Report upon a series of forty-seven cataract operations / by John B. Story.

  • Story, John B.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Report upon a series of forty-seven cataract operations / by John B. Story. 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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    thoroughly understood what I mean by an uncomplicated case. This report includes all the operations I have performed on the lens up to September 24th, 1879. The operations divide themselves naturally into the following groups:— I. Extraction of uncomplicated senile (so-called) cataracts. II. Extraction of complicated cataracts. III. Solution and suction operations for soft cataracts. IV. Operations for traumatic cataracts. It is needless to dwell on the advantages of this classification. What an operator wishes to ascertain from the record of his cases is whether by his methods he has reached as high a percentage of successes as has been attained by others in similar cases, and for this purpose it is almost impossible to make use of any cases except those of uncomplicated senile cataract, as, once complications are admitted into the statistics, all comparative value depends upon the character of the complications, and the statistics are worthless for the comparison of methods. For a similar reason traumatic cases form a group by themselves, and the great difference in the method of treating soft cataracts justifies their appearance in a separate table. The method of operating in all cases, where the reverse is not distinctly stated, was as follows:—Angesthetics were never given; the patient lay on a couch facing the window, and the surgeon, standing or sitting behind the patient's head held the knife (von Grsefe's), right-handed for the right eye, and left-handed for the left eye. The difficulty of using von Grsefe's knife with the left hand seems to have been greatly overrated by some surgeons. A stop speculum was always used; the plan of holding the lids open by means of assistant's fingers, Avhich has been adopted in some foreign cliuiques, does not seem to have anything to recommend it—not even noveltv. The assistant's finders were used instead to restrain the action of the extra palpebral portion of the orbicularis. The globe being fixed by a toothed force})s, the incision Avas made upwards. An iridectomy was never omitted. Until an operator has satisfied himself that his results Avith iridectomy are as good as it is possible to jjroduce by that method, it is Aviser not to experi- ment in operating without iridectomy. In performing the iridec- tomy the fixation forceps, Avhen necessary, was given over to the assistant to hold, this plan being manifestly better than allowing