History of Intra ocular Lens Implants
During the second world war some aircrew suffered injuries to the eyes from shattered pilot and turret canopies. These structures were made of perspex (polymethyl methacrylate or PMMA) and in some cases tiny fragments penetrated and remained within the eye. It was then observed that this material caused very little reaction within the eye and remained stable over many years. It was deduced that perspex would be a good material from which to make intra ocular lens implants. It remained the principle material used until the mid 1990's and is only now being superseded by more modern plastics.
The British ophthalmologist Harold Ridley is credited as the first eye surgeon to place an artificial lens into the eye following removal of a cataract. This was around 1949 - 1950. At the time he was considered to be a bit of a maverick by his colleagues. In the face of opposition from the rest of the medical profession he initially abandoned the technique though continued to pursue the concept with lens manufacturers. In 2000, aged 93 and just before his death, he was knighted for his pioneering work.
It was not until the late 1970's and early 1980's that intra ocular lenses gained widespread popularity and acceptance amongst eye surgeons within the UK. The idea of inserting a lens into the eye had to wait until surgical techniques had developed to the point where it was safe and possible to do so. There have been two particularly important factors in this.
Firstly the development of gel like substances (called viscoelastics) which can be placed within the eye during surgery to create space and protect the delicate internal structures of the eye. These substances allow the lens implant to be safely manipulated into position within the eye.
The second factor was the development of surgical techniques which preserve a platform within the eye onto or into which a lens implant can be securely positioned. The best location for an intra ocular lens implant is behind the pupil, i.e. as near as possible to the position of the natural lens of the eye. The move away from intra capsular cataract surgery to the extracapsular technique in the 1980's made it possible to support a lens implant behind the pupil. Phacoemulsification cataract surgery popularised in the 1990's now means that the lens implant can be placed within the pocket (the so called capsular bag) of the natural lens.