File:Atlas and epitome of operative ophthalmology (1905) (14782610945).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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introduced into the upper part of the anterior chamber,making a corneal incision, the size of which is gauged bythe size of the nucleus of the cataract and the size of thecornea. The darker and more yellow the nucleus appearsthrough the small quantity of cortical matter, the largerit will be. If, on the other hand, the cortical materialrepresents a thick layer surrounding the nucleus, as, forexample, in young individuals, such a condition betraysitself by the fact that the grayish, translucent, rathermilky coloration extends deep into the cataract. Thediameter of the cornea also may be quite variable. The,cornea may be small without the cataract behind it neces-sarily being small also, and in such cases it is speciallyimportant not to make the incision too small. The heightof the flap must be increased, and the incision must, ifpossible, lie entirely within the scleral border. If thecornea is large, as is sometimes the case in myopic eyes,the flap need not be so high as shown in Plate 2, espe-
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OPERATION FOR SENILE CATARACT. 137 cially if marked myopia is actually present. In a myopiceye of this kind it is important to guard against the lossof any vitreous material, the danger of which is greaterwhen the incision lies within the scleral border. It istherefore advisable in these cases to keep the incisionentirely within the cornea. It appears, therefore, that inmaking the incision for cataract extraction it is necessaryto individualize; but it is always better to make theincision somewhat too large than too small. Having carefully noted the points where the instrumentis to enter and to emerge, the knife (which is held like acoffee spoon) is rapidly carried through the anterior cham-ber, in doing which the operator must not bear heavilywith his hand on the patients head and, if possible, shouldnot support his hand at all. The incision is then com-pleted by drawing the knife backward and forward—thatis, by a sawing movement, closely following the cornealborder. Beginners, in

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