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Ancient timesAlthough cataract surgery is now considered to be a routine procedure, this has evolved greatly from the ancient practices of the past. Cataracts were believed to be caused due to solidification of a humor known as suffosio or hypochymia. Couching (Figure 1) emerged as a technique in Egypt as wellas other parts of Asia, as it is described in Sanskrit manuscripts in the 5th century BC. This method involved using a sharp needle (Figure 2) to displace the cataractous lens away from the pupil and into the vitreous, enabling some vision to be restored. Vision remained blurred after couching, due to there being no refractive replacement (Garcia 2013, Chua 2013). A few years later Samuel Sharp developed a new technique to remove the entire lens via an incision, by applying pressure with his thumb (Garcia 2013). The first form of extracapsular cataract extraction (ECCE) was found by Jacques Daviel in Paris in 1748.In this technique the inner lens contents were removed, leaving the lens capsule and Zonules intact (Garcia 2013). General anaesthetic was not introduced to cataract surgery until the 1840s by Karl Koller, an eye surgeon in Vienna (Garcia 2013).
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