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Subspecialties Cataract, Refractive

A Brief History of IOL Materials

At a Glance

  • Cataract surgery stretches back three thousand years
  • Harold Ridley introduced the modern era in 1949, with an intraocular lens made from poly(methyl methacrylate)
  • Foldable IOLs, requiring much smaller incisions, came to dominate, especially silicone IOLs in the 1980s
  • Patients in the developing world are often denied these superior IOLs on grounds of cost

Cataract surgery, the most commonly performed surgical technique in the world today, has an illustrious history. The earliest example, cataract “couching”, was first reported around three thousand years ago in India in their ancient text, the Mahabharata. Couching is a procedure that should be consigned to historical textbooks: the pressing down of cloudy lenses into the vitreous with a thorn or a needle. It leaves the patient aphakic (but with some visual function) requiring a powerfully positive prescription lens to compensate. While unthinkable in most part of the world, it still occurs today in some rural regions of Sub-Saharan Africa, and is performed by local healers rather than by ophthalmologists.

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About the Authors

Author Florian Kretz

Florian Kretz

One of The Ophthalmologist’s Top 40 under 40 cadre, Florian is a lead surgeon at the Eyeclinic Ahaus-Raesfeld-Rheine, Ahaus Germany, as well as a consultant ophthalmologist and research fellow at the International Vision Correction Research Centre Network and David J. Apple International Laboratory for Ocular Pathology at the Department of Ophthalmology, University Hospital Heidelberg. When not in the clinic, lab, office, or on the autobahn, Florian enjoys spending time with his wife and young family.


Sibylle Scholtz

Sibylle Scholtz is a Specialist on Ophthalmic History at the International Vision Correction Research Centre (IVCRC)


Gerd Auffarth

Gerd Auffarth is the Director of the David J. Apple International Laboratory of Ocular Pathology and IVCRC as well as Chairman of the Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Germany.

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