Techniques in cataract surgery (C6325)

This article is best viewed in a PDF Format.

View PDF

Couching

Surgical treatment of cataracts began with couching, described as early 800BC by Sushruta in India (Figure 1). A needle was passed through the sclera or cornea to push the white lens downward or backwards into the vitreous cavity. Patients were able to see forms and figures afterwards. In the middle ages, couchers travelled from town to town and using a common sewing needle would couch cataracts in the village square. Complication rates were obviously high and a couching procedure was considered a success if the patient was able to ambulate without assistance.