The practical details of cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1903
Catalogue details

Licence: In copyright

Credit: The practical details of cataract extraction / by H. Herbert. Source: Wellcome Collection.

    100/142 page 78
    to perfect and complete protection of the wounds from infection, is shown by the rare occurrence after our operations of the graver forms of irido-cyclitis, ending in atrophy of the eyeball (the three cases of Group 2, p. 53) —infective evidences beyond the reach of treatment. There are a few mild inflammations chiefly localized in the ciliary body, with tenderness on pressure and low tension. The prognosis is usually good. An appreciable degree of Non-Infective Iritis is very common after our operations, for the most part very transient, and recognisable only by signs without symptoms. That it is due mainly to irritation from minute particles of lens-substance left behind is shown by its almost complete absence, both after extractions of the lens within its capsule,* and after most of the ordinary operations for Morgagnian cataract. Occasional additional sources of reaction are (r) a varying degree of traumatism, especially bruising of the iris in squeezing out the lens through too small a wound ; (2) prolonged irrigation of the anterior chamber ; and (3) reflex dis- turbance from an exceptional degree of surface irritation by the perchloride. Focal illumination on the day after operation shows us but few perfectly clear and active pupils, with bright iris. There are degrees of reaction culminating in a pupil partly occupied by, and in thickened iris partly hidden by what looks like lymph more or less mixed with traces of blood and lens-^ATm. And it may take several days’ free use of atropine, morning and evening, to obtain fair dilatation of the pupil. As already suggested, infection probably plays a part in most of the higher grades of exudative processes, but * See the remarks on this point by Captain Henry Smith, I.M.S., who has had such an exceptional acquaintance with extraction within the capsule {Indian Medical Gazette, xxxvi. 221).
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