Excerpt from A Report of Fifty Cases of Extraction of Cataract Without Iridectomy

Immediately on the delivery of the lens I refused to manipulate the eye further than to lift the upper eyelid and observe the cornea deeply sunken into the globe, but in fair coaptation and with no prolapsus of the iris. This patient recovered without excessive reaction, but vitreous opacities were found. The vision was Q. I could not ao count for the loss of vitreous in this case and also in the subsequent one. The latter, which is recorded as a failure, showed nothing unusual in the extraction until after the expulsion of the lens, when the Bowman spoon was used in manipulating the cornea so as to more perfectly restore the dislocated iris, the wound suddenly widely gaped, and from one quarter to one third of the vitreous suddenly es caped. No speculum was used; the eye was looking to the front, there was absolutely no faulty conduct on the part of the patient, and I could not in the least account for the accident. No violent reaction occurred; the pupil was drawn far upward without prolapsus or incarceration, but there has been circumcorneal injection and some photo phobia most of the time since the operation, and the eye ball shows diminished tension. At one time the vision was $33, but three months afterward it is not more than counting fingers at four feet.

I can not but feel that extraction of cataract is some times an exciting cause of sympathetic Ophthalmia. Some years since, I reported to this society several cases of sym pathetic Ophthalmia following extraction of cataract. In this list of fifty extractions I had one case of extraction in the right eye, with no unusual reaction, but which was followed in two months by exudative iritis, with diminished tension in the left eye. Some of my colleagues did not re gard this as a case of sympathetic Ophthalmia.

In another of these cases a perfect extraction was done with a high visual result, and no secondary operation. In two years the patient returned to the hospital with the fel low eye far advanced in phthisis from iridochorioiditis, with no explanation of the cause of the trouble, except the Opera tion on the fellow eye. The eye was red and irritable, and en'ucleation was at once done.

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