Have come a long way, but the advances are not yet available to all

Just over 50 years ago Harold Ridley implanted the first intraocular lens.1 Artificial lens implants have since revolutionised cataract surgery. In 2000 foldable intraocular lenses with a 6 mm lens optic can be delivered through a self sealing 3.2 mm valve incision. Sutured closure is not normally required, the strength of the eye wall is not diminished,2 and the refractive power of the lens can be tailored to minimise the postoperative requirement for glasses. In the absence of comorbidity, most patients can expect to see the driving standard or better without spectacle correction from the day after surgery. Though lens surgery has come a long way, development continues and access to the best new intraocular lens technology needs to be widened.

Ridley was ahead of his time. Developments in lens design and surgical technique were required to make intraocular lens implantation safe, so lens implantation did not become widely adopted as an integral part of cataract surgery until the 1980s. Key advances were the introduction of viscoelastic fluids to …