Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

The Last Step to Daviel’s Cataract Extraction. “La Boutonnière”, most Advanced Technology of Cataract Couching

Henning A.

Julius-Hirschberg-Gesellschaft

Purpose: In 1750 Jacques Daviel as first replaced methodically the couching of cataracts by its extracapsular extraction, developed by him since 1746. His pretentious technique was simplified soon after, and since 1754 in many cases replaced by the extraction of the whole lens. Its simpler surgical technology and the intention to prevent postoperative renewing the cataract let prefer the intracapsular extraction of the cataract through 200 years, until in the second half of the last century microsurgery made possible phacoemulsification. The question arises, why the inventor of the methodical extraction himself did not prefer the simpler intracapsular method, especially because the extraction of the whole lens seems to be methodically near to couching the cataract as depression of the lens. Both are dislocations of the whole lens away from its anatomical place.
Method: Daviel’s methodical turn to the extracapsular extraction of the cataract can be understood by the development of the transscleral cataract couching to its most advanced modification, the extracapsular couching of the dimmed kernel of the lens, having been delivered through the capsule of the lens at the back, called Boutonnière by Antoine Ferrein (16


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