Intraocular Lens Implants (IOL)Intraocular lens implants were developed in the 1940's by an English eye surgeon by the name of Sir Harold Ridley. There is an interesting history of the development which I will go into in a heading below. They were meant to replace a cataractous lens. There have been many iterations of lens implants which is another interesting story. The accompanying photo shows the size of these implants compared to a dime.

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Intraocular Lens Implants (IOL)

Intraocular lens implants were developed in the 1940's by an English eye surgeon by the name of Sir Harold Ridley. There is an interesting history of the development which I will go into in a heading below. They were meant to replace a cataractous lens. There have been many iterations of lens implants which is another interesting story. The accompanying photo shows the size of these implants compared to a dime.

IOL compared to a dime

      

 

The cataract (clouded lens) is removed in most instances by phacoemulsification developed by Charles Kelman, MD,

       

 

Surrounding the lens is a clear capsule. This capsule is routinely left in the eye and provides support for the lens implant. It would be very unusual that a lens implant was not inserted in the eye after cataract surgery.

The current state of the art in lens implantation is the Technis lens implant

Sometimes after the lens implant is present for a variable period after surgery, it clouds. Some would compare this to the cataract coming back. This condition is called an "after cataract" and can be helped by creating a hole in the capsule with a Nd-YAG laser.

Intraocular lens implants have been a true miracle in the treatment of cataracts. As technology advances, so does IOL enhancements. It does require a skilled surgeon do do this operation well. Tolerances are less than 10 microns (a micron is one millionth of a meter which is roughly 39 inches). This surgery is done with a very expensive operating microscope and computerized removal devices. We have done over 20,000 of these operations, and teach it at the University of Colorado where Dr. Pfoff is a Professor of Clinical Ophthalmology.

History of Intra-Ocular Lens Implants

The first report of intraocular lenses comes from the German literature. The individual known as "Casanova" (1725-1798) was jailed in Barcelona Spain. His jailer was an itinerant eye surgeon by the name of Knight Tadini. To make a long story short, Tadini apparently told Casanova that he had performed cataract extractions, and inserted a small glass lens in the eye of his patients. This is the first documented use of lens implants.

Two centuries would pass before we hear of lens implants again. In the Battle of Brittan during WW II  a British ophthalmologist, Sir Harold Ridley, observed that plastic fragments of the canopies of Spitfire fighters, if blown into the eye of the pilot caused no inflammation if stable. This plastic called Perspex has optical qualities. After the war, as the story goes, Sir Harold was operating on cataracts with a medical student. The medical student commented that since we remove the lens in cataract surgery, why couldn't we replace it with a substitute lens. Since Sir Harold had observed the optical qualities of Perspex and he thought that this would be an ideal material to do just that. Thus was born the modern Intra-Ocular Lens Implant (IOL). The material was called Perspex CQ (Clinical Quality).

Since that time a large variety of lens implant styles and materials  have been used. A major advantage was created when the material was able to be folded on itself. This allowed a very small incision to be made causing the eye to not loose strength from large incisions, and no stitches were necessary. Stitches cause more astigmatism.

          

           

Top Row left to right: Copland Lens, Copland lens inside eye, Lens from Barraquer's cigar box of lenses removed for complications (Courtesy of Robert Drews, MD), Binkhorst lens, Binkhorst lens inside the eye,

Second Row left to right: Worst Medallion lens, Worst Medallion lens inside the eye, Choyce lens, Simcoe lens, Simcoe lens inside the eye.

Bottom: Drawings of various styles of lenses. From Dr. Pfoff's personal CU lecture photos

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 Home | Patient Education | Patient Instructions | Laser FAQ | Cataract FAQ | About Our Doctors
Pfoff Laser and Eye, 6881 South Yosemite Street | Centennial, Colorado 80112 | 303-588-7900|