Cataract surgery by “couching” is one of the oldest surgical procedures, first described by Maharshi Sushruta, an ancient Indian surgeon, and later adopted by the Greeks, the Romans as well as the Egyptians, Arabs and Europeans.
Couching was typically performed on mature cataracts. The technique involved using a sharp instrument, such as a thorn or needle, to pierce the eye at the limbus. The opaque lens was then dislocated from the central visual axis and pushed down into the vitreous cavity through the pars plana. The cataract thus remained in the eye but was no longer blocking
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