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

  • Elliot, Robert Henry, 1864-1936.
Date:
[1903]
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Licence: In copyright

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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    his fixation-forceps, just below his expected point of counter- puncture, instead of in the usual position, and (2) that he appears to cut out with a straight pull instead of sawing out as others do. He is one of the most skilful operators I have ever watched at work. Method of lacerating the Capsule.-Yox this purpose the cystitome remains the favourite instrument. Indeed, I saw it in use in nearly every country of Europe. The use of capsule-forceps, though warmly championed by Fuchs and by De Wecker, does not seem to have recommended itself to the profession. Sbordone, of Naples, and the Duke Carl Theodore and his assistant, Dr. Zenker, were the only other ophthalmologists, beside the two just mentioned, whom I saw using this instrument. De Wecker admits that it is a difficult instrument to work with and that it easily gets out of order. Trousseau, of Paris, lacerates the capsule with his knife-point during incision. This procedure has advocates in England, and I have used it myself in dealing with tough Morgagnian capsules, but it is not likely to be generally adopted, since it tends to sacrifice precision without offering any substantial gain in return. Nowhere out of India have I seen the capsule lacerated with a Bowman's needle before the incision is under- taken, and yet for precision and safety in effecting the needling, for the easy sterilisation of the instrument used, and for the valuable information thus acquired as to the consistency of the cataract, and the size of its nucleus (enabling us to graduate out- size of incision accordingly), this method has to my mind no equal. Before leaving the subject, one must mention Landolt's method, which, if rather quaint, has at least the virtue of thoroughness, a virtue which pervades all this surgeon's work. He uses two sickle-shaped cystitomes, one of whose curves looks to the right, whilst the other looks to the left. These instruments are introduced in turn, and swept across the capsule, which is thus freely lacerated in opposite directions by their curved cutting blades. THE QUESTION OF IRIDECTOMY IN CATARACT-EXTRACTION. This question has been so long discussed that some apology may be needed for bringing it up again. I trust that the V 7675.-2. 1]