_Remote._ 1. Panophthalmitis, which must be treated by evisceration.
2. Irido-cyclitis; if this be prolonged, and keratitis punctata appear,
enucleation should be performed.
3. Traumatic cataract; this may subsequently require needling.
4. Detached retina as the result of organization in the vitreous; this
may occur months after the original injury.
=With the giant magnet.= The foreign body should have been previously
localized by the X-rays, and its position and size determined, so that
it may be removed by the shortest possible route and with the least
amount of injury to the eye.
=Instruments.= Giant magnet (Fig. 126), steel spatula. (Watches and
magnetizable metal should be removed from both the patient and the
surgeon.)
=Operation.= Under atropine and cocaine. The patient is at first seated
in a chair some three feet in front of the magnet, the eyelids being
held apart by the surgeon; the electric circuit is closed. The patient’s
head is next gradually advanced towards the magnet. If a foreign body be
present in the eye and be magnetizable, the patient will usually
withdraw his head or cry out with pain, and the foreign body may be seen
bulging forward the iris from the posterior chamber. From this position
it may be removed by manipulating the head and eye in relation to the
magnet so as to withdraw it into the anterior chamber, from whence it is
removed through the entrance wound or an incision at the limbus either
by the giant magnet directly applied to the wound or by magnetizing a
steel spatula which is inserted into the anterior chamber and connected
with the magnet by a flexible steel cable. The small magnet previously
described may be used, or the foreign body removed by means of iris
forceps.
[Illustration: FIG. 126. LARGE ELECTRO-MAGNET. The current is turned on
by means of the foot pedal.]
A piece of steel in the vitreous always travels round the posterior
surface of the lens and through the suspensory ligament, and does not
injure the lens capsule.
=Complications.= These are similar to those described under the small
magnet operation.
CHAPTER V
OPERATIONS UPON THE CORNEA AND CONJUNCTIVA
OPERATIONS UPON THE CORNEA
REMOVAL OF A FOREIGN BODY FROM THE CORNEA
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