Transactions of the American Ophthalmological Society, Eighth Annual Meeting, Newport, July, 1871.
- American Ophthalmological Society
- Date:
- 1871
Licence: Public Domain Mark
Credit: Transactions of the American Ophthalmological Society, Eighth Annual Meeting, Newport, July, 1871. 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.
135/146 page 133
![appeared so honestly written that a trial of his method was instituted in the next case that presented itself in the Aber- deen Hospital. In this case, as in all the cases where I have tried it, the operation was followed by no bad results as regards the iris; but, though the adhesion was seen to tear, the contraction of the pupil, which invariably followed on the escape of the aqueous humor, allowed the two ends of the ad- hesion to lie so close to each other that they united again in spite of the free use of atropine, and by the time the corneal wound was healed the same state of matters existed as before the operation, only the adhesion was not so broad as before.” As Dr. Ogston does not minutely describe his method of operating, I can only imagine his results were due to having made a larger and more peripheric wound in the cornea than was necessary, whereby the aqueous cliamber was not quickly enough reestablished. I found no such trouble as be describes, lie now operates in a different, and, as I contend, much more dangerous method, namely, he passes a not too sharp needle into the aqueous chamber opposite the point of iritic attach- ment, and, engaging the point of the needle in the iris tissue, forces it away to break the synechia, using the hole in the cornea as a fulcrum. The unnecessary danger of wounding the lens, and thereby producing cataract, which we must run in such a procedure, would be sufficient to induce me to hold to Dr. Passavant’s method, which I liave so far always found successful, and not so very difficult for those accustomed to ophtlialmic operations, especially as I am now convinced it can be readily ]:>erformed under nitrous oxide, a hundred gal- lons of which anaesthetic may be carried about with perfect safety in a case twenty inches long and eight square, as Dr. Amory has practically demonstrated. Instead of an iridectomy-knife, I now use a broad para- centesis-needle. I find no difficulty in manipulating my deli- cate forceps in the corneal wound this makes, and I lose but little aqueous before the iris is grasped, when the escape of the fluid rather assists in the breaking the attachment. Atro- pine is continued, and the humor secretes so quickly, that there is no time for the iris to again fasten itself to the capsule. I liave occasionally succeeded in not losing all of the aqueous humor during the whole operation.](https://iiif.wellcomecollection.org/image/b22449887_0137.jp2/full/800%2C/0/default.jpg)
