Ophthalmology was revolutionized by the transition from cataract displacement posteriorly (couching) to cataract extraction, beginning in the mid-1750s. Jacques Daviel of France performed his first well-documented planned cataract extraction in a patient on September 18, 1750 in Cologne (1-2). But what triggered this transition? It turns out three Paris-based eye surgeons all began to actively pursue cataract extraction in the first week of July 1750 (2,3).
Possibly the first was a surgeon and monk named Jean Baseilhac, who, had received the moniker "Frère Côme" (Saint Côme being the patron saint of surgeons) when he took the habit in 1729. Frère Côme was already known for innovations in lithotomy, but beginning in July 1750 he began to perform cataract extraction. Ophthalmologists have generally never heard of him for two reasons. The first is that he absolutely refused to discuss his eye surgeries, even when directly questioned. The second is that his technique was horrible: he made a limbus-to-limbus horizontal incision directly through the visual axis in the cornea; some of his patients could see, but, in other patients, the eye was lost (3).
The second surgeon to dabble with cataract extraction was Natale Pallucci, an Italian practicing in Paris who, on July 3, 1750, extracted the lens capsule and residual lens fragments following cataract couching. His corneal incision was somewhat below the visual axis, but not at the limbus (Figure 1) (2,3). Pallucci’s secondary removal of lens fragments was similar to a case which Daviel had already published in a letter of September 1748.
Finally, Jacques Daviel, who was planning on making a grand tour of Europe and had recently arrived at Leuven, began a four-month program of animal experimentation with cataract extraction. His first documented experiment, on July 7, 1750, was a cataract extraction in a sheep (2,3).
Ultimately, Daviel and Pallucci squabbled about who was the first to perform cataract extraction (2,3). Daviel was certainly the first to contemporaneously document planned primary cataract extraction in patients of the entire lens through an incision, and to communicate his methods to his peers.
Nonetheless, the mid-century revolution in cataract extraction might have been triggered by a daring but silent monk, who was probably - as his cataract patients might have attested - a better lithotomist than an ophthalmologist.
References
- 1. CT Leffler et al., “Jacques Daviel performed the first documented planned primary cataract extraction on Sep. 18, 1750,” Eye, 38, 1392 (2024).
- 2. CT Leffler et al., “Cataract extraction from Antiquity through Daviel in 1750,” In: CT Leffler CT (ed.), A New History of Cataract Surgery, Part 1: From Antiquity through 1750, 377, Kugler: 2024.
- 3. CT Leffler et al., “Jacques Daviel (1696–1762) and the Competition to Extract Cataracts: A Reappraisal,” Clinical Ophthalmology, 31, 2835 (2025).
