Glaucoma iridectomies / by G. A. Berry.

  • Berry, George A. (George Andreas), 1853-
Date:
1907
Catalogue details

Licence: In copyright

Credit: Glaucoma iridectomies / by G. A. Berry. Source: Wellcome Collection.

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    to much below the normal amount, owing to the escape of aqueous —and inferred that the tension in glaucoma might be reduced in the same way. The cases are, however, by no means parallel. In point of fact, they are barely, if at all, related. Yet the effect of iridectomy at once proved in his hands to not only temporarily but perma¬ nently reduce the abnormal tension, and thus arrest the process of destruction caused by the disease. Ho more beneficent operative procedure than iridectomy for glaucoma exists probably in the whole range of surgical operations. Yet the operation is still an empirical one. It remains to be shown why iridectomy should be capable of permanently reducing increased tension within the eye. The most curious point, how¬ ever, in connection with this treatment—the brilliant results of which its author lived long enough to prove to be lasting and to see generally recognised—is that its value is even to-day very differently appreciated by different operators. In other branches of surgery an operation which has been introduced and adopted for any definite condition is either abandoned altogether for some better treatment, or modified in different ways at the hands of different surgeons. It is either superseded altogether or perfected. It would not appear at first sight, however, that so simple a proceeding as cutting into the eye and removing a piece of the iris would admit of much variation. Yet although every writer who gives his experience of iridectomy for glaucoma simply dis¬ cusses the question of how far his statistics show this to be the best treatment or not, as compared with other methods of treatment which have since been recommended, every one does not by any means operate in exactly the same manner. Of the literature which has appeared on the subject of glaucoma since v. Graefe’s time—which in bulk would no doubt fill a small library—there continue to be published every year not a few papers, more or less exhaustive, dealing with the practical question of the results of operation. In almost all the large foreign clinics at least, statistics are from time to time given. These vary so much that they are often more bewildering than useful. Some surgeons actually discard iridectomy altogether, others only iridectomise in cases of more or less acute congestive glaucoma, whilst some continue to regard v. Graefe’s operation as indispensable in all cases. Provided the statistics are carefully and conscientiously drawn up —which many at least bear evidence of being—and provided that the technical skill of the operators does not vary so widely as to make any material difference,—which I think must be admitted in the case of surgeons of experience,—it follows that there must either be some confusion in the classification adopted by the various writers, or some difference in the method of operation, or both. I believe there is both.