From couching to phacoemulsification: the history of cataract surgery

The earliest recorded cataract treatment, couching, pushed the clouded lens backwards out of the visual axis with a needle. It offered crude light perception and carried terrible risks of infection and glaucoma.

The extraction era

In eighteenth-century France, Jacques Daviel removed a cataract through an incision rather than displacing it — the beginning of true extraction surgery. Recovery took weeks of immobility, and thick 'cataract glasses' were the only correction available.

The microscope changes everything

The surgical microscope and fine sutures in the mid-twentieth century made controlled, repeatable eye surgery possible for the first time.

Phacoemulsification

In 1967 Charles Kelman used ultrasound to break up the lens so it could be removed through a tiny opening. That principle underpins nearly every cataract operation performed today.

Where we are now

A modern operation takes ten to fifteen minutes under local anaesthetic, through an incision that usually needs no stitch, with a lens implant chosen to correct the patient's prescription at the same time.

What this means if you are considering surgery in the UK

New technology only helps when it is matched to the right eye. Ms Tahmina Pearsall FRCOphth is a UK consultant ophthalmic surgeon on the GMC specialist register with more than 40,000 eye procedures performed, and she assesses every patient personally before recommending anything. If modern cataract surgery is relevant to you, a consultation will tell you whether it changes your options — or whether a simpler, better-established treatment gives you a safer result.

Book a consultation with Ms Pearsall

Consultations are available at clinics across the UK, including London Harley Street, Birmingham, Manchester, Leeds, Edinburgh, Cardiff, Reading and Southampton. You can book a consultation, arrange a free 15-minute call, see treatment prices, read verified patient reviews or find your nearest clinic.