The International Intra-Ocular Implant Club IIIC

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IIIC Medal Lecture and
Annual Membership Meeting

October 8, 2017 - Lisbon, Portugal

IIIC Medal Lecture by David F. Chang:
"Lessons from the World´s Greatest Team of Cataract Surgeons"

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for Professor Eric John Arnott BM BCh BAO DO FRCS FRCOphth

June 12th 1929 – December 1st 2011

Eric Arnott was a combination of establishment doyen and visionary innovator prepared to
challenge accepted medical opinion. He was one of the first ophthalmic surgeons to
recognise in the work of Charles Kelman, the inventor of phacoemulsification, a new
approach to cataract surgery that heralded the dawn of small incision surgery. Kelman had
found a method of removing the cataract through an incision of 3.5mm compared to the
12mm required for most surgery at the time. This meant that patients no longer had to lie in
bed for two weeks after their surgery with all movement restricted. In 1971 Arnott went to
the USA and attended one of Kelman's first courses. On returning to England he raised the
money to buy the very expensive equipment needed. When he started performing this
surgery it raised a storm of protest amongst his colleagues, but Arnott carried on
undeterred. The early machines for this minimally invasive surgery were crude by
comparison with modern methods; nonetheless it was the beginning of a trend. Today
almost all cataract surgery in the developed world is carried out using a variation of the
technique Arnott helped to pioneer.

Arnott was born on June 12th 1929 in Sunningdale, Berkshire, the second son of Sir Robert
Arnott Bt. The family were an important part of the Anglo‐Irish establishment owning
Arnotts Stores, the Irish Times and Phoenix Park racecourse. He was educated at Harrow
and studied medicine at Trinity College Dublin. After medical school he trained at the
Adelaide Hospital and the Royal Victoria Eye and Ear Hospital, Dublin, before moving to
Moorfields Eye Hospital to pursue his chosen specialty of ophthalmology in 1959. Whist at
Moorfields he worked with Sir Harold Ridley, the inventor of the intraocular lens; not only
did Ridley's still controversial work on lenses inspire him, but it led to a lifelong friendship.
After completing his training at University College Hospital he was appointed as consultant
first to the Royal Eye Hospital and then in 1965 to Charing Cross Hospital then still in the
Strand. In 1973 the hospital moved to its current site in Fulham. Arnott was responsible for
setting up the ophthalmic surgical services. In 1974 the year after the hospital moved to
Fulham Palace Road, Arnott organised the First Live Ophthalmic Micro‐Surgical Symposium
where ten of the world's top eye surgeons performed live surgery, relayed to over 300
international delegates, courtesy of the BBC. This novel concept in advanced surgical
teaching was to set a standard for future surgical conferences and was widely reported in
the international press. He organised two other equally successful live symposia which
helped to bring new ideas in cataract surgery to a wider audience.

In 1976 Arnott having been influenced by Sir Harold Ridley's work on lens implantation
designed one of the first intraocular lenses to be positioned behind the iris, the normal
position of the natural lens. All lenses at this time were implanted in front of the iris and
many of them caused severe ocular problems, hence why their use was very limited. He
followed this up with several other designs before inventing "the all encircling loop" lens
which he patented. This lens maintained a very good position within the eye when
implanted and over 2 million were used around the world. Although all the lenses
that Eric Arnott designed were made of polymethyl methacrylate (Perspex) and
therefore rigid he, with his then senior registrar at Charing Cross Hospital, Richard
Packard, were the first to describe in 1981 the use of a soft lens material which
could be folded to go through an unopened phacoemulsification incision.

Arnott was very early in recognising the new trend of laser refractive surgery. He acquired
one of the first excimer laser's for the Cromwell Hospital in 1991 where he had already
created a satellite subsidiary of the Arnott Eye Centre, a unique multidisciplinary ophthalmic
private practice. Ophthalmologists of differing subspecialties worked together to give the
patients access to experts in all aspects of diseases of the eye. This still exists and bears his
name as Arnott Eye Associates in Harley Street. It became a magnet for patients from across
the world, many of whom that already had failed surgery elsewhere. He retired from
practice in 1999 to write his memoirs "A New Beginning in Sight".

India had always fascinated Arnott and he went there many times. He was awarded an
honorary professorship by the University of Indore and raised money for a fully equipped
mobile operating theatre to tour rural areas and carry out modern cataract surgery.
Eric Arnott, in 1960, married Veronica (neé Langué) who predeceased him in 2001. He is
survived by two sons, and one daughter. He died on December 1st 2011 after a long illness.

Richard Packard, December 2011


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