Albert Lasker
Clinical Medical Research Award

It is with mixed feelings that I humbly stand here before you to accept this prestigious honor on behalf of my husband. Our family is extremely proud of Charlie's dedication, persistence and relentless belief that phacoemulsification would greatly improve the quality of life of cataract patients. We are honored that the scientific community, specifically the Lasker committee, has recognized his contribution. And sad, that although Charlie knew he was nominated, he never knew of today's honor.

Charlie always believed that the journey was as important as the destination. He knew of the many letters written by colleagues worldwide to support his nomination. This gave him some satisfaction, and for us there is comfort in this knowledge. Many times Charlie told me how happy he was to see phacoemulsification become the accepted, safe cataract operation, and he always added that he never expected that it would impact ophthalmology and general medicine as it has. In November 2003, the American Academy of Ophthalmology celebrated 35 years of phacoemulsification. It was the last honor Charlie received personally. Please allow me to read excerpts from his presentation.

The story of phacoemulsification reads like a high wire act. Every step was fraught with possible failure, loss of equilibrium, and catastrophe. Even the concept itself might have never happened, had I not been touched by the infirmity and suffering of elderly cataract patients. Four years after my residency applying for a grant to study the effects of freezing on various ocular structures, I finished the application and went to bed. But I was troubled that the Hartford Foundation would not find this exciting enough to warrant a grant. In the middle of the night I awoke and almost in a trance, I added the words, which would affect the rest of my life, and the lives of more than a hundred million others. I wrote as an addendum, "In addition to the freezing studies, this investigator will develop a method for removing a cataract through an incision small enough so that no hospitalization would be required." It could have ended there... Instead, even though I could not say how I would do it, since I had no idea, Mr. Roy somehow had confidence that I would succeed and gave me a grant for three years.

Mr. Roy's confidence was misplaced for 2 years and 8 months, while I tried Lens bags, and every rotary, every oscillating, every pulverizing tool I could get my technician to miniaturize. It would have ended there, but because of my obsession with this problem, I had neglected my personal appearance, and I needed a haircut and a teeth cleaning. It was at the dentist that I discovered the ultrasonic vibrator to clean tartar off teeth. This device had no suction, only a vibrating needle, and needed to be modified. Cavitron refused to spend the time or money to do so, not knowing whether this would ever be a commercial product. It could have ended there, but I persisted with the company, and they finally agreed to make a prototype.

After several months of successful animal work, I was ready for my first patient, a man with a painful blind eye from burned out glaucoma, who agreed to let me experiment. The next day, his eye had to be removed. It could easily have ended there. I spent two years looking for and developing a way to prevent corneal collapse. One year later, I finally had the nerve to try again. The difficult operation was a success. The next patient fared even better. The senior surgeon at my hospital found out what I was doing, and tried to convince the board to rescind my operating privileges. Fortunately, by this time, my results were quite good. One bad case, and it could have ended there. I began teaching the technique in 1970 with the first commercial model, but the profession rose up against all those who adopted the technique. Surgeons had to learn not only phaco, but the use of a surgical microscope. The fact that its main proponent, me, was playing the saxophone and singing in the casinos of Atlantic City, and appearing on the Johnny Carson show did not help the cause. And if it were today, with the FDA, and with malpractice, the operation would have absolutely been abandoned. Had I not been in the right place at the right time, with the right obsessive motivation, I believe we might still be doing intracapsular 180-degree surgery. Looking back on all that I did, I have to wonder what kept me going. What made me take the risks I took? I'm sure there were many reasons, a desire to be recognized, a fear of failure, but most of all, when I would close my eyes and dream, it was the dream of someday addressing you on an occasion such as this.

Another point I would like to make is that no animal was ever treated cruelly. I probably sacrificed more than a few laboratory animals but contrast these animals against the 100 million patients who have benefited from this work.

Charlie wanted be described as lucky. He said, "It means that they're looking at your life as a package rather than one little facet. If you're lucky, your life has been a happy passage."

On behalf of my husband Dr. Charles Kelman, I thank you for this most prestigious honor and for respecting our wishes and presenting the honorarium to the International Retinal Research Foundation.