Reviews and Notices

1890 BMJ (Clinical Research Edition)  
June 21, 1890.] THE BRITISH MEDICAL JOURNAL. 1429 the iris to the capsule, which easily gave way to atropine. The lens generally came away very cleanly, leaving a clear pupil, and no after-needling was required.-Dr. HILL GRIFFITH (Manchester) had done the operation in 28 cases, but always by direct trituration by means of a silver spoon introduced through the iridectomy wound. In 24 of these cases, no result whatever was produced in 13, or just over a half, and in one of these partial
more » ... n of the lens took place; this was the only mishap he had had from the operation. In the remaining 11 cases rapid maturation was effected, followed by extraction, with slight loss of vitreous in one case only. Good vision was ultimately obtained in all, but convalescence was very tedious from retention of cortex. The operation was useless for dealing with opacities which had no natural tendency to progress, as he had proved in zonular cataract and cart-wheel-like opacities in the posterior layers of the lens, and he had been disappointed in several cases of exceptionally slow growing cataracts, so that he thought that the cases in which the procedure might be of use were not so frequent as Mr. MeHardy's statistics seemed to indicate.-Mr. BRAILLY thought the question required very careful examination, first on account of the limited applicability of the method, and secondly with regard to the ethics. In many cases the condition of the lenses did not seriously interfere with the occupation and progressed extremely slowly. Of 82 immature cataracts seen in one year and a-half 26 were seen a second time, and of these only four required operation, and only four others had progressed appreciably. In many vision had actually improved, probably through a diminished use of the eyes. The ethics of the question also deserved careful consideration. Iridectomy had been introduced as a panacea for everything, and had brought operating to some extent into disrepute. Many cases operated on when immature would probably not have advanced if left alone.
doi:10.1136/bmj.1.1538.1429 fatcat:4dfopvzsafhyhctr2ztsqanquy