Case 2.--_History._--J. S., aged 30 years. O. S. injured and
enucleated. O. D. sympathetic inflammation, chorioidal cataract;
three discissions and one iridectomy, down and in. Membranous
occlusion of pupil. I first saw him in 1888 while house surgeon at
the Wills Hospital, where iridotomy was skilfully performed nine
times by one of the surgeons, the methods being varied and ingenious,
but without success, as the incision was invariably closed by plastic
exudate. My interest in this series of operations first drew my
attention to the subject of iridotomy, and stimulated me to develop
the method I have here submitted and which I first tried in Case 1.
One year later this patient came to my clinic at St. Joseph’s
Hospital. Iris was discolored, capsule thickened and visible through
the coloboma, down and in; areas of scleral thinning, with pigmented
chorioid showing through. T--3. Light perception good, projection
only fair.
_Operation._--On June 17, 1889, I made a V-shaped iridotomy along the
outlines of the former iridectomy. The membrane freely opened up into
a triangular or pear-shaped pupil (Fig. 43), which proved permanent,
but was only useful for quantitative vision, about 5/200. No further
test could be made because the disorganized vitreous was filled
with floating masses. I have seen him within a year, going about
and earning his living. From an operative standpoint I have always
considered this early effort one of my most successful cases, chiefly
because of the great density of the iris-membrane and the lowered
tension of the eyeball.
[Illustration: Fig. 43, (Case 2).--Iridotomy in a soft eyeball, with
dense iris-membrane.]
Case 3.--_History._--Mrs. A. D., aged 45 years. O. D. iridectomy
for glaucoma seven years ago. O. S. iridectomy two years ago by
another surgeon, at which time there occurred slight incarceration
of iris, followed by sympathetic ophthalmitis in O. D. The severe
iridochorioiditis resulted in cataract and some shrinkage of globe.
The cataracts were extracted from both eyes in 1907, followed by
dense opacity of cornea above, iris bombé, shallow anterior chamber,
T--2. Here was a soft, distensible, iris tissue with shallow anterior
chamber and greatly lowered tension of the eyeball, constituting one
of the most difficult conditions to operate on.
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