Eyeworld

EW SECONDARY FEATURE 132 Phaco turns 50 • April 2017 rience with phaco, despite a lack of experience with it, at the 1973 at the Welsh Cataract Surgical Congress, and "patients with bad results were paraded at the event." sidered "ridiculous" or even grounds for "malpractice" at the time. 6 The National Eye Institute deemed phaco experimental, eliminating re- imbursement for the procedure. Dr. Packard added that surgeons were slated to present about poor expe- tested those who wanted to take the course. "Charlie didn't want surgeons to perform the procedure unless he was confident they were precise, steady, and comfortable using the heavy hand-piece in the eye, under a microscope. Operating microscopes weren't commonly used in cata- ract surgery before phaco. Charlie felt that any bad results would not only be irresponsible, but would crush the endeavor," Mrs. Kelman said. Critical reception, to say the least Dr. Kelman's work to develop this small-incision phacoemulsification technique for cataract surgery was met with criticism from the start, Dr. Dodick said. Even that first phaco procedure was scheduled over a weekend to avoid the eyes of the ophthalmology chairman. Richard Packard, MD, Wind- sor, U.K., wrote in a chapter for The Eye in History that phaco was con- with the technique … and became an early adopter," Dr. Dodick said. In contrast to new trainees today who are comfortable with the technique after 10 or so cases, Dr. Dodick said it took him 30 to 50 cas- es to adjust and feel confident with it. In the early years, Dr. Kelman taught an intense, several-day course for those interested in learning in the new procedure. "To test our dexterity and steadi- ness of hand, we were all required to insert a fine copper probe through a small electrified coil without touching its inner surface," wrote Eric Arnott, DO (1929–2011), in his book A New Beginning in Sight. 5 Dr. Arnott attended the course in 1971 and brought the first Cavitron phaco unit to the U.K., the fourth in the world. "At this time, only 5% of surgeons who attended phaco courses went on to practice this type of surgery—such was the degree of new skills that were required." 5 Ann Kelman, Dr. Kelman's wife, described how her late husband continued on page 134 Phaco continued from page 131 Dr. Kelman pictured with early pioneers who took his phaco course. Source: Family of Charles Kelman, MD Illustration depicts the grooving made by a phaco probe. Source: Family of Charles Kelman, MD The man behind the ophthalmoscope I t's well-known that ophthalmolo- gy was not the first love of Charlie Kelman, MD. From a young age, Dr. Kelman, born in Brooklyn, New York, wanted to be a musician, a performer, a showman. In the end, one could argue that he became all three, though perhaps not in the way he would have imagined. "You know, I always wanted to be an entertainer, and when I was a kid my dad caught me sneaking out of the house to run away and go play with Louie Prima. He said, 'Charlie, it's your life. You can do whatever you want with it. You can be a saxophone player, you could be a singer, you can be a songman—whatever you want—but first, you'll be a doctor,'" Dr. Kelman quipped from a stage in a recording that was featured in the documentary Through My Eyes: The Charlie Kelman Story, which aired in Jan. 20, 2010, on public television in New York, WLIW-TV. Dr. Kelman did indeed put himself on track for medical school, first attending Tufts University in Boston for his undergraduate degree. He went on to medical school at the University of Geneva in Switzerland, and he completed residency at Wills Eye Hospital in Philadelphia. While Dr. Kelman was an ophthalmologist by day, he continued to write songs and compose music. In 1960 under the pseudonym Kerry Adams, Dr. Kelman and Chancellor records released his single "Telephone Numbers," which received recognition on national bill- board charts. After devising phacoemulsification as a method to perform small-incision cataract surgery, Dr. Kelman brought news of his inno- vation, as well as his performing skills, to television shows like those hosted by Johnny Carson, Dick Cavett, David Letterman, and Oprah Winfrey. EW Charles Kelman, MD

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