File:Atlas and epitome of operative ophthalmology (1905) (14782253772).jpg

Identifier: atlasepitomeofop00haab (find matches)
Title: Atlas and epitome of operative ophthalmology
Year: 1905 (1900s)
Authors: Haab, O. (Otto), b. 1850 De Schweinitz, G. E. (George Edmund), 1858-1938
Subjects: Ophthalmologic Surgical Procedures
Publisher: Philadelphia, New York (etc.) : W.B. Saunders and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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d, was often a source of in-fection ; for we know that the edges of the lids are very frequently themost infected part of the eye. Sometimes, when this method of milk-ing was resorted to, the operation would terminate most disastrously inprolapse of the vitreous, for the peripheral wound was uncomfortablynear the vitreous. As the incision was also very near the ciliary body, inflammation ofthe wound was very apt to be followed by dangerous cyclitis, causingnot only blindness in the operated eye, but not infrequently destroyingthe other eye as well, through sympathetic inflammation. However, postoperative suppuration diminished, and the fact thatiridectomy had to be accepted in this method was less objectionable,because the defect was covered by the upper lid. Owing to the dimin-ished curvature of the incision, the wound healing more rapidly, and theshortened length of the incision were probably chiefly responsible forthe better results that were obtained; for, as we now know, it was a
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18 123 124 OPERATIONS ON THE EYE. mistake to suppose that iridectomy diminishes the danger of postoper-ative inflammation. Nevertheless the danger of this incision caused even a partial returnto the corneal margin, even among many of von Gräfes followers, thusgiving the incision a certain degree of curvature. Iridectomy, how-ever, was retained. During the seventh and eighth decades of the lastcentury, when the knowledge of antisepsis and asepsis and of the use ofmiotics and of cocain was gained, there was a growing tendency toreturn more and more to the old flap incision and to suppress iridec-tomy whenever possible. As the true causes and correct method ofcombating suppuration became better known the dread of such a compli-cation diminished correspondingly. Prolapse of the iris, it was found,could be combated by means of the miotics, especially physostigmin,and it became possible to retain the upper incision because the painof the operation was practically reduced to zero by the use

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