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FORGOTTEN GIANT

Slovenian inventor, Anton Banko, was behind the success story of phacoemulsification that started with Charles Kelman

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Anton Banko was born in a Slovenian family in Istria on 26 August 1927. He studied engineering and electronics in Ljubljana and later moved to the US where he worked in the field of ultrasound instruments for dental use with the Cavitron company as director of research and development.

Charles Kelman turned to him with a request to construct an ultrasound device for cataract removal and their first joint US patent No.3589363 was filed on 25 July 1967. The patent described an instrument designed for "breaking apart and removal of unwanted material", especially cataracts, using a handheld tip operating in the "ultrasonic range with an amplitude controllable up to several thousandths of an inch". Their pioneering work was described in Charles Kelman's book, Through My Eyes: The Story of a Surgeon Who Dared to Take on the Medical World. (New York: Crown Publishers, 1985).

Closed vitrectomy

In 1968, Anton Banko established his own company in New York, Surgical Design, committed solely to innovation in the design and development of ophthalmic instruments. The company soon started to produce and market a series of very reliable and successful phaco machines that are still used worldwide. He followed up his invention for cataract surgery by not only inventing instruments for phacoemulsification but also patenting the first surgical procedure for closed vitrectomy (Apparatus for Performing Surgical Procedures On the Eye. U.S. Patent No. 3,528,425; filed on September 16,1968 and patented September 15, 1970).

The vitreoretinal surgical work was performed with Charles L Schepens, MD, the founder of the Retina Foundation of Boston and is described in his book, quoting Banko's primacy before Robert Machemer. Extensive courses were given by the Retina Foundation of Boston and Surgical Design to surgeons throughout the world, teaching them the techniques of vitreoretinal surgery. These courses were also attended by Richard Mackool and Buol Heslin with whom, in 1980, Anton Banko presented the first combined computerised instrument for phacoemulsification and vitrectomy named 'Mackool/Heslin Ocusystem', one of the most successful surgical consoles of its time. As Richard Mackool described in his paper: Closed Vitrectomy and Intraocular Implant, (Ophthalmology 88:414-424, 1981): "Closed vitrectomy instrumentation that permits simultaneous cutting, aspiration, and replacement of the vitreous was first developed in 1968 by Banko, but was not reported in the ophthalmic literature until 1971 by Machemer."

Sadly, soon after the success of his company, Anton Banko died of an incurable disease. Slavi Banko, his widow, recalls: “Anton Banko was always very healthy and a dynamic person. In April 1986 he felt for the first time that he gets tired quickly. 16 of April he went to the hospital and he died of severe autoimmune disease in four weeks despite all medical efforts. He died on 16 May 1986 at the age of 58. This was a tragedy for the family with two young children.”

After the death of Anton Banko, his company was led by his son William. William Banko received his MD in 1987. Dr Banko also holds several patents on surgical and medical instrumentation. He has co-authored 20 publications in ophthalmic and general surgery and co-edited a book entitled Phacoemulsification Surgery, Pergamon Press, (now McGraw Hill), 1991. Altogether, Surgical Design holds more than 40 patents for the instruments used in their surgical consoles which are still produced today. Anton Banko’s wish to donate one of the machines to the University Eye Hospital in Ljubljana was conveyed by his family. Due to his legacy, surgeons from Slovenia started to use phacoemulsification as early as 1989 after training in the wetlab of Surgical Design company. Anton Banko remains one of the (largely forgotten) giants of instrumentation in ocular surgery with Slovenian origins.  

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