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.

    130/142 (page 108)
    THE EXTRACTION OF SOFT CATARACT. Operation for the removal of soft cataract—i.e.^ opacity in lenses which have not yet developed hard nuclei— is mostly performed on lenses which have been rendered more or less completely cataractous by discission or ‘ needling,’ either for partial cataract—generally lamellar —or for the treatment of high myopia. In other cases operation is for traumatic cataract, from accidental wound or rupture of lens-capsule ; or again, for idio- pathic general cataract in young persons. Traumatic cataract is nearly always met with at an age when the lens is still fairly soft. There is often inflammation, in- fective or otherwise, which may render delay in operative inter- ference advisable, unless pressure from the swollen lens appears to be keeping up the inflammation. Sometimes extraction is an expeditious alternative to the very tedious, but on the whole safer, absorption of lens-matter under repeated needlings; or it may be com- pulsory for the removal of inflammatory or glaucomatous complication.* In the former case it is not done until the cataract is ripe, and therefore easily removable; in the latter case it may be only a very partial operation, much sticky unripe lens-matter being unavoidably left behind. The usual operation is known as linear extraction or ‘ curette evacuation.’ A straight linear wound, 5 milli- metres long, is made in the cornea with a triangular keratome, rather nearer the margin than the centre of the cornea. If the lens-capsule has not previously been * These complications are especially likely to follow the too free admission of aqueous to transparent lens-matter, which rapidly swells as it becomes opaque. On the other hand, in over-ripe cataracts sudden high tension may result from a quantity of albuminous milky fluid being thrown into the anterior chamber.