On the day in December 1978 I started as senior registrar at Charing Cross Hospital in London, I observed a phacoemulsification procedure – a type of cataract surgery hardly yet performed in the UK – and recall this as my ‘road to Damascus’ moment. I had been planning a career in ocular oncology but changed my mind instantly. Within one month, I had performed my own first phaco surgery.
It was the American ophthalmic surgeon Charles Kelman who developed phacoemulsification which made it possible to remove cataracts through a tiny 3mm incision, removing the need for long hospitalisation post-operatively.
Until then, cataract surgery required the surgeon to make a 12mm incision in the eye which required extensive stitching. Patients were subsequently forced to spend two weeks in a hospital bed with sandbags around their heads to restrict movement.
Charlie Kelman practised on an endless amount of cats, failing miserably for three years until one day when he visited the dentist. The guy was using an ultrasonic tool to clean his teeth and Charlie realised he could use this device to inscribe small cuts on the lens.
Charlie’s ideas were not popular with the American establishment, however, who saw them as controversial. The US health department reported that his surgery was experimental so insurance companies would not cover his work.
He was a self-publicist and even appeared on television on The Tonight Show with Johnny Carson which served to make him even more popular with the public, if not his peers.
