Eric John Arnott FRCS[1][2] was a British
ophthalmologist and
surgeon who specialized in
cataracts,
a condition which in many parts of the world still remains the
principal cause of blindness died he was 82.. He is known for inventing new surgical
techniques for treatment of various ophthalmological disorders, and
received professional awards for his contributions.
(12 June 1929 – 1 December 2011)
Career
Arnott was educated at
Harrow School (Elmfield) and
Trinity College, Dublin
where he was awarded the Surgical Prize in 1952; BA (Hons) 1953 and MB
(Hons), BCh(Hons)and BAO (Hons)1954. He gained his Diploma in
Ophthalmology (DO) in 1956 and Fellowship to the
Royal College of Surgeons (FRCS) in 1963.
Arnott's first ophthalmic appointment was as Houseman at the
Royal Adelaide Hospital and
Royal Victoria Eye and Ear Hospital, Dublin, following which he held early appointments at
Moorfields Eye Hospital, London, and
University College Hospital London, where he trained under
Sir Stewart Duke-Elder and
Henry Stallard.
Whilst at Moorfields he worked with
Sir Harold Ridley, the inventor of the intraocular lens; Arnott was inspired by Ridley’s work on the
intraocular lens and they later became lifelong friends.
After completing training at
University College Hospital, Arnott was appointed as consultant initially to the Royal Eye Hospital and later, in 1965, to
Charing Cross Hospital; then still in the Strand. In 1973 the hospital moved to its current site in
Fulham, where Arnott was responsible for setting up the ophthalmic surgical services.
In 1974, Arnott and his wife Veronica organised the first Live
International Ophthalmic Micro-Surgical Symposium in Charing Cross
Hospital, 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 set a standard for
future surgical conferences. He later organised two other live symposia
with Professor Emanuel Rosen, with the objective of bringing new ideas
in
cataract surgery to a wider audience.
Arnott was known for his pioneering work in ophthalmology and many of
today’s top eye surgeons were trained by him whilst registrars at
Charing Cross.
He retired from the
NHS in 1994.
Phacoemulsification
In 1968, whilst Secretary of the Ophthalmic Society of the United Kingdom he invited Dr
Charles Kelman MD, the inventor of
phacoemulsification ("phaco"), to address the Society. 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 remain in
bed for two weeks after surgery with all movement restricted.
In 1971, Arnott visited the USA to attend one of Kelman’s first
courses. On his return, he privately raised the finance to buy the
expensive equipment required for the procedure. When he started
performing this new type of cataract operation, history indicates that
it was not well received by his colleagues. Six years later Arnott was
virtually alone in performing and teaching this procedure outside
America.
Today, almost all cataract surgery is carried out using a variation
of the technique that Arnott pioneered in the UK in the early seventies.
Lens implantation
In 1974, influenced by Sir
Harold Ridley's work on lens implantation, Arnott designed the Little-Arnott lens, which was manufactured by
Rayners. This was one of the first intraocular lenses to be positioned behind the
iris,
the normal position of the natural lens. Previously, lenses were
implanted in front of the iris, and many of them caused severe ocular
problems.
[3] Arnott followed this up with several other designs before inventing “the totally encircling loop” lens
[3] which was manufactured under license by
Alcon, Pharmacia and
Smith & Nephew
and others. Clinical data demonstrated that this lens maintained an
excellent position within the eye and over 2 million were implanted
worldwide during the 1980s and 1990s.
[4]
During the seventies, all of the lenses designed by Arnott were made of
polymethyl methacrylate (PMMA). In 1981, Arnott and Richard Packard, his then senior registrar at
Charing Cross Hospital, were the first to describe the use of a soft lens material, which could be folded to go through a small incision.
[5] In 1988 Arnott was the first surgeon to insert a bi-focal lens implant in Europe.
Following cataract removal, it used to be common for patients to
require thick pebble glasses to be able to see. Nowadays, virtually all
patients receive a lens implant following
cataract surgery, avoiding the need for glasses.
Other contributions
Arnott was also responsible for introducing other surgical techniques.
In 1966 he was amongst the first surgeons in the world to follow Dermot Pearce’s use of the surgical microscope.
[6]
In 1967 he and Paddy Condon, his then senior registrar, used the first silicone implant for
retinal detachment surgery.
In 1968 he modified the final approach to
glaucoma surgery by making the opening into the anterior chamber through the clear
cornea, as opposed to the previous dialysis approach.
In 1976 he and Jared Emery of
Houston,
Texas, invented the diamond tipped “spear headed” surgical knife for
making the phaco incision and in 1978 he was the first surgeon to
perform a combined phaco cataract and glaucoma operation.
Arnott was very early in recognising the new trend of laser refractive surgery to correct
myopia (shortsightedness). He acquired one of the first
excimer lasers, which he located in
Cromwell Hospital in 1991, where his private practice was based. In 1992 he was the first person in the UK to perform
LASIK.
[7]
In 2000 Arnott received an award from the
International Intra-Ocular Implant Club - the IIIC Medal, at the Club's annual autumn meeting in Brussels, Belgium.
Charity work
In 1982 he reduced his work in the
NHS
(from maximum part time) to four sessions a week and began
concentrating on charitable work at the Royal Masonic Hospital, London,
(where he remained an honouree consultant until 1994) and international
teaching commitments.
Over the course of his career, Arnott lectured and performed live
surgery throughout the world, paying particular attention to the Asian
and African continents where cataracts are most prevalent.
In 1984 he was one of the first surgeons to demonstrate phaco surgery and lens implantation in
India and in 1991 he received a special award from the Asian branch of the
Royal National Institute for the Blind for “outstanding support“ to blind Asians in
London and
India. The same award was presented a year later to his son Stephen,
[8]
who managed Arnott's private practice. In 1996, Arnott was invited to
officially open the first meeting of the Indian Academy of
Ophthalmology, and in 1998 he was made an honorary visiting Professor at
Indore University.
After Arnott’s retirement in 1999, with the help of his wife Veronica
[8]
and son Stephen, he raised funds to fund and equip a mobile operating
theatre to perform modern eye surgery in remote Indian villages. This
project was undertaken in conjunction with the Sathya Sai Institute.
[9]
Along with Dr G Chandra, he established the charity organisation
'Balrampur Hospital Foundation UK' in 2007 and served as a Trustee and
its President.
Medical societies
Arnott was a member of many international ophthalmic societies and
was the founder President of the European Society for Phaco and Laser
Surgery (1986–89), Secretary of the Ophthalmic Society of the United
Kingdom (1967 – 1968), President of the Chelsea Clinical Society (1985)
and President of the International Association of Ocular Surgeons
(1983).
He was also one of the original founder members of the American Society of Cataract and Refractive Surgery.
In 2007 Arnott received the Honoured Guest award from the ASCRS for his services to ophthalmology.
[10]
Publications
He wrote over 40 published scientific articles for British and
foreign ophthalmic journals on strabismus surgery, congenital
abnormalities, cataract extraction, Phaco-emulsification and
intra-ocular lenses.
[11]
Between 1992 and 1997 he wrote a regular chapter on the latest ophthalmic advances for the annual Royal College of
General Practitioners Reference Book
[12]
Arnott was co-author of the 1983 textbook Extra-capsular Cataract
Surgery and contributed specialist chapters to many other medical books
including Emergency Surgery by H Dudley, Intra-ocular Lens Implantation
by Rosen et al., Current Perspectives in Ophthalmic Surgery by Easty et
al., and a Colour Atlas of Lens Implantation by Percival.
[13]
Arnott, with assistance from his son Stephen, wrote and published “A
New Beginning in Sight” in September 2006, chronicling the development
of modern cataract and refractive surgery.
[14]
Personal life
Arnott was born in Sunningdale, Berkshire, the second son of Sir Robert Arnott Bt.
[8] and Cynthia Amelia (née James) . His family were notable Anglo-Irish philanthropists who owned, amongst other things,
Arnotts department store,
the Irish Times, and the
Phoenix Park Racecourse.
He was married to Veronica (née Langué) from 1960 until her death in
2011 and had two sons, Stephen John 1962, Robert Laureston John 1971 and
one daughter Tatiana Amelia 1963.
[8]
Until 2001 he remained fit by swimming a mile every morning and in
1974 he successfully completed a challenge to swim from the infamous
Alcatraz Island to the shore of
San Francisco.
When Arnott finally retired at the age of 70 years, he bought a retirement cottage in
Cornwall in
Mounts Bay overlooking the
Atlantic Ocean from where he wrote his memoirs “A New Beginning in Sight” before his death 1 December 2011.
To see more of who died in 2011
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