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Abstract
The earliest extant description of a surgical operation for the cure of cataract is that of Celsus, who practiced medicine in Rome at the beginning of the Christian era. In his text De Meclicina he described in detail his method of couching, by which he inserted a bronze needle into the eye at the equator on the lateral side of ihe globe and depressed the cataract downward into the lower part of the vitreous where the surgeon hoped it would remain out of the way of vision. The same method had been employed by the Greeks and Hindus for at least several hundred years earlier and was to continue as the only operation available until the middle of ihe eighteenth century when Daviel of Paris described extraction of the lens through the cornea. The early couchers toorked on the premise that the crystallin humor we know as the lens was the receptor for vision, and that in certain conditions of disease a suffusion flowed doivn in front of the crystallin humor where it solidified and formed a dense curtain. The purpose of couching was to press the hardened corrupt humor out of the way of the lens. That cataract was opaque material within ihe lens itself was not recognized until after ihe middle of ihe seventeenth century. Until then ihe surgeons were not even aware that it was the lens they were dislocating.