Tadeusz Krwawicz – the one who revolutionised the world ophthalmology

29.09.2018 | By Tomasz Turejko

Around 20 million people throughout the world suffer from cataract. It is the most frequent cause of blindness (48% of all cases), and its treatment was a challenge, despite medicine’s development, even just a few decades ago.  Tadeusz Krwawicz, a medical professor and son of a gunsmith, who combined his studies with working in a mine, began his  difficult fight against the disease. Twenty years later he would set up the best Eye Clinic in the world – in a deserted flat in Lublin. Western scientists couldn’t tell whether he was a madman or a genius.  After the first surgeries were performed, they had no longer any doubts.

„Dad, I want to become a doctor”

Tadeusz Krwawowicz was born in 1910 in Lviv. He was to follow the family tradition and become a miner. In 1931 he started his studies at the University of Science and Technology in Kraków. The studies were difficult because he had to combine studying mathematics and physics with working at the coal mine, as it was a requirement of his major. After one year of his education, he decided to have a serious conversation with his father and he said to him “Dad, I want to become a doctor”. His father, who believed that his son was sensible, supported  the decision. Thus, Krwawowicz started to study medicine in 1932 at the Jan Kazimierz University in Lviv. He earned his medical degree in 1938 and a year later he received a PhD degree in medicine. Before the WWII broke out, he started working as an assistant in the Eye Clinic owned by professor Adam Bednarski.

It occurred by pure chance. Krwawicz wanted to become a surgeon after he received his diploma, but a difficult financial situation forced him to modify his plans. When the opportunity to work at the clinic arose, he did not ponder on it very long.

Earlier he managed to convince the professor that in case it was possible, he would leave his place of employment and try his hand at surgery. After a few months he was completely immersed in his work as an ophthalmologist, so he abandoned his initial plans. Unfortunately, his work at Bednarski’s clinic was interrupted on the 1st of September in 1939 when shots were fired from the Schleswig-Holstein battleship.

During WWII he continued to work at the clinic whenever it was possible. Krwawicz helped hundreds of sick and injured in air-raids which took place in Lvov. His mentor Professor Bednarski died in 1941. In the same year, Germans executed professors from the University of Lvov, and among those who died was the direct superior of Krwawicz – associate professor J. Grzędzielski. Another person killed was professor Boleslaw Jalowy, his earlier employer at the department of histology for a brief time before he took the job position at the eye clinic. In 1944, Krwawicz was conscripted into the Second Polish Army. After the war, he was offered a job position at the University of Maria Sklodowska-Curie in Lublin.

A Clinic in a deserted flat

Thus, the crucial period of Krwawicz’s life began. He spent the first three years after the WWII ended on trying to establish an eye clinic which would operate with the support of the University of Lublin (since 1950s Medical University). In 1948 it was decided that the leadership of a yet non-existent clinic would be assumed by Tadeusz Krwawicz. There was a lot of problems. The clinic lacked financial resources, medical equipment, stuff, which was reduced during the war, and even a building. Krwawicz, who was full of enthusiasm, began to work on the assigned task. The first laboratory with hospital rooms was curiously established in a deserted flat. In 1954 the clinic was moved to a renovated mansion located on the Chmielna street.

Research which was carried out in the clinic was concerned with immunology and biochemistry of eye tissues and experimental surgery. During pilot studies on the possibility of storing grafts of the cornea, the need emerged to create a method which would allow getting a lens of the eye without causing unnecessary damage. At that time, Krwawicz came up with the idea of implementing experiments found in cryotherapy. The Results turned out to be positive. In 1959 it was decided that the studies would be continued and Krwawicz proposed to use cryotherapy in the treatment of cataracts.

First treatment procedures of cataracts were performed in antiquity, but this surgery had been a challenge for centuries due to difficulties encountered during the removal of the lens of the eye. Krwawicz’s method could solve this problem. The lens would become hard after the temperature was lowered and it would make it easier to remove it from the eye. Therefore, it facilitated the whole process considerably.

This method of treating cataracts, which was brilliant in its simplicity, proved to be very effective. Polish doctors were the first who wiped their glasses with astonishment during the 18th Convention of Polish  Ophthalmology Society in Poznan in 1960. Some years later, the whole of Europe would be astonished.

The worldwide revolution

The new method caught the attention of doctors from all over the world. Using method introduced by Krwawicz, doctors started treating patients suffering from cataracts. In more and more clinics on both sides of the Iron Curtain, thousands and then millions of patients would undergo surgery. Annually, 17 million people from all over the world waited for their operation. It was a golden age for the world ophthalmology. As was claimed later by professor Krwawicz himself, “Combined knowledge of past and present researchers established the art and science, which aims to secure the fundamental, human ability of sight.”

However, there was no shortage of sceptics. In the United States and in the United Kingdom the new method was met with suspicion. One of the British doctors, professor Riddel from Glasgow, even decided to visit the clinic in Lublin, where he observed several surgeries which used cryosurgery. Even though these surgeries turned out to be successful, the British doctor couldn’t believe in what he saw on the operating table. After his return to the United Kingdom, he allegedly stated “I was there for quite a long time, and I witnessed a lot of things. I came to the conclusion that he is either a madman or a genius. We’d better wait for some time”. Krwawicz’s method would be used by British doctors for treatment only after 1965.

The discovery of the Polish professor sparked a technological revolution in the field of cryosurgery throughout the world.

It was at this time when John Bellows, the oculist from Chicago wrote “The exceptional progress which was made in the last decade regarding cataract treatment is the turning point in the history of ophthalmology. The technique of cryoextraction, developed by Krwawicz, is competitive regarding value with an epochal contribution of Daviel who performed the first known cataract extraction in 1747. Cryoextraction replaced forceps, just like Daviel’s progress replaced cataract reclination. This technique brought a revolution in cataract surgery”.

Hence, in the 60s, the nationwide innovation centre of ophthalmology could not be found in Chicago, Oxford, United States, Germany, France or even Moscow.  It existed in the clinic in Lublin, the one that Krwawicz established in the deserted flat and miraculously adapted to provide medical services.

Professor Hollwich, the president of the World Academy of Ophthalmology, during the XXXIVth Congress of Polish ophthalmologists in Lublin in 1980 declared, that “within the last hundred years, critical progress has been made in two fields of ophthalmology: von Graefe’s iridectomy in glaucoma surgery and closing retinal tears using Gonin’s technique. I am inclined to regard professor’s cryoextractor as the third huge step forward, which is comparable to von Graeffe and Gonin’s achievements. Since that time, a great number of oculists who treat cataract, as well as their patients, benefit thanks to the progress and are grateful to Krwawicz”.

The father of polish ophthalmology

Professor Krwawicz experienced a great period in his life at that time. He was received with honours everywhere during his visits. He was invited to give a lecture in many medical centres and universities. In 1970 in Bogota, Krwawicz was awarded the Barraquer y Barraquer Golden Medal by the president of Colombia for his achievements in cryosurgery. In his memoirs, Krwawicz provided one statement of a Colombian doctor – “It was well deserved that you were awarded the Barraquer y Barraquer Golden Medal by the president himself and with many oculists present. However, you are not aware that I want to give you my special thanks for something. When I wake up in the morning, shave, and whistle happily, I am not as filled with tension as I used to be on the day of the surgery. Now I know that every cataract surgery I will have is going to be successful.”

In 1966, during a Congress in Florida, Krwawicz was appointed as the first president of International Society of Cryo-ophthalmology. He received numerous awards and medals, such as Special Contribution Award of International Cryosurgery Society (1968), the Th. Axenfeld Prize during European ophthalmologists Congress in Budapest (1972), The Nessim Habiff Prize in surgery at the Geneva University (1974), as well as countless medals for his medical and pedagogical achievements.

Being the head of the department and of the Ophthalmology Clinic of Medical University in Lublin for 34 years, Krwawicz taught a substantial number of ophthalmologists, and many of them set out to become heads of ophthalmology wards in Poland. 28 of his students obtained the PhD diploma, and 8 of them obtained a post-doctoral degree (7 of them were awarded the academic title of professor). Altogether, Professor Krwawicz published 194 scientific and research works. Most of them are still read by medical students in numerous academic institutes of the world.

Professor Tadeusz Krwawicz died in Lublin in 1988. Ophthalmology Department of Medical University in Lublin was named after him. Since that year, Tadeusz Krwawicz Gold Medal Awards, provided by Foundation under his name, are given to students.  In 2004, Foundation of Tadeusz Krwawicz, supported by Polish Ophthalmology Society, offered to put medals at the disposal of the International Council of Ophthalmology. This offer was accepted, and since 2008, the medal has been awarded during world ophthalmology congresses.

Currently, in connection with developments in medicine, the method of treating cataract has changed as well. Phacoemulsification, which uses ultrasounds is applied. However, even today in many clinics in case of a subluxation of a lens (for instance after an injury) cryoextraction remains the only possible way of removing the cataract.

In the end remains man and his dignity.

Professor Tadeusz Krwawicz is definitely one of the most remarkable figures in the field of ophthalmology of the XXth century, as well as in the entire history of this profession. The man, who never decided to live in the Western world, although he had such a possibility. He wouldn’t leave to any European capital or American centre of the world medicine. Instead, he would move this centre to Lublin and keep it for 20 years. There, in the 19th-century palace on Chmielna street, ophthalmologists from all over the world would learn how to treat one of the most severe diseases of the organ of sight.

As professor Krwawicz himself wrote about his work, maybe in a slightly lofty manner, “To restore the eyesight of a person and not allow for this person to remain blind for the rest of his or her life is not only the matter of humanism but also the expression of the highest civilisation in our society. Cryosurgery, from which modern cryo-ophthalmology developed, also furthers our society. Polish science achieved global eminence in this area”.

Professor Krwaicz was buried in a cemetery in Kazimierz Dolny. There, at the small parish cemetery, rests a person, whose innovative discovery helped millions of people all over the world restore their eyesight.

Translation from Polish: Daria Walczak

 

This publication has been cofinanced by the Ministry of Foreign Affairs of the Republic of Poland within “Cooperation in Public Diplomacy 2018” programme.
This publication reflects the views of the author and not the official stance of the Ministry of Foreign Affairs of the Republic of Poland.

 

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