Professor Peter Choyce: an early pioneer of intraocular lenses and corneal/refractive surgery

Abstract

Professor Peter Choyce, FRCS, DOMS, MS, was one of the pioneers of intraocular lens implant surgery. He developed an interest in artificial lens implantation following cataract surgery, a procedure that was widely criticized by the ophthalmic establishment in the UK, Europe, North America and other countries. Owing to the opposition to the intraocular lenses, Peter Choyce together with Sir Harold Ridley co-founded the International Intraocular Implant Club in 1966, which was responsible for the gradual acceptance of artificial lens implantation. Peter Choyce developed several models of intraocular lens, but did not patent the majority of them. The Choyce Mark IX, manufactured by Rayner Intraocular Lenses, became the first US Food and Drug Administration-approved intraocular lens in 1981. A review of Peter Choyce's record confirms a significant number of original innovations in the field of anterior segment surgery, including many procedures taken for granted today, but not associated with his name. These include early work on both kerato- and intraocular lens-refractive procedures, keratoprosthesis, pioneering paediatric implant procedures and others. Unfortunately his tenacious adherence to anterior chamber lens technology, while in general clinically sound, caused many to question his influence and hence he remained poorly understood even until after his death. He passed away on 8 August 2001 after a long fight with colon cancer. In this article, we provide evidence and elaborate Peter Choyce's accomplishments, which places him as one of the most innovative ophthalmologist in his surgical field in the twentieth century.

Major Advances in Cataract Surgery

“…In 1949 Ridley implanted the first such IOL in London and set about trying to popularise the practice. He met for many years with severe resistance from many other surgeons, some of which seems to have been likely due to an element of professional rivalry [20]. Ridley's attempts to popularise IOLs were not helped by the fact that the early surgeons performing the procedure forgot that the refractive index of PMMA was different in air and in water (and hence inside the eye) -leading to a massive miscalculation of the postoperative refraction.…”

“…This however opened the door to the applied science of biometry, which would eventually spawn a large number of mathematical equations to accurately compute the target IOL power within the eye, a field which has had many contributors from both sides of the Cold War which was going on at the time including the Russian surgeon Fyodorov, and which continues to advance with equations such as the SRK-T, Hoffer Q and Holladay 2 which are currently the most widely used formulae to calculate the IOL power. Ridley and another British surgeon Peter Choyce co-founded the International Intraocular Implant Club in 1966, an organisation which was in large part responsible for the gradual acceptance of artificial lens implantation [20]. Nevertheless for these and related reasons IOL implantation took a long time to became standard spreading slowly and haphazardly to different parts of the world.…”

Cosmetic iris implants - double edge sword

“…This was the direct forerunner of modern artificial iris diaphragms used today for traumatic or congenital iris defects. 2…”

Novel surgical technique of sutureless artificial iris and intraocular lens scleral fixation using Yamane technique

“…Iris prosthesis were first implanted in the late 1950s by Peter Choyce in form of modified anterior chamber (AC) IOLs that had opaque colored haptics (available in ferrous brown, indocyanine green and cobalt blue). 1 , 2 Forty-four years later, in 1994, Sundmacher et al developed a polymethyl methacrylate (PMMA) IOL with a black diaphragm (black diaphragm IOL, BDI) produced by Morcher (Morcher GmbH, Stuttgart, Germany). 3 , 4 , 5 Now, a colored version, the Irismatch , is available with 45 colors to choose from.…”