02/21/2025
The history of the Intraocular lens implant! A fascinating story! Just WOW!
Wall Street Journal - Feb 7, 2025
The Doctor and the Pilot Who Saved the Eyesight of Millions
Seventy-five years ago, Harold Ridley successfully implanted the worldâs first artificial intraocular lens.
By Andrew Lam
Feb. 7, 2025 4:02 pm ET
Saturday is the 75th anniversary of a medical breakthrough: the invention of the artificial intraocular lens. The majority of us will receive one in each eye during routine cataract surgery. But the story of this discovery is anything but routineâit began amid falling N**i bombs.
On Aug. 15, 1940, Royal Air Force pilot Gordon Cleaver scrambled into the cockpit of his Hawker Hurricane and lifted into the sky. A wave of Luftwaffe bombers was thundering across the English Channel. Cleaver was already an ace, credited with downing seven German planes, but this mission would be his last. He was shot down over Wi******er. Enemy bullets shattered his canopy, showering debris into his eyes. Flying blind and in excruciating pain, Cleaver managed to escape his doomed plane and parachute to the ground.
He was a hero, one of âThe Few,â credited with defeating the N**is and saving Britain. But humanity owes Cleaver more for what happened next: His misfortune saved the sight of millions.
Cleaverâs damaged eyes were examined by a 34-year-old ophthalmologist, Harold Ridley. Shards of Plexiglas from his shattered canopy remained in the pilotâs eyes. This was a disaster. Foreign bodies in the eye such as lead or shrapnel usually caused inflammation or infection so severe that the eyes often had to be removed. But Ridley noticed something peculiar: The fragments of clear plastic werenât causing any inflammation or infection. They sat quietly inside Cleaverâs eyes, glistening in the light of the ophthalmoscope. This was a shocking discovery.
Ridley examined Cleaver multiple times. The pilotâs sight was severely damaged, but the Plexiglas remained inert in his eyes, causing no inflammation. In 1948, while Ridley was removing a cataractâa clouding of the eyeâs lensâfor another patient, the memory of Cleaverâs case sparked an epiphany. A medical student observing the operation said, âItâs a pity you canât replace the cataract with a clear lens.â Ridley recalled the well-tolerated Plexiglas in Cleaverâs eyes and realized that he could use the material to make an intraocular lens that the body wouldnât reject.
In Ridleyâs era, surgeons could remove patientsâ cataracts to restore some sight, but they didnât insert anything to restore the lensâs refractive power. Instead, patients wore spectacles that were mocked as âCoke-bottle glasses.â Although the lenses were thick, the quality of vision was poor.
Ridleyâs idea to improve patientsâ sight by replacing cataracts with a clear, artificial lens seemed outlandish. Surgeons had never come up with something to be permanently implanted in the eyeâor anywhere in the body. Doctors had always focused on removing things from the body, not inserting them.
But Ridley was determined. With the help of optical company Rayner & Keeler and Imperial Chemical Industries, he made a prototype of high-quality acrylic that was convex on both sides, like a natural lens. At St. Thomasâs Hospital in London on Nov. 29, 1949, Ridley performed a cataract extraction and attempted to implant an artificial lens into a patientâs eye. He aborted the effort because the lens appeared unstable but resolved to try again after the patientâs inflammation had subsided.
On Feb. 8, 1950, he made his second attemptâand completed the first successful implantation of an artificial intraocular lens. Ridley performed more operations and improved his technique. Some of his patients regained 20/20 vision.
His invention has saved the sight of millions. But instead of stirring professional acclaim, Ridleyâs invention was a disaster for his career. The ophthalmology establishment labeled him a heretic.
Leaders in the field accused him of malpractice, ridiculed him at science conferences and poisoned colleagues against his ideas. They argued that the procedure was a âtime bombâ and that âmanufacturers should be prosecuted for supplying implants.â Ridley worked for decades to improve his operation and gain converts, but fell into a deep depression. When he retired in 1971, he considered his career a failure.
In the 1980s a new generation of ophthalmologists became more comfortable with the operation. By the 1990s, this sight-restoring surgery became the standard of care. At last, Ridleyâs contribution was recognized. In 2000, at 93, he was knighted by Queen Elizabeth II. He never patented his lens and never earned a cent from it. He died in 2001 at 94.
Today, ophthalmologists worldwide perform more than 26 million cataract surgeries with lens implantations every year. Modern lenses are so advanced that they can be folded to fit through a self-sealing 1.8-millimeter incision. Inside the eye they spontaneously unfold while being guided into position. Seventy-five years later, we all owe a debt to a courageous RAF pilot and an inventive ophthalmologist who turned misfortune into humanityâs gain.
Dr. Lam is a retina surgeon and an assistant professor at the University of Massachusetts Medical School. He is author of âSaving Sightâ and âThe Masters of Medicine: Our Greatest Triumphs in the Race to Cure Humanityâs Deadliest Diseases.â
Image Credit:
An intraocular lens held up by tweezers. Photo: Getty Images
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