Eye surgery has been performed for over 1,000 years. Ancient Romans and Indians were performing ‘couching’ surgery on cataract-affected eyes as far back as the 5th century BC. This surgery was extremely crude – the surgeon having to use a needle to slide cataracts away from the visual axis of the eye.
In more recent times, there has been a huge amount of innovation in the technology and practice of eye surgery. Patients with previously lifelong conditions are being offered respite. Here, we list four of the most important recent developments in the field. There have been improvements in ptosis eye surgery over the last decade as well, but here, we list four of the most important recent developments in the field.
Laser eye surgery (LASIK)
The sculpting of the stromal bed inside the eye can be used to correct refractive errors. In other words, by reshaping the stromal bed you can remove the need for wearing glasses and reduce any disparity between the function of each eye.
The problem with doing this was that the procedure was incredibly invasive and had to be done by opening a large incision in the eye’s tissue. However, the use of excimer lasers instead of scalpels for the sculpturing of stromal tissue was a revolutionary breakthrough. LASIK surgery matured enough to be commercially viable in 1990. Using a laser meant that the procedures could be undertaken with minimal or no physical incision. This meant that patients were far less likely to suffer from blinding infections while they were healing.
Small Incision Lenticule Extraction (or SMILE) is a further development of LASIK laser eye surgery. Essentially, the new procedure uses extremely accurate laser dissection to ‘carve’ a very thin lenticule from the stromal bed. There is minimal resculpting of the stroma involved – the surgeon just slightly thins the tissue.
This technique has been described as painless, but there is some controversy as to how effective it actually is. It is likely that SMILE surgery has less of a chance of returning complete vision to a patient, but that it is still a far more comfortable experience than traditional LASIK.
Multifocal IOL implants
After modern cataract surgery, an Intraocular Lens needs to be implanted in order to correctly protect the eye. Traditionally, single focus lenses have been implanted, which often require the patient to wear special eyeglasses for the rest of their lives.
Multifocal IOL cataract lens implants negate the need for postoperative prescription eyeglasses. Multifocal lenses emulate the physiological division of light that healthy eyes can achieve. This enables surgeons to theoretically offer cataract solutions that can completely restore the visual independence of their patients.
IOL implants would not be practical without the development of phacoemulsification surgery. Before this innovation, cataract surgery involved making a large and invasive incision, removing the cataract and then stitching the wound back up.
Phacoemulsification involves making a small keyhole slit, dissolving the cataract tissue with ultraviolet rays and then inserting IOL implants through the same tiny slit. It allows surgeons to work on more complicated ocular procedures with great accuracy – crucially without damaging the fragile tissues of the human eye.
Tommy Williamson did his degree in psychology at the University of Edinburgh. He has an ongoing interest in mental health and well-being.
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