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.

    117/142 (page 95)
    very over-ripe and shrunken cataracts, almost entirely capsular, but only as a primary operation. The glaucomatous complications of needle-operations are referred to later. The most suitable time for interference with after- cataract varies with the nature of the opacity. For occluded pupil, a delay of some months after the dis- appearance of ciliary injection is perhaps advisable, lest the old inflammation be revived ; but for the results of lens-cell activity, the sooner treatment is undertaken after the eye is free from injection the better, since delay will only add to the toughness of the membrane. A fort- night is frequently a sufficient interval between the extraction and the ‘ needling.’ SECONDARY GLAUCOMA has been said to follow about I per cent, of ‘ combined ’ extractions, but is less often seen after ‘ simple ’ operations. In India one has very little experience of it; its apparent rarity is probably an illustration of the reluctance of the patients to come for treatment a second time. The larger proportion com- plicating the combined operation represents the greater liability to incarceration or adhesion* of iris and capsule in and about the wound, which take the place of the prolapses of simple extraction. The obliteration of part of the filtration angle, with narrowing of the remainder, by the forward displacement of the iris, especially with a purely corneal wound, appears sufficient in some eyes to set up glaucoma. In other eyes the high tension is secondary to chronic iritis, which may also serve to draw forward the iris and capsule to the wound by the con- traction of inflammatory lymph. The relative parts played by this narrowing of the anterior chamber, and * At times impossible to avoid in restless patients, but otherwise preventable by proper replacement of iris and capsule at the close of the operation.