Heidelberg, 29 November 2019. Today is the 70th anniversary of Sir Harold Ridley’s implantation of an intraocular lens – the very first IOL operation.
The lens implantation took place at St Thomas’s Hospital in London. The lens was made of PMMA and manufactured by the British company, Rayner Intraocular Lenses Limited – a remarkable company which continues to make IOLs, and which remains British and thrives as an independent, privately-owned company.
Here is David Apple’s account (from the notes for his biography of Harold Ridley – in our AppleLab archives) of what happened on that day.
Everything was ready and plans for the first implant were made for November 29, 1949. Although Harold was on the consulting staff of Moorfields and St. Thomas’s Hospital, he chose the latter for the first implant. There are varying theories as to why he did this. Some of his detractors feel that he was trying to hide his work from others. Ridley himself provides a more credible reason, namely that he could do his work in a quieter scientific fashion without interruption and he had chosen a staff that he approved of, including most importantly, his operating theatre nurse, Mrs Ogg (nee Clark). …
… it was a quiet day in London, with unusually good weather for November. Miss Clark, a young Florence Nightingale Nurse, was chosen by Ridley to play a pivotal role… In those days there were no fancy, modern operating microscopes, and the person who held the flashlight (torch).
Ridley’s absolute respect for the patients … is exemplified by a short quote that he penned for the foreword of my 1989 book on intraocular lenses as follows:
“We must not fail those two brave Londoners who, though well aware of the dangers, risk the loss of an eye so that our future patients might benefit. To them, ophthalmology owes a great debt: for all of us involved in the history of intraocular lenses, they are the true pioneers”. …
Harold had planned on perhaps a two-year follow-up before publicizing his surgery. However, this was disrupted by a patient’s misreading of the telephone book. Seeking a postoperative visit, one of his patients came across the number of the office of Mr Frederick Ridley, (also an ophthalmologist, but no relation to Harold). When he presented himself to Frederick Ridley as a follow-up IOL patient, Frederick Ridley was, of course, surprised and indeed the secret was broken from then on. Therefore, Harold submitted his first publication in the proceedings of the St. Thomas’s hospital in order to assume priority and then proceeded to publish two important articles, one in the Lancet and the other in the transaction of the Ophthalmological Society of the U.K.
There is one slight matter regarding the timing of the operation that has been discussed and bears mentioning. Mr Ridley specifically asked Miss Clark to simply write the following in the operative logbook, “extracapsular ext”. He instructed her not to mention the IOL. He intended to keep the entire project under wraps at that time, both for scientific reasons and also, as he explained to me later, out of fear of some sort of retribution or legal process if things had gone wrong. This was probably the incorrect thing to do, but at that time, that was his decision and it turned out not to be problematic. Ridley always considered the first date of his surgery, therefore to be November 29, 1949, and indeed until his death, every publication he was involved stated this to be the date and this has been entrenched in the literature.
I myself was the first to possibly entertain a different date. Dr John Sims and I had noted that the implant had been a two-step procedure, the first step being the extracapsular extraction on November 29 and the second one a later insertion of the IOL after the eye had quieted down. However, Ridley apparently had lumped this together as one procedure and we left it as such. In 2001, the staff of St. Thomas’s noted the lack of mention of the lens implantation on November 29, 1949, but also the presence of a second operation on the same patient, on February 8, 1950, described as a lenticular graft. They considered this to be the date of the actual implant and a plaque was mounted on the wall at St. Thomas’s Hospital to this effect.
I would have left this totally at rest except for the fact that during my interviews with Mrs Ogg, she strongly insisted that an actual lens was implanted in the eye on the first date. It is difficult to doubt her statement since I found her to be an intelligent, reliable lady with an excellent memory. … It is clear that the operation started on the earlier date and that Ridley wished this to be the official date.
Fifty years after the first operation, on 29th November 1999, Sir Harold Ridley was the guest of honour at a meeting organised by Rayner (joint CEOs: Ian Collins and Donald Munro) at the London Science Museum to mark the 50th anniversary, There was no question or suggestion from Ridley that any other date be recognised for the 50th celebrations – thus it is for the 70th –
HAPPY 70th BIRTHDAY!