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
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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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    Previous to the bring'ing forward of either of these methods, Schuft (now Waldau) of Berlin, had invented, and, in 1860, published an account of certain instruments for facilitating the linear extraction of cataract, a series of spoons, one of which, introduced through the incision and passed behind the lens, was to hold the nucleus, pressed forwards against the cornea, between its edges, and withdraw it by simple traction. These instruments, however, turned out to be too large and clumsy for the purpose desired, their introduction doing appreciable violence to the eye. But, in 1865, Critchett and Bowman, the distinguished surgeons of Moorlields Hos- pital, London, devised scoops or spoons, far better than and preferable to those of Schuft; and, through the articles written and the cases treated by them, scoop extraction, or out-spooning, was raised to the dignity of a separate method. For some time it held its place as the favorite operation at Moorfields, and proved remarkably successful. In doing the scoop operation, an incision is made upwards, with a broad lance knife, specially made for thepurpq^e, atthe sclero-corneal junction, from 4' to 4=}/ in length. A large piece of iris is removed. The capsule is next opened very freely. The scoop must then be introduced, so as to glide readily behind the posterior surface of the cataract, which, being grasped by the scoop, is to be slowly removed. This latter manoeuvre requires great delicacy of manipulation. Especial care must be taken not to dislocate the lens in in- troducing the scoop, and not to press it so far forward as to injure th‘e iris or cornea during its extraction. ‘'Thus,’’ says Critcliett, in his description of his method, “ there suddeidy appeared three new methods of operating for cataract, bearing the name of their several c]iani])ions— Mooren, Jacobson and Schuft; but justice compels me to state that these gentlemen lighted tlieir tapers at the torcli of their great master. Prof, von Graefe. Each of these methods had been previously suggested and practised by him, but only in exceptional cases instead of as a general rule.” You Avill observe that each of these methods differs from