Surgery, 1739. Journal of Medical Biography. 1996;4(1):1-7. doi:10.1177/09677720960040010

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Keratoprosthetics as thought in "Précis au cours d'operations sur la chirurgie des yeux"

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Keratoprosthetics as thought in "Précis au cours d'operations sur la chirurgie des yeux"

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Keratoprosthesis is a surgical procedure that involves replacing the damaged or diseased cornea with an artificial cornea (1).  The idea of an artificial cornea to replace an injured one was devised by French ophthalmologist Guillaume Pellier de Quengsy in 1789 during the French Revolution (1).

The book shown above is titled Précis au cours d'operations sur la chirurgie des yeux, which translates to "Accurate During-Eye Procedures" but it roughly means that it was a comprehensive list of techniques that de Quengsy was hypothesizing and one of them was, what we modernly call, keratoprosthetics (2).

Keratoprosthesis is typically used in cases where traditional corneal transplant surgery has failed or is unlikely to be successful (2). It is generally considered a last resort due to the complexity and potential risks involved (2) but it is an immediate fix to healing a damaged cornea and providing the relief that a patient needs.

De Quengsy’s work and comprehensive studies/books highlight early neuroscience influence and it’s evident how many of these techniques have been modified and improved over the years, providing a comprehensive look at neuroscience. This book and keratoprosthetics have helped reduce infection, residual neuropathy post-surgery, and many other fatal side-effects that could prove serious neurological damage if left untreated or done incorrectly (2).

References:
1. https://archive.org/details/BIUSante_56107x01/page/n7/mode/2up
2. Chen, M., Ng, S. M., Akpek, E. K., & Ahmad, S. (2020). Artificial corneas versus donor corneas for repeat corneal transplants. The Cochrane database of systematic reviews, 5(5), CD009561. https://doi.org/10.1002/14651858.CD009561.pub3

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Jacques Daviel performs the first extracapsular cataract extraction on M. Garron

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Jacques Daviel performs the first extracapsular cataract extraction on M. Garron

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Jacques Daviel was a French ophthalmologist who is credited with performing the first extracapsular cataract extraction surgery in 1748 (1). Daviel believed that removing the cloudy portion of the lens and leaving the capsule intact, would be a safer and more effective method of restoring vision (1). He compared this method as safer than "couching" and variations of it that were developed around the mid-1700s (1).

Daviel performed the surgery on a wigmaker named M. Garron and the surgery involved making a small incision in the eye, then carefully removing the cloudy portion of the lens (2). The capsule was left intact to provide support for the artificial lens that was later implanted (2).

Daviel detailed his procedure and technique through detailed drawings in his notebook, as seen above, in 1748 (2). It is important to truly visualize how the eye and its surrounding connections were treated and how surgical procedures involved many different iterations of drawings (2).

The surgery was a success, and M. Garron's vision was restored (2). The extracapsular technique soon became popular among ophthalmologists, and it is still widely used today in modern cataract surgery (2).

Daviel's significant contributions to the field of ophthalmology helped to advance the practice of cataract surgery and also contributed greatly to the fields of neuroscience (2). Today, the surgery is a routine and effective procedure that has improved the visual quality of millions without peripheral neuropathy for years (1).

References:
1. Obuchowska, I., & Mariak, Z. (2005). Jacques Daviel--twórca zewnatrztorebkowej metody usuwania zaćmy [Jacques Daviel--the inventor of the extracapsular cataract extraction surgery]. Klinika oczna, 107(7-9), 567–571.
2. HUBBELL AA. JACQUES DAVIEL AND THE BEGINNINGS OF THE MODERN OPERATION OF EXTRACTION OF CATARACT. AN ADDRESS COMMEMORATIVE OF THE THIRD SEMI-CENTENNIAL ANNIVERSARY OF THE PUBLICATION OF THE FIRST DESCRIPTION OF THE OPERATION. JAMA. 1902;XXXIX(4):177–185. doi:10.1001/jama.1902.52480300001001a

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Sushruta and the early cataract surgery is known as "couching"

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Sushruta and the early cataract surgery is known as "couching"

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Sushruta was an ancient Indian physician and surgeon who lived in the 6th century BCE India. He is widely considered the father of modern surgery and made significant contributions to the field of ophthalmology, such as the development of a method of eye surgery called couching (1).

The image shown above is a scripture from the 6th century BCE that depicts many of his contributions to neuroscience and ophthalmology: he was the first to describe the anatomy of the eye, including the retina, optic nerve, and ciliary body (1). He also developed techniques for treating various eye conditions, including glaucoma, conjunctivitis, and corneal ulcers (1).

Couching involved pushing a blunt needle or probe through the cornea and into the eye to displace a clouded lens caused by cataracts (2). Cataracts had been an ancient problem in India so Sushruta’s innovation was extremely important in the catalysis of neuroscience research and eye surgery in India and surrounding territories (2). However, the technique had limitations, and patients who underwent the procedure often had to rely on others for assistance due to the loss of near vision (2.)

Sushruta's contributions to medicine and neuroscience have had a lasting impact, and his techniques and teachings continue to influence medical practice today. His method of couching, while no longer practiced due to advancements in surgical techniques, shaped the way for modern cataract surgery and continues to be an essential part of the history of ophthalmology and neuroscience. Without his contributions, we would not be as far as we are today in modern cataract surgery in India.

References:
1. https://www.eyenews.uk.com/features/ophthalmology/post/ophthalmology-in-ancient-india-sushruta-s-time-and-the-modern-era
2. Grzybowski, A., & Ascaso, F. J. (2014). Sushruta in 600 B.C. introduced extraocular expulsion of lens material. Acta ophthalmologica, 92(2), 194–197. https://doi.org/10.1111/aos.12037

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VIDEO: Surgeon details techniques for scleral fixation of IOLs

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Doctor details research being done for techniques in scleral fixation of intraocular lenses (IOL's)

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Doctor details research being done for techniques in scleral fixation of intraocular lenses (IOL's)

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In this video made in 2023, Dr. Michael Amon, MD, describes various surgical techniques for scleral fixation of intraocular lenses (IOLs) in patients with poor capsular support (1). Scleral fixation is a method used when the natural support structures of the eye (capsular bag) are insufficient for holding traditional lenses in place (2).

He explains the steps involved in the procedure: marking the scleral entry points, creating scleral tunnels, and inserting the haptics of the IOL into the tunnels (1). Dr. Amon also describes how to ensure proper centration of the IOL and how to avoid potential and fatal complications such as retinal detachment or vitreous hemorrhage (1). He elaborates on various techniques but two, in particular, are the "Yamane technique of flanged intrascleral fixation and the Canabrava double-flanged technique, which can be used to exchange a lens but also to re-fixate a lens" (1).

This video is important in highlighting the innovative techniques being developed in medicinal and neuroscience research daily. The history of ophthalmology has been filled with scholars who are constantly trying to develop safer and better methods for eye treatment. In terms of neuroscience, this can help reduce neurological pain from these procedures as well as reduce risk of peripheral neuropathy.

References:
1.https://www.healio.com/news/ophthalmology/20230405/video-surgeon-details-techniques-for-scleral-fixation-of-iols
2. Kumar, B., & Muni, I. (2022). Scleral Fixation of Intraocular Lenses. In StatPearls. StatPearls Publishing.

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VIDEO: Surgeon details techniques for scleral fixation of IOLs

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VILAMOURA, Portugal - At the ESCRS winter meeting, Michael Amon, MD, speaks about the latest techniques for intrascleral fixation of IOLs in cases that lack capsular support.

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Ammar ibn Ali al-Mawsili (also known as Ammar ibn Ali of Mosul) was a famous Islamic and Sufi scholar who was one of the first ophthalmologists who pioneered the hypodermic syringe in his practice of cataract removal (1). He lived in Mosul, Iraq during the 9th century, which was an important center for learning, philosophy, and scholarship (1) He studied Islamic Studies and Theology in Mosul before journeying to Baghdad to further his education into deeper and broader fields (1).

He is mostly known for his invention and further development of the hypodermic syringe (2). This syringe was used with a hollow needle to extract delicate, fine organic material from the body. He used this technique frequently in cataract extraction (2).

He eventually left Iraq to travel to Egypt, and it was there that he was ordered to write a book detailing the treatments known at his time, including his novel approaches in the field of eye diseases to benefit his students and patients (1). His book, titled "The Book of Choice in Ophthalmology, was used as a reference by many scientists for centuries (1).

The work he has done has laid some foundational groundwork for many future scholars who were venturing into the science of the eye, neuroscience, and anatomy, in general. Some of these are, but not limited to: Rhazes, Ibn al-Nafis, Ali Ibn Isa al-Kahhal, etc (3). These people have all been influenced to pursue further research in the fields of pre-modern neuroscience.

References:
1. Qari, Mohammed. (2010). pioneers in hematology Al Mawsili: The Inventor of the First Hollow Needle and Syringe. Journal of applied hematology. 1.
2. National Institutes of Health. (2011, December 15). Islamic culture and the Medical Arts: Ophthalmology and surgery. U.S. National Library of Medicine. Retrieved April 5, 2023, from https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_09.html
3. Lindberg, David C. (1981), Theories of Vision from Al-Kindi to Kepler, University of Chicago Press, p. 238, ISBN 0-226-48235-9