Sir Harold Ridley

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The Independent Online

Nicholas Harold Lloyd Ridley, ophthalmic surgeon: born Kibworth Harcourt, Leicestershire 10 July 1906; surgeon, Moorfields Eye Hospital 1938-71; ophthalmic surgeon, St Thomas' Hospital 1946-71; FRS 1986; Kt 2000; married 1941 Elisabeth Wetherill (two sons, one daughter); died Salisbury, Wiltshire 25 May 2001.

In 1949, at St Thomas' Hospital, London, Harold Ridley performed the first cataract extraction combined with an artificial lens implantation, pioneering the surgery that would restore the sight of millions of people around the world.

Visual failure due to the onset of cataract has been recognised since ancient times; the nature of cataract as a clouding of the natural lens within the eye has also long been understood. The logical treatment of the condition was the surgical removal of the clouded lens. This operation readmitted light, but without a lens in the eye the light remained unfocused, requiring the patient to use thick, heavy and distorting spectacles.

The concept of substituting the opaque cataractous lens with a clear artificial lens, thus restoring normal vision without the need of glasses, had long remained a dream. Attempts during the 19th century to find some type of material that the eye could tolerate had proved unsuccessful.

During the Second World War, as a surgeon at Moorfields Eye Hospital, Ridley treated injured RAF pilots whose eyes had been penetrated by slivers of Perspex from the cockpit. He noted how well the eyes tolerated the material. He later found an able ally in John Pike, an optical scientist at the lens manufacturers Messrs Rayners, who was able to obtain high-quality plastics and to design and to make the artificial lens. On 29 November 1949, Ridley successfully performed the first artificial lens transplant, on a 45-year-old female patient.

However the prevailing climate in which Ridley undertook his pioneering work was inherently hostile, for the ophthalmic establishment was rigidly opposed to such a daring project; the instrumentation at the time was of 19th-century design and obsolescent and the operation would need a daunting level of dexterity.

It is not surprising therefore that, from the outset, Ridley planned only to publish his original work after he had established the integrity of the operation. In the event, however, the secret was not well kept and the adoption of the operation in the early 1950s by a wider circle of surgeons led to a unacceptably high complication rate. With the courage of his conviction that the concept of the operation was correct, and himself achieving good results, Ridley persevered, but was prepared, in the light of experience, to introduce modifications to improve the outcome of the operation. (These in turn sometimes also led to problems of their own and to further criticism.)

Ultimate triumph came in the 1970s with new technology, new instrumentation, and the adoption of microsurgical techniques, all of which combined to bring a success rate hitherto unknown. The world-wide adoption of the operation in the last two decades has led to the successful restoration of normal vision to some 200 million cataract patients.

Just as professional recognition of the merits of Ridley's early work was late in coming, so too was official recognition. Long after his retirement in 1971 to the countryside and to obscurity, he was elected to the Fellowship of the Royal Society. This, and his knighthood conferred in 2000, helped greatly to assuage the natural bitterness he felt in the intervening years.

For those who were privileged to work with Ridley during those stressful years, it soon became apparent that his single-mindedness and determination were quite exceptional. These qualities, together with the atmosphere of conflict, did not make him an easy man to work for, yet over the years he was devotedly served, admired and respected at St Thomas' by a host of loyal trainees, for whom he always showed the greatest consideration and interest. His concern for others is also seen in his setting up of the Ridley Foundation, a charity which works to help aspiring young ophthalmologists.

Nicholas Harold Lloyd Ridley was born in 1906 at Kibworth Harcourt in Leicestershire, the elder son of a naval surgeon who later graduated into ophthalmology. His mother came from the Parker family and was a friend of Florence Nightingale, upon whose knee, Harold was fond of saying, he was dandled.

Following his schooling at Charterhouse and Pembroke College, Cambridge, he completed his basic medical training at St Thomas'. He was appointed to the consultant staff at Moorfields Eye Hospital in 1938. Early in the war he was posted as a Major in the Royal Army Medical Corps to the Gold Coast; here he set about the study of the prevailing local cause of blindness, the parasitic tropical disease known as onchocerciasis (river blindness). His original observations, made during intensive field work, he later published in a monograph which has remained as one the most important publications on the topic (Ocular Onchocerciasis Including an Investigation in the Gold Coast, 1945). The results of this work led to better management of the disease with much reduced incidence of blindness in the area.

Among the many medical honours which he received ­ long after his retirement from the National Health Service ­ were the Gullstrand Medal of the Swedish Medical Society and the Gonin Medal from the International Council of Ophthalmologists.

One of his main sources of recreation was fly-fishing, a pursuit well suited to life at his weekend retreat, and latterly his retirement home, on the banks of the River Wylie in Wiltshire. The quality of his own life, towards the end, was greatly enhanced by undergoing what he termed "his own operation" in both eyes.

John Winstanley

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