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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    solution, and also ophthalmic discs of * hemisine.' The solution, I in i,ooo, unsterilized,* was not mixed with the cocain drops, nor instilled alternately with them, but was used only before the cocain period. It was dropped into the eye immediately after the perchloride irrigation, and the cocain instillation deferred for five minutes. In cases where much perchloride had been used, and where, in consequence, an unusual degree of hypersemia had to be combated, a second instillation was made two and a half minutes after the first. This aid is quite necessary in the subconjunctival extraction of Czermak, and almost so in operations with a large conjunctival flap, to control haemorrhage. It is of great value also in nervous, excitable patients. The docility and quietude of these patients during operation, thus rendered certainly painless, are in striking contrast with their uncertainty and unreasonable- ness under cocain alone. It is thus calculated to reduce the number of vitreous losses from spasmodic closure of the lids, and is indicated where vitreous loss is especially to be feared, as in high myopia. The more complete anaesthesia may be useful also in operating upon children by linear extraction. And for eyes still congested from a glaucomatous attack (Chapter VI), and especially in excising prolapsed iris, the help of adrenalin is needed, since, as is well known, cocain alone acts imperfectly in these conditions. In some of these latter cases a third instillation of adrenalin solution was made^ and the intervals between the cocain instillations prolonged, so that a total period of possibly half an hour was thus occupied. Even thus the pull upon previously congested iris may be painful. * To avoid frequent opening of the original bottle of solution, about enough for the day's supply was decanted into a small sterilized bottle for immediate use.
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