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.

    110/142 (page 88)
    jecture'' only, if cases of obvious incarceration of iris, vitreous, or capsule in the wound are excluded. It com- plicates simple perhaps as much as combined extraction.! It is curious that imperfect union rarely leads to evil consequences. Prolapse of iris, infective inflammation, corneal opacity (see p. 8o), and anterior synechiae are all possible, but uncommon, results. Treatment.—Nothing has ever been required in our cases beyond continual bandaging. Light stimulation of the wound with nitrate of silver or iodine solution and iridectomy are means which have been successfully em- ployed in obstinate cases. Filtration CEdema of the ocular conjunctiva, from subcon- junctival leakage through the wound, is to be expected as an occasional unimportant transient effect from the use of a wide conjunctival flap. Through the semi-transparent membrane the lips of the sclero-corneal wound may perhaps be seen to be slightly separated. It looks rather alarming until the absence of signs of grave complication are noted. It is paler than inflammatory oedema, and is confined to the ocular membrane, and tends to gravitate to the lowest part of the conjunctiva. Acute Dermatitis of the eyelids and neighbouring skin may be occasioned rarely by overfree use of perchloride, aided by the subsequent bandaging. It probably indicates a special idiosyncrasy. In the few cases we have seen (some years ago) there was no particularly remarkable reaction of the conjunc- tiva. The sharply-defined, reddened area of skin had an erysipelatous appearance. In one patient numerous bullse formed, and the discharge from them caused an extension backwards of the inflammation over the scalp, and, entering the conjuncti\'a, produced an hypopion, evidently by infection * It seems likely that in some nervous patients repeated reopening of the wound by spasm of the orbicularis, even under the bandage, may be the disturbing factor ; for uncontrollable, more or less rhyth- mic, contraction of the muscle is occasionally seen at the close of operation. No clear connection of delayed union with ill health has been made out. t Norris and Oliver’s ‘ System,’ iv. 398.