Cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Cataract extraction / by H. Herbert. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    hesitate to ascribe it to drainage of aqueous through the wound, though there be no longer any noticeable general filtration oedema. The anterior chamber is frequently rather shallow, but not always so. In other cases gaping of the wound is very slight, and in still others it cannot be made out at all. These soft eyes without visible separa- tion of the wound margins, and with partly or completely re-formed anterior chamber, were, I think, with us much commoner since we operated with an extensive con- junctival flap than when we placed the incision at the superficial sclero-corneal junction. And there does not appear to be sufficient reason to consider them separately from cases in which the deep wound gapes visibly, though there is always the possibility that the leakage may be between choroid and sclerotic, and not through the wound. And other explanations of the low tension have been suggested. For example, Czermak* suggested their relationship with so - called ophthalmo - malacia, and Chevalleraut explains a case of enophthalmos after opera- tion as possibly due to a sympathetic lesion. I looked for choroidal detachment in several cases without finding it, but with after-cataract present the signs of this detach- ment may have escaped notice. I remember one such case several years ago, discharged from hospital with the eye soft after operation without conjunctival flap ; the patient returned a few months later with a prolapse of iris occupying a portion of the cicatrix. There is a general feeling that an anterior chamber of normal depth, or deeper than normal owing to the removal of the lens, shows an absence of drainage through the wound sufficient to account for a tension - 2 or - 3. But that this is not so I have seen in glaucomatous eyes after the establishment of * 'Die Augenarztlichen Operationen,' p. 944. t La Clin. Opht.^ 1899, p. 23.
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