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Definition of «Cataract surgery»

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Cataract surgery: Removal of the clouded lens (the cataract) in its entirety by surgery, usually followed by replacement of the lens with an intraocular lens (IOL) made of plastic, silicone, acrylic or other material. The operation typically takes about an hour, is done under local anesthetic only, and does not require hospitalization.

Most cataract surgery today is performed using a technique called phacoemulsification. Before the advent of this technique, people with cataracts could expect a 10-day hospital stay followed by a lengthy recovery. Today, it is an outpatient procedure. Instead of making a large incision in the eye and removing the lens, the ophthalmologist can make a tiny one and then insert an ultrasonic tip which, vibrating thousands of times a second, breaks up the cataracts without damaging the surrounding tissue. The remains of the cataract are suctioned out.

Phacoemulsification was introduced in 1967 by Charles D. Kelman, an American ophthalmologist (1930-2004). In his memoir, "Through My Eyes: The Story of a Surgeon Who Dared to Take On the Medical World" (Crown, 1985), Dr. Kelman described how he went to a dentist have his teeth cleaned. "I sat in his chair, as he reached over, took a long silver instrument out of its cradle and turned it on," Dr. Kelman wrote. "A fine mist came off the tip but the tip didn't seem to be moving. He applied the tip to my teeth, and I felt an exquisite vibration and heard a high-pitched sound." Dr. Kelman asked, "What is that thing?" An ultrasonic probe, came the reply. "I knew this was the moment," Dr. Kelman wrote.

Cataract surgery has a long history. It was first done in India in the 5th century BC by a surgeon named Susruta who did a procedure called couching (or reclination) in which the clouded lens is pushed into the back of the eye, permitting better but by no means normal vision. Couching was still done in some countries until the mid-20th century. The first description of the cataract and its treatment In the West was in 29 AD by the Latin encyclopedist Celsus who performed the practice of needling (also called discission) of cataracts to break up the cataract into smaller particles to facilitate their absorption. Modern cataract surgery was first done in 1748 in France by Jacques Daviel who removed the cataract from the lens. Today, the IOL is now usually the best type of cataract surgery.

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