The capsulotomy has a fascinating history – one tinged with jealousy, rivalry, fashion, evolution, revolution and even nationalistic pride – and it’s a story that’s got a great deal more to tell.
It started with the Frenchman, Jaques Daviel, who ushered in the modern era of cataract surgery, abandoning couching (Box 1) for the first extracapsular cataract extraction (ECCE; Box 2). The British, for predominantly patriotic reasons, preferred couching (Box 3), but ECCE was always going to win out. Albrecht von Graefe improved it in 1850 with his eponymous knife (Box 4) and, extraordinarily, his technique lasted for over a century. That’s not to say that competing approaches weren’t developed along the way – Ignacio Barraquer devised the suction cup-based erisophake in 1917, which enabled rapid intracapsular extraction of the lens (Box 5), but its uptake was limited. So the von Graefe method persisted into the 1970s.