The First Decade

Ridley presented his first paper on ‘Intra-Ocular Acrylic Lenses’ at the Oxford Ophthalmological Congress on 9 July 1951. It was earlier than he had planned. Anticipating criticism, Ridley had performed his early series of operations quietly and without publicity. He had proceeded cautiously, implanting only three lenses in 1950 but in that year he overcame the early problem of the calculation of the implant power. Ridley had not wanted to present his results until he had at least two years follow-up, but news of his work leaked out.

Opposition, in the form of outright hostility, began at the Oxford presentation when several senior professional colleagues, whose support Ridley had hoped for, refused to examine two patients he had brought to the Congress. A year later in October 1952, at the American Academy meeting in Chicago, Ridley’s work, in spite of his demonstration of good results, was condemned as reckless.

There were, however, early supporters and the Instrument Department of the Rayner Optical Company, now in Lorna Road, Hove, East Sussex, began a small but slowly growing supply of lenses to surgeons throughout the world. In 1954, Rayner made available the first technical data sheet and the cost of a lens in that year was one guinea.

Surgeons who began to test Ridley’s technique and to implant his lens included Edward Epstein (South Africa), Dr Warren Reese (USA), Peter Choyce (UK), Cornelius Binkhorst (Holland), Benedetto Strampelli (Italy) and Joachin Barraquer (Spain).

Until 1956, the Rayner Company supplied the lenses unsterile. The earliest method used by surgeons was a solution of 1% Cetrimide which was considered difficult to rinse from the lens and to cause a severe postoperative reaction. In 1956, Frederick Ridley with the help of Rayner and ICI developed the use of sodium hydroxide as the sterilising medium, a method that would prove successful for over 20 years. From 1957 Rayner supplied all lenses sterilised in this manner.

Within a few years of the first implantation an increasing number of surgeons approached the Rayner Company with suggestions for new lens designs.

Notable among these were Strampelli, for whom the company manufactured in 1954 the first rigid anterior chamber lens, and Epstein who first proposed modifications to the Ridley lens and then became the first surgeon to utilise the iris for support with his collar stud design.

Throughout the 1950‘s the manufacture of intraocular lenses was confined to a small number of people at Rayner’s Lorna Road site. Len Rofe, an engineer who had joined the company in the 1920‘s, manufactured the first lenses for Ridley. His nephew John Ingham, who went on to become Production Director in the 1980‘s before retiring in 1997, joined him in 1956.

From the beginning of the decade the circular optical blanks, which were then cut or profiled to the finished lens shape, were compression moulded. ICI provided valuable advice on the setting up of this process, which was an extension of the thermoforming methods used to produce the fighter aircraft canopies. Profiling and polishing of the lens was entirely by hand and included complex shapes such as the semi-flexible anterior chamber design of Boberg-Ans.

Peter Caudell, who as Instrument Department Manager for Rayner had assisted John Pike from the earliest days of the Ridley lens, recorded that by 1960 Rayner had made 42 different IOL designs that had been used in human eyes. Lens designs with toric optics and Choyce’s coloured haptic designs were produced during this period. Over 300 ophthalmic surgeons internationally had been supplied with implants.