Variations in the technique of cataract-extraction as performed in some continental eye-hospitals / by R. H. Elliot.

  • Robert Elliot
Date:
[1903]
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Credit: Variations in the technique of cataract-extraction as performed in some continental eye-hospitals / by R. H. Elliot. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    bringing a nervous subject back to self-respect. Tacke gives a timid patient chloroform. My own practice, which I cannot too strongly recommend, is, if I find a patient getting out of hand, to delay the operation for 15 minutes, and give a hypodermic of morphine. The result is magical, but it is essential that the preparation used should be fresh and active, and that the injection should be rubbed in, so as to secure an early and powerful action. Of course the state of the kidneys must have been ascertained beforehand. The Incision—-The great majority of European operators make an upward incision, which they keep in the limbus throughout its whole extent. A few, like Fuchs and Pagen- sticher, prefer to add a small conjunctival flap. Professor Snellen (junior), of Utrecht, has adopted a sideral incision wholly outside the limbus, and he denies that this procedure increases the risks of vitreous or iris-prolapse. Adelheim, of Moscow, is the only other surgeon I have met who adopts this method of opening the eye. Volckers, of Kiel, who makes a limbus-incision for simple extractions, modifies his method for the combined procedure, and while making his puncture and counter-puncture in the sclerotic brings out his blade at the summit of the clear cornea, thus irresistibly reminding one of Von Graefe's modified linear extraction. Italy was the only country in which I saw purely corneal incisions in use. Professor Sbordone, of Naples, and Professor Scellingo, of Rome, were, indeed, the only two operators in Europe whom I noticed adopting this rare method of commencing an extraction. I could not help observing that, in Sbordone's cases at least, the low placing of the incision led to increased difficulty in delivery of the lens. Another curious feature of Scellingo's technique is that he invariably makes a downward section, believing that it is much easier to deliver through a downward than through an upward cut. Schroeder, of St. Petersburg, and Nordenson, of Stockholm, prefer a downward section in the deeply-sunken eyes of Mongolian patients, in whom they find it difficult to make an upward section. In all ordinary cases, however, they follow the usual rule of working in the superior quadrant of the eve. Rogman, of Ghent, has two peculiarities in the first stage of his operation, viz. :—(1) That lie seizes the conjunctiva, with
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