Samuel Sharp, the first surgeon to make the corneal incision in cataract extraction with a single knife : a biographical and historical sketch / by Alvin A. Hubbell, M.D., Ph.D., Clinical Professor of Ophthalmology, University of Buffalo.

  • Hubbell, Alvin A. (Alvin Allace), 1846-1911
Date:
[1904?]
Catalogue details

Licence: In copyright

Credit: Samuel Sharp, the first surgeon to make the corneal incision in cataract extraction with a single knife : a biographical and historical sketch / by Alvin A. Hubbell, M.D., Ph.D., Clinical Professor of Ophthalmology, University of Buffalo. Source: Wellcome Collection.

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    the lower half of the cornea at its “circumference,” he says: “This Wound will be almost semilunar, and nearly parallel to the inferior half of the Circumference of the Pupil, so that the Cica¬ trix will obstruct the Light but very little. M. Daviel recommends an Incision of nearly two thirds of the Circumference of the Cor¬ nea, but I believe what I mention will be found more commodious and so large a Wound as he directs is apt to give Issue to the Vitreous Humour.” In regard to the escape of the vitreous hu¬ mor and its management he suggests that “it might be owing to a Convulsive Contraction of the Muscles surrounding the Globe of the Eye during the Operation. When this is the Case, the Surgeon must instantly shut the Eye-lid to prevent the total Evac¬ uation of the vitreous humour, and at the same time both he and the Assistant cease to press upon the Eye-lids: But if the Chrys- talline [lens] does not immediately rush out of the Eye, the Operator must press gently with one or two Fingers against the inferior Part of the Globe, till the Chrystalline advance through the Pupil into the anterior Chamber, from whence it will generally fall through the Wound of the Cornea upon the Cheek. How¬ ever, shou’d it not readily fall out of the Eye, but remain lodged in the anterior Chamber, I would advise the Operator not to press the Eye in order to expel it, but immediately to stick the Point of the Knife into the Body of it, and extract it contained in the Capsula.” He laid much stress on this maneuvre and enlarged upon the benefits to be derived from it, as in his second paper be¬ fore the Royal Society. Sharp continued to advise the removal of the cataract with its capsule, but if this were not always prac¬ ticable, he believed that the capsule “probably will waste; for, in milky Cataracts, when the Fluid is discharged, the Membrane in length of time wastes.” Further on, however, he modifies this statement by saying “that probably one cannot always certainly judge at the time of the Operation, whether it [the capsule] be taken away, or whether it remain; for I suppose that the Mem¬ brane at the time of the Operation may be transparent, and after¬ wards become thick and opake; and if this conjecture be well grounded, the Operator will not be able to discern it, though it shf/jild remain. . . . However, it is a matter of no Conse¬ quence, whether the remaining Capsula be discernable or not, if it be disposed to waste afterwards, as my experience hitherto has proved it.” It is now known that Sharp was mistaken in this, as the capsule does not absorb. Sharp further argues for the use of the curette “in removing the capsula,” both after the ordinary