The modern operation for cataract : a lecture delivered at the Harvard Medical School, April 5, 1871, with an analysis of sixty-one operations / by Hasket Derby.

  • Hasket Derby
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: The modern operation for cataract : a lecture delivered at the Harvard Medical School, April 5, 1871, with an analysis of sixty-one operations / by Hasket Derby. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    manner, and to follow it up, step by step, from the lower edge of the cornea till the last particle has emerged. The leaving behind of cortical substance may thus most satisfac- torily be avoided. It is of extreme importance, adds Graefe, to keep pressing perpendicularly against the cornea until the cataract is brought up and into the wound, and then, and not till then, to press upwards. If this direction be disregarded, cortical substance is very apt to become detached and left behind. When, in spite of these precautions, cortical masses have remained behind, their removal must, if possible, be effected in the same manner. Should they resist this, the fixation forceps and speculum must be removed, and the patient left alone a short time, till the effects of the anesthetic have in part passed away, and a slight amount of aqueous humor recollected. lie must then be directed to look down, and gentle pressure and counter-pressure applied with the tips of the fingers, through the lids, as in the case of flap extraction, until the pupil appears black and clear. We now come to the very important subject of after- treatment. We fortunately possess a short article of Graefe’s on this point, written a few months before his death, and embodying all the results and deductions of his ripened experience. It is in substance as follows. And it may be well here to observe that Graefe’s inducement to prepare it was, in large part, the fact that his own cases of cataract thus treated did so much better than those of other leading operators. ^ The edges of the wound being well in contact, and all coagula removed from their vicinity, the eye is to be gently closed, no atropine being now used. The bandage is to bo applied in the manner described in the last lecture, a circular piece of soft linen being first laid upon the eye, little tufts of charpie then evenly distributed so as to fill the orbital cavity, and the flannel roller finally passed thrice around the head and thrice over the eye, each ascending fold overlapping its predecessor and being carefully adapted to the eqfuable
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