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.

    85/142 page 63
    Hypersclerotic lenses are generally excluded, being too large to pass easily through the pupil. If the latter be small and rigid, as it occasionally is in old people, or if posterior synechiae be present, an iridectomy must be made. The patient should be quiet, not prone to spas- modic closure of the eyelids, and there must be no cough. The conjunctiva should be fairly normal, so that if prolapse should occur, the iris may not be exposed to the attack of pathogenic organisms. If the fellow eye has been lost from any cause, many surgeons prefer to do an iridectomy. Finally, an operation begun as a simple extraction is often converted into a combined one, owing to difficulties encountered. At the Cowasjee Jehangir Hospital simple extractions have only been regularly performed for rather less than three years, and in this period their number has been only about half that of the combined operations. The proportion would have been higher were it not that many unripe cataracts have been extracted, and that the state of the conjunctiva was often unsatisfactory. I have never performed simple extraction in private work at patients’ houses, because it would entail visit- ing on the following day with an assistant, prepared to excise prolapsed iris. The Technique of the Operation is, of course, simpler and shorter than with iridectomy ; but care must be taken not to overstretch the sphincter of the pupil, nor to leave cortical matter hidden away behind the iris. A full-sized incision is more commonly required. And the spoon - pressure for the delivery of the lens is directly backwards, about the junction of the lower and middle fourths of the cornea, so as to tilt the upper edge of the lens well forward, to enlarge and occupy the pupil other hands this operation necessitates an iridectomy, both to facili- tate the expulsion of the lens and to diminish the liability to subse- quent prolapse of iris from pressure of vitreous.
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image