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.

    107/142 (page 85)
    The objects of later treatment include the removal of disfigurement and the reduction of corneal astigmatism. After the late removal of a small prolapse it is quite feasible, and it appears to me desirable, to cover the site with a strip of neighbouring conjunctiva. A band of undermined membrane may be drawn over it, and fixed by suture on one or both sides of the cornea. In the treatment of a few prolapses too large to be covered by conjunctiva, fearing the connection of iris and uveal tract with the exposed, though altered, tissue, I have severed the adherent base of iris by a sclerotomy upwards, after- wards excising a portion of the prominence to produce flattening. Possibly in such cases it might be better to wait for some months for partial closure of the neck of communication with the anterior chamber, and then to adopt Berry’s treatment* for cystoid cicatrices. After freely laying open the ‘ cyst,’ he cauterizes superficially the defective portion of the sclero-corneal cicatrix, which may then be expected generally to close firmly ; the cyst wall is not removed, but remains as a covering to the cauterized tissue. Eserine drops will not completely reduce a prolapse, though they may keep it from increasing in size, After excision of prolapse they may be used if the iris and pupil are quite clear ; otherwise atropine may be required for accompanying iritis, and should be used unhesitatingly. EXPULSIVE RETRO-CHOROIDAL HEMORRHAGE. This we have met with only twice in considerably over 2,000 extractions, and one of the eyes thus destroyed was in a state of subacute glaucoma at the time (see p. 103). In the latter case the eyeball was found filled, and the wound distended, with clot the day after operation ; in the other case, the haemorrhage occurred * Transactions of the Ophthalmological Society, xxii. 273.