Saturday, February 8, marked the 75th anniversary of the first successful cataract surgery intraocular lens placement. Cataract surgery has been performed for thousands of years, and up until recently, the outcomes were meager compared to modern surgery.
In the tragic collision of humanity and conflict, two brave Englishmen and World War II’s Battle of Britain created an opportunity for an advancement that has aided millions of people.
“The whole fury and might of the enemy must very soon be turned on us. Hitler knows that he will have to break us in this island or lose the war. If we can stand up to him, all Europe may be free and the life of the world may move forward into broad, sunlit uplands. But if we fail, then the whole world, including the United States, including all that we have known and cared for, will sink into the abyss of a new Dark Age made more sinister, and perhaps more protracted, by the lights of a perverted science. Let us therefore brace ourselves to our duties, and so bear ourselves that, if the British Empire and its Commonwealth last for a thousand years, men will still say, ‘This was their finest hour.’”
– An excerpt from Winston Churchill’s “Their Finest Hour” speech, which he delivered in the House of Commons in June 1940
At the time, many in the U.K. were calling for a treaty with Hitler. France had fallen two days prior to his speech, and Churchill’s call to defend Great Britain from a Nazi invasion that he called the Battle of Britain rallied brave defenders in the summer of 1940.
War Injury Sparks Innovation
One of those selfless pilots was British flying ace, Squadron Leader Gordon “Mouse” Cleaver, a member of the No. 601 Squadron, known informally as the Millionaires’ Squadron, a group largely composed of wealthy, sporting Englishmen.
On August 15, 1940, his lunch was cut short as the alarm sirens wailed. He quickly scrambled to his Hawker Hurricane plane and had forgotten his goggles in his haste.
During the ensuing air battle, his plane was crippled with bullets and explosive shells. Cleaver, maimed and rendered blind from the onslaught, flew his burning plane upside down, ejected from the cockpit, and parachuted to safety.
Cleaver’s left eye was damaged beyond repair, and some of his right eye vision was later preserved by a young British ophthalmologist, Dr. Harold Ridley. Typically an injury such as Cleaver’s requires urgent surgery. Foreign contaminants within the eye cause blinding inflammation, whether wood, metal, fabric, leather, which are all materials found in and around a World War II fighter plane cockpit.
Cleaver’s injuries were different than most, as he had shards from his clear acrylic canopy embedded in his eye. Dr. Ridley noticed that the plastic particles didn’t incite inflammation during the many months of recovery.
Later Dr. Ridley had the ingenious idea of making a lens implant of the acrylic. Up to that point, cataract surgery was performed with no implant and only the cataract was removed. The resulting vision was quite poor, and required thick and uncomfortable contact lenses or clunky glasses that had a fried egg-like appearance, which offered compromised vision.
The Genesis of Modern Ophthalmology
The relationship of two brave souls, Cleaver and Dr. Ridley, sparked the genesis of modern ophthalmology.
After collaboration with ocular scientists and several false surgical starts, ridicule, and damning accusations of malpractice, Dr. Ridley implanted the first successful intraocular lens on February 8, 1950.
His groundbreaking surgery was initially somewhat unpredictable and fraught with complications, but became much more refined and standardized by the 1980s. A worldwide collaboration involving thousands of ophthalmologists and millions of patients contributed to the procedure’s success, with Americans proudly contributing great strides, most notably Dr. Charles Kelman.
Cataract surgery is now the most commonly performed surgery in the world, and arguably one of the most successful. Cataracts are the world’s most common cause of blindness, and the surgical success rate is outstanding with overwhelmingly positive outcomes. The use of advanced technology lenses and modern measuring devices have continued to revolutionize the procedure.
Ridley’s accomplishments were slow to be recognized, and it took 31 years before he was awarded membership into Britain’s Royal Society. A beautiful event occurred a year after his honor: Cleaver underwent successful cataract surgery with an acrylic implant in 1987.
In science and health care, we all stand on the shoulders of giants, and we owe thanks to those who remained steadfast “in their finest hour.”