Cataract extraction : being a series of papers with discussion and comments read before the Ophthalmological section of the New York academy of medicine, 1907-1908 / edited by J. Herbert Claiborne.

Date:
1908
Catalogue details

Licence: Public Domain Mark

Credit: Cataract extraction : being a series of papers with discussion and comments read before the Ophthalmological section of the New York academy of medicine, 1907-1908 / edited by J. Herbert Claiborne. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    stage is distressing to the patient and in not a few instances entails hardships on himself and his family. During a long experience in the removal of the non-cata- racous lenses in the dead house, conducted for self-instruc- tion as well as for the instruction of students in the operative surgery of the eye, the writer has studied the behavior of the transparent lens. It was observed that in the lenses which were twenty-five or thirty years old, the nuclear por- tion was fairly firm, about two-thirds of the mass of the lens coming away with the nucleus. It was further observed that much of the detached cortex could be made to follow the nuclear portion. The firm nuclear portion becomes larger as the age of the lens increases. On the strength of these observations, in spite of the dictum hands off in reference to operations on immature cataract, I began to remove the cataractous lens soon after it had reached a degree of opaqueness sufficient to interfere with useful vision, whatever the form of the cataract might be, in all cases in which such removal was particularly urgent, those cases being excepted in which the lens was much swollen. If the lens is much swollen, the narrow anterior chamber makes the extraction much more difficult; it is much better then to wait until the lens has shrunken to some degree before attempting the operation. Before this plan was followed, the operation of ripening advocated by Forster was tried in a number of cases. The lenses became rapidly opaque, but it was found that re- moval six weeks or two years later was complicated by ad- hesion of cortical substance to the capsule to probably the same extent as would have been the case had the extraction been performed at the time of the Forster operation. This experience was sufficient to cause the writer to abandon all ripening operations as not of sufficient value to com-