Contributed by Puja Laroia, OMS-III MSUCOM
Gottfried Wilhelm Hubert Custodis and Antonie Maria Josefine Schmitz welcomed Ernst Wilhelm Custodis into the world on March 23, 1898, in Düsseldorf. He had two siblings, and he married Erika Sonntag, with whom he had three children. Dr. Custodis earned his doctorate in medicine with honors from the University of Bonn in 1924. In 1925, he received his license as a medical practitioner.[2,3]
After completing his internal medicine studies, he continued his medical education in ophthalmology at several hospitals in Düsseldorf, Bremen, Aachen, and lastly at the eye clinic in Tübingen, where he worked under the superision of Prof. Wolfgang Stock until his graduation. He also served as the Head Physician of the Academic Eye Clinic in Düsseldorf. In 1933, he received his doctorate from Heinrich Heine University and was promoted to Associate Professor. In 1946, he was appointed Director of the clinic and was elevated to the rank of Professor in Ordinary.[2,3] In his scientific career, he was concerned with a wide range of topics in the field of ophthalmology. Dr. Custodis has published articles in several scientific journals on his results as well as on practical and clinical themes that he developed.
An important part of his life’s work is that he laid the groundwork for what is now known as scleral buckling surgery for retinal detachment. In 1949, he performed the world's first scleral buckling procedure. Dr. Custodis localized retinal breaks using a monocular indirect ophthalmoscope, treated retinal breaks with surface diathermy, and then sutured polyviol, a synthetic material, onto the sclera to "buckle" (indent) it toward the retinal breaks.[5,6] Over the prior treatment options, the explant surgery provided two significant advantages: it enabled non-drainage surgeries to be performed and the indenting permanently reduced vitreous traction on retinal breaks. In the years before Custodis, it was widely believed that it was necessary to drain the entire amount of subretinal fluid to bring the sensory retina into contact with the pigment epithelium.6 By introducing the polyviol explant, his procedure resulted in the successful reattachment of the retina without the need for drainage.6 In 1956, he described his experience with over 500 patients and reported a successful reattachment rate of 83.3 percent. He honed his surgical techniques in a way that was both practical and effective.
Dr. Custodis shared the findings of his research and the lessons he learned from his experiences with a large number of other ophthalmologists around the world. He paved the way for implant surgery in scleral buckling, and along the way, many individuals who were suffering from retinal detachment received his assistance. To a large extent, his approach was a stepping stone toward the most recent developments in contemporary detachment surgery. Ophthalmologists such as Dr. Harvey Lincoff, even visited Düsseldorf to observe Dr. Custodis conduct the Custodis method of scleral buckling. In reality, Dr. Lincoff stayed for a whole week to ensure that the nondrainage procedure was effective in other cases, and he became convinced of the legitimacy of the novel technique during his time there. So much so that he was instrumental in introducing scleral buckling to America, albeit with some changes.[5,7]
Dr. Ernst Custodis was awarded the Gullstrand Medal in 1972 by the Swiss Society for Medical Sciences in recognition of his pioneering work in retinal surgery.[3,8] The Gullstrand Medal is an honorary award presented every ten years to an ophthalmic scientist for outstanding developments in the field of ophthalmology. Dr. Custodis died on August 2, 1990, in Düsseldorf, Germany, at the age of 92. The Custodis Lecture, awarded by the Retinological Society of Germany in memory of Ernst Custodis, is awarded every two years to a renowned researcher in honor of their life’s work and contribution to understanding and treating retinal diseases.