Sushruta Did Not Introduce Extracapsular Cataract Removal

      We read with interest the letter by Mehta pointing out that Sushruta (c. 600 BCE) accurately described extracapsular cataract extraction (ECCE).
      • Mehta H.
      Extra-capsular cataract removal—not couching—pioneered by Sushruta.
      Nevertheless, we believe that it is not so obvious that the description of the Indian physician is of extracapsular removal of cataract. Thus, although some sort of extraocular expulsion of cortical masses, and not only a couching technique, could be described by the ancient surgeon, the detailed Bhishagratna description of the surgical procedure, despite the difficulty of some particular words, leaves no room for doubt that it was not a classic extracapsular technique with nucleus evacuation.

      Bhishagratna KKL. The Sushruta Samhita (vol. III, ed 2).Varanasi, India, Chowkhamba Sanskrit Series Office, Varanasi, 1963 [An English translation based on the original texts]. Calcutta, Kaviraj Kunja Lal Bhishagratna, vol. 1–3, pp 1907–16. Available at http://ia600309.us.archive.org/13/items/englishtranslati01susruoft/englishtranslati01susruoft.pdf. Accessed 20 January 2012

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      References

      1. Bhishagratna KKL. The Sushruta Samhita (vol. III, ed 2).Varanasi, India, Chowkhamba Sanskrit Series Office, Varanasi, 1963 [An English translation based on the original texts]. Calcutta, Kaviraj Kunja Lal Bhishagratna, vol. 1–3, pp 1907–16. Available at http://ia600309.us.archive.org/13/items/englishtranslati01susruoft/englishtranslati01susruoft.pdf. Accessed 20 January 2012

        • Mehta H.
        Extra-capsular cataract removal—not couching—pioneered by Sushruta.
        Surv Ophthalmol. 2011; 56: 276-277
      2. Singhal GD, Sharma KR. Ophthalmic and Otorhinolaryngological Considerations in Ancient Indian Surgery (Based on Śālākya-Tantra Portion of Uttara-Tantra of Suśruta Samhita). Varanasi, India, Institute of Medical Sciences, Banaras Indu University, Singhal Publications, 1976, Chapter 17, pp 183–210

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      • Author's Response
        Survey of OphthalmologyVol. 57Issue 6
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          I thank Grzybowski and Ascaso for their interest in my letter.3 They admit that some sort of extracapsular expulsion of cortical masses could have been described by Sushruta, but that it was not a classic extracapsular technique. It is logical to surmise from their statements that they do accept that Shushruta1,5 devised a form of extracapsular removal of cataract, and that it is just by semantics that Sushruta is denied the credit. In fact his technique cannot be called classic (or typical) as there was no precedence, but he should be credited with laying the foundation for extracapsular cataract extraction (ECCE).
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