War injuries, ingenuity lead to intraocular invention

Sadly, if it were not for World War 2 pilots getting shards of shattered plastic from aeroplane windscreens in their eyes, the world’s most successful and innovative cataract treatment may never have been discovered.

Today marks the 75th anniversary of the first intraocular lens surgery, invented by British surgeon Sir Harold Ridley.

Earlier this week, Dunedin Hospital consultant eye surgeon Dr Francesc March and retired Dunedin ophthalmologist Dr Rod Keillor marvelled at one of Sir Harold’s original lenses, held under lock and key in the city like a precious gem.

Dr March said Sir Harold served as an ophthalmologist in the British Royal Air Force during WW2 and treated many pilots with eye injuries from shattered aircraft windows.

During this time, he discovered that a shard of polymethyl methacrylate (PMMA) from an aircraft window was "well tolerated in the eye" and did not cause an inflammatory reaction.

At the same time, other patients with cataracts were left aphakic after their cloudy lenses were surgically removed from their eyes, requiring them to wear thick, bulky glasses to compensate for the loss of the power refraction of the lens.

With his new-found knowledge of PMMA plastic, he designed a flexible artificial lens, and on November 29, 1949, at St Thomas’ Hospital, in London, he performed the first successful implantation of an intraocular lens, in a 45-year-old woman with a traumatic cataract.

"It was 75 years ago that Sir Harold successfully implanted the first intraocular lens, changing the course of cataract surgery forever," Dr March said.

"It meant people could be spectacle-free and not have to wear big thick glasses that looked like the bottom of milk bottles.

"His insight, ingenuity and perseverance reshaped cataract surgery and established the foundation for one of the most commonly performed and successful surgeries worldwide."

At the time, placing a foreign object inside the eye was controversial in the medical community and he was ridiculed for doing it.

But Dr March said these days about 30 million people around the world had the surgery every year.

"It’s a lot of people we help, definitely."

Dr Keillor now owns one of the first lenses created by Sir Harold.

He said he was given the lens by the late University of Otago ophthalmology professor John Parr, who worked with Sir Harold in London while he was developing the new technology.

"He acquired this lens and brought it back to New Zealand.

"He probably kept it because it was significant — no artificial lens had been put in a human eye before [Sir Harold] did it.

"It’s a piece of history because now all we as eye surgeons ever do, is put artificial lenses in people’s eyes when we take their cataracts out."

Dr March said being able to see and handle one of Sir Harold’s original lenses was humbling and very memorable for a young eye surgeon.

"It’s amazing. This is something so important and so cool, and to be able to touch it and to know that it is in Dunedin, it’s really outstanding."

Dr Keillor was now looking to put the lens in a place for safe keeping and for posterity.

john.lewis@odt.co.nz