Cataract surgery up to the age of Daviel

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Abstract

The knowledge of ocular anatomy in the classical time was limited. Aristotle considered the lens as a post-mortem artefact. For Celsus the lens was the essential organ of vision, a misconception which will remain till Vesalius, one of the first to consider its optical role. Platter recognized the role of the retina and Aquapendente will correct the position of the lens in the eye, which was thought to be in its centre. Cataract was considered an accumulation of “miasma” between the lens and the iris. It is not certain that the ancient Egyptians performed cataract surgery. It was first mentionned by Sushutra, the father of Indian surgery. His technique reached Rome probably via Alexandria. The description of couching by Celsus corresponds to 17th century descriptions of the procedure. Till the late 18th century this was often performed by itinerant cataract surgeons. One of the most notorious of these quacks was Chevalier Taylor who blinded Bach. Because Daviel, as others, experienced failures with couching, he introduced the corneal incision and expression of the lens by gentle pressure. This revolutionized cataract surgey although couching was still used in a number of centres till the middle of the 19th century.

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