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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    what has been said above upon unnecessary disturbance of the vitreous, further detailed description of the procedure and discussion of the suggested dangers appears superfluous— risk of haemorrhage into the vitreous, dislocation of the capsule into the vitreous, danger of detachment of retina from healing of vitreous in the puncture. Pinto in 133 operations improved the vision in ninety-five, and reduced it in seven cases. In three cases glaucoma followed. Noyes^ considers that this treatment should be adopted one to three months after the original operation, where a small and undilatable pupil (whether simply rigid or bound down by synechi^e) does not provide sufficient room for ordinary discission of the capsule through the pupil. In such cases, however, no particular harm follows limited incision of the iris. Opinions upon the treatment of the thicker, denser, and inelastic forms of after-cataract, including those resulting from iritis and irido-cyclitis, vary greatly. All of these after-cataracts are divisible primarily into those which can, and those which cannot be cut with a narrow Graefe's knife. The latter membranes may be torn, or divided with scissors, or extracted. The former group includes the results of iritis and irido-cyclitis after cataract extraction, even to complete occlusion of pupil and coloboma, and matting together of iris and capsule by organized exuda- tion. I have been in the habit of practising simple division of such membranes with the narrow knife, cutting the iris freely together with the tissues behind it when necessary. This is not commonly considered sound practice, for the pull upon the ciliary body is considered to be too great. Further, on this account only one incision must be made at a time. If there be dense occlusion of pupil, the single incision in the matted tissue does not gape well. A second incision at right angles to the first may be needed Mediciiie^ January, 1900.
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