NOTES ON THE EXTRACTION OF CATARACT.*1
THE routine operation for the extraction of cataract has not yet been generally agreed upon, and adherents of one 01 other of the wellrecognised methods still claim the superiority of their own choice above all others. The discus. sion of the subject is rendered difficult to some extent by the paucity of statistics as to ultimate results in long series oj cases, and in this connexion it will probably be a disappointment to many that a record of 200 or 300 consecutive cases i. not forthcoming
... not forthcoming even from the vast number operated on by Lieutenant-Colonel H. Smith, who states that he ha. extracted over 20,000. It is, however, well known that the difficulty of obtaining statistics in India is extremely great, owing to the impossibility of tracing old patients. The operation for the extraction of the cataractous lens in its capsule as performed by Lieutenant-Colonel Smith has aroused such widespread interest, and the publication of his book will probably lead so many ophthalmic surgeons to try his operation, and so many patients to inquire about it, that it may not be out of place to review the various methods of operation now commonly practised, to attempt to appraise their individual merits or demerits, and finally, to hazard an opinion as to whether the older operations for the extraction of cataract have been found wanting. It is the opinion of the writer that no single operation is equally suitable for all cases, but that various features, all of which may have an important bearing on the choice of operation, have to be considered. The possible complications and sequels of the various operations have to be kept in mind, together with the reasons for which the operation was undertaken; and last, but by no means least, the character of the cataract itself. It has long been recognised that success does not follow equally all operations for the extraction of cataract, however uniformly and skilfully they have been performed ; and as the ultimate result of an extraction will depend upon the presence or absence of various important sequelae, it will be probably more profitable to consider these first, and the various methods of operation later.