Eyeworld

131 EW SECONDARY FEATURE April 2017 • Phaco turns 50 a "sling," which he said was made from piano wire. In the end, the first patient's cornea collapsed dozens of times and the next day, the eye was "a bag of pus," according to an account by Dr. Kelman. He published his preliminary report on the procedure in the American Journal of Ophthal- mology and went back to refining the technology and technique in animal experiments. 4 A year later, Dr. Kelman's system had a smaller handpiece and a tip that vibrated at 40,000 cycles per second, com- pared to the earlier iteration's 20,000 cycles per second. In 1970, the Kel- man-Cavitron phaco unit was ready for surgeons to perform small-in- cision cataract surgery, Dr. Kelman wrote in his paper recalling phaco's history. It was being manufactured by Cavitron Corporation, which was later bought by Coopervision (Lake Forest, California), followed by Alcon (Fort Worth, Texas). Dr. Kelman began performing phaco cataract surgery more reg- ularly but at hospitals other than Manhattan Eye and Ear due to a crit- ical reception of the technique from hospital leadership, Dr. Dodick said. "[Not many] witnessed the early cases that he did. However, in the mid-1970s, he started doing some at Manhattan Eye and Ear, which I observed. I became very fascinated only with an ultrasonic frequency," Dr. Kelman wrote. A dentist's chair might not be where most imagine having a eureka moment, but that's exactly where Dr. Kelman's came. The dentist used a high-frequency, vibrating device to remove tartar from Dr. Kelman's teeth. "I ran out of his office with the doily around my neck shouting, 'I've got it. I've got it,'" Dr. Kel- man recalled during the speech he gave while accepting the inaugural Laureate Recognition Award from the American Academy of Ophthal- mology (AAO) in 2003. Dr. Kelman returned to the dentist's office later that day with a cataract and used the probe to score lines in it while it rested on his finger. "[T]hat to me meant that I could do a cataract inside of the eye without the cata- ract spinning up against the corneal endothelium," he wrote in his paper, recalling the moment. The ultrasonic probe by Cavit- ron became the basis for the Kelman phacoemulsification irrigation-aspi- ration system. Dr. Kelman proceeded to mod- ify this unit to better perform the surgery, and by April 1966, he was conducting animal experiments. In 1967, he performed phacoemulsifi- cation on a consenting blind man whose eye was already scheduled for enucleation. "This piece of equipment was quite big," said Cheryl Jalbert, Dr. Kelman's lab assistant at the time, in Though My Eyes: The Charlie Kelman Story, a documentary that aired on public television in 2010. "I was ready to put it in the OR and for some reason I said, 'I can't do this.' So I put it into the nurse's locker room and that's where I slept. I slept there with the instrument. I just didn't know what was going to happen that night. I was scared to death," Ms. Jalbert said, referencing the secrecy of Dr. Kelman's research. Ms. Jalbert recalled in the documentary that during this operation Dr. Kelman's hand would start to shake under the weight of the handpiece, and he had to pull it out of the eye to take a frustrated break. Dr. Dodick described the early phaco handpiece as being "very crude," weighing 2.2 kilograms (4.8 lbs.), and had to be supported with continued on page 132 Dr. Kelman (seated) and lab assistant Cheryl Jalbert (right) conducted research on lab animals at the Manhattan Eye, Ear, and Throat Hopsital, before later performing the first phacoemulsification on a human subject in 1967. Source: Family of Charles Kelman, MD The early phaco emulsification machine developed by Dr. Kelman and Cavitron Source: Family of Charles Kelman, MD ASCRS celebrates the 50th anniversary of phacoemulsification T he 50th anniversary of phacoemulsification will be honored in several ways at the ASCRS•ASOA Symposium & Con- gress in Los Angeles, May 5–9. • Sunday Summit: The Sunday Summit General Session, May 7, will include a special session to celebrate this anniversary. • Phaco timeline: The ASCRS Foundation will feature a timeline wall to note the major milestones in phacoemulsification's evolution. Attendees will be able to take their photo and put it up on the timeline on the date when they performed their first phaco. • Giving campaign: The ASCRS Foundation will host a $50 Pha- co50 giving campaign. • Phaco tally: There will be a display where doctors can post how many phaco surgeries they've done. • Social media: Celebrate the 50th anniversary with @ascrs on your social media accounts using #phaco50. Vanguard sponsors of the ASCRS Phaco50 celebration include Bausch + Lomb (Bridgewater, New Jersey), Johnson & Johnson (New Brunswick, New Jersey), and Carl Zeiss Meditec (Jena, Germany). The $25,000 gifts from these companies will celebrate the anniversary by supporting the humanitarian eye- care work of the ASCRS Foundation. EW C e l eb r a t i n g 5 0 Y e a r s o f P h a c o e m u l s i c a ti o n 1967–2017

• Blank Page
• Blank Page (1)