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April 1997

A Bicenquinquagenary Worth NotingDaviel's Introduction of the Modern Cataract Operation

Author Affiliations

From the Ophthalmology Associates of York, York, Pa.

Arch Ophthalmol. 1997;115(4):526-528. doi:10.1001/archopht.1997.01100150528015

Patient:  NA.

Date:  7 April, 1751.

Surgeon:  Jacques Daviel.

Procedure:  Cataract extraction, left eye.

Anesthesia:  None.

Findings:  This 59-year-old woman has had decreasing vision in both eyes for more than 15 years. She can no longer read or sew. Examination reveals count fingers visual acuity in the right eye, hand motions vision in the left eye. Bilateral mature cataracts, with thickened anterior capsules, are present in both eyes. The pupils react briskly and she has good 2-point discrimination.

Procedure:  The patient was seated on a low stool before the surgeon. The right eye was covered with a cotton patch. The assistant steadied the patient's chin with his right hand and retracted the left upper eyelid with 2 fingers of his left hand. The surgeon retracted the lower eyelid with his left hand. The anterior chamber was entered at the 6-o'clock position with a keratome. The wound was enlarged slightly to the left and right with the same keratome. The corneoscleral section was completed with curved corneoscleral scissors between the 2- and 10-o'clock positions. The cornea was elevated with a blunt curved spatula. The thickened anterior capsule was excised in a circular manner with scissors and removed with a forceps. The spatula was then used to free the nucleus from the surrounding capsule and cortex. It was used to break the nucleus into pieces and extract these from the eye. A small iris prolapse was reposited with the same instrument. The edges of the wound were carefully apposed. The wound was cleaned with a cotton-tipped applicator that had been dipped in collyrium. The eyelids were closed with a plaster, cotton pledgets were applied, and a light bandage, exerting no pressure, was applied. The patient tolerated the procedure well and left the surgical suite in good condition.

Postoperative diagnosis:  Same.

Time of surgery:  9 minutes.