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Cataract surgery has a long history in Europe, Asia, and Africa, with Chrysippus of Soli, a stoic Greek philosopher providing the earliest account. [106] Couching was the original form of cataract surgery, and was used from antiquity. It is still occasionally found in traditional medicine in parts of Africa and Asia.
"Couching for cataract"; Wellcome Collection illustration of Indian doctors performing the technique. Couching is the earliest documented form of cataract surgery. It involves dislodging the lens of the eye, thus removing the cloudiness caused by the cataract, resulting in aphakia.
Manual small incision cataract surgery (MSICS) is an evolution of extracapsular cataract extraction (ECCE); the lens is removed from the eye through a self-sealing scleral tunnel wound. A well-constructed scleral tunnel is held closed by internal pressure, is watertight, and does not require suturing.
Couching is the earliest-documented form of cataract surgery, and one of the oldest surgical procedures ever performed. In this technique, the lens is dislodged and pushed aside into the vitreous cavity, but not removed from the eye, thus removing the opacity from the visual axis, but also the ability to focus. [ 10 ]
The intraocular lens did not find widespread acceptance in cataract surgery until the 1970s, when further developments in lens design and surgical techniques had come about. As of 2021, approximately four million cataract procedures take place annually in the U.S. and nearly 28 million worldwide, a large proportion in India.
The AAFP Foundation; American Family Physician—a journal by the AAFP; Family Practice Management—a journal by the AAFP; Annals of Family Medicine—a collaborative journal of the six family medicine organizations; familydoctor.org—The AAFP's patient education site. Includes handouts, brochures, flowcharts and other resources for patients