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.

    108/142 page 86
    during the operation, as is usual, forcing out the lens in its capsule, together with the vitreous. In some cases there is trouble in stopping the bleeding, which is profuse. Immediate enucleation has been required ; and suturing the wound, the erect posture, morphia injections, and a pressure bandage have been tried. Though it affords a presumption of disease of bloodvessels, there may be no other indication of this. It has happened shortly after successful cataract extraction from the other eye of the same patient. Sometimes vomiting or exertion appear to have brought it on, possibly a few days after operation. The question of operation on the second eye, after this accident, has been already considered (p. 15). Once, in performing iridectomy for chronic glaucoma, we had a haemorrhage large enough to expel the lens with a quantity of vitreous, and to afterwards distend the wound. But the patient a month later could count fingers at 9 inches ; before operation he could count them at 2 feet. Such a case links the more profuse and uncontrollable haemorrhages with the comparatively frequent small fundus haemorrhages pro- duced by operation in advanced glaucoma. Probably such a limited intra-ocular haemorrhage was responsible for a large escape of vitreous at one of our cataract operations. The upper part of the cornea was slowly pressed forwards at the close of the operation ; then followed sudden rupture of zonule and large loss of vitreous, but no blood appeared in the wound. A month afterwards the patient could count fingers at 2 feet with this eye ; but later the vision fell to moving bodies, and the eyeball was shrinking, BLEEDING INTO THE ANTERIOR CHAM- BER a few days after operation formerly occurred rather frequently in our hospital practice, when the eyes were not protected by shields. It was mostly attributable to injury, by the patients wandering about or fingering their band- ages, which also led to some slight inflammatory reaction. Unlike the blood left in the anterior chamber at the time of operation, which is often entirely absorbed, this later haemorrhage more frequently leaves some permanent
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