Maloney Robert K, Mahone Sloan
Maloney-Shamie Vision Institute, Los Angeles, CA, USA.
Faculty of History, University of Oxford, Oxford, UK.
J Cataract Refract Surg. 2024 Dec 10;51(7):629-34. doi: 10.1097/j.jcrs.0000000000001591.
Harold Ridley permanently implanted the first intraocular lens (IOL) in 1950. The widely accepted narrative is that Ridley and his invention received a hostile reception from Stewart Duke-Elder and other ophthalmic thought leaders. Ridley suffered greatly but was eventually vindicated as later IOL designs were widely accepted. This narrative casts Ridley as a prophetic innovator who suffered and eventually triumphed against the forces of animosity, jealousy and close-mindedness arrayed against him. We argue that this narrative is biased because it was told by Ridley himself and amplified by his biographer and close friend, David Apple. There were good reasons to be skeptical of Ridley's invention. Ridley had not done pre-clinical studies, so his first patients suffered avoidable complications. He worked in secret at a time when openness was the norm. Ridley's IOL had a high percentage of poor outcomes. The cautious approach that Duke-Elder and others had towards IOLs is understandable. The accurate history is a story of a clash of worldviews between an inventor who was focused on innovating quickly to solve a major clinical problem and established leaders who were concerned about the harm to patients from a flawed invention. The skepticism of established thought leaders remains a valuable check on aggressive innovation today.
1950年，哈罗德·里德利首次永久性植入了人工晶状体（IOL）。广为流传的说法是，里德利和他的发明遭到了斯图尔特·杜克 - 埃尔德以及其他眼科思想领袖的抵制。里德利遭受了巨大痛苦，但随着后来人工晶状体设计被广泛接受，他最终被证明是正确的。这种说法将里德利塑造成一位具有预言性的创新者，他遭受苦难，最终战胜了针对他的敌意、嫉妒和守旧势力。我们认为这种说法是有偏见的，因为它是由里德利本人讲述，并由他的传记作者兼密友大卫·阿普尔加以渲染的。对里德利的发明持怀疑态度是有充分理由的。里德利没有进行临床前研究，所以他的首批患者遭受了本可避免的并发症。在以开放为常态的时代，他秘密开展工作。里德利的人工晶状体有很大比例的不良结果。杜克 - 埃尔德和其他人对人工晶状体采取谨慎态度是可以理解的。准确的历史是一个关于世界观冲突的故事，一方是专注于快速创新以解决重大临床问题的发明家，另一方是担心有缺陷的发明会对患者造成伤害的既定领导者。既定思想领袖的怀疑态度在今天仍然是对激进创新的一种宝贵制衡。
