The Indian operation of couching for cataractElliot, Robert Henry
History
The Indian operation of couching for cataract
Elliot, Robert Henry
Cataract -- Surgery -- India; Ophthalmology -- India -- History
(4) In No. 108 the only evidence of lens material present was the
capsule of a Morgagnian cataract, which lay impacted in the lower part
of the anterior chamber (Pl. II., Fig. 13). On section, Morgagnian
fluid escaped, and no trace of a nucleus could be detected. It is of
interest to record that the writer has, on a number of occasions,
operated on Morgagnian cataracts in which the lens nucleus had been
reduced to the thickness of a lamellar disc, or in which no trace of a
nucleus could be detected. In this case no adhesions had formed, and
during the transit of the specimen to England the capsule fell from its
position to the bottom of the bottle.
PLATE II
Fig. 10: Specimen No. 8, Whole-Section.--The lens can be seen
dislocated between the ciliary body and the sclera; the pectinate
ligament had been ruptured at the operation.
Fig. 11: Specimen No. 44.--The small Morgagnian nucleus lies in the
anterior part of the vitreous chamber; it passed freely between this
and the aqueous chambers, sometimes appearing in the one, and sometimes
in the other. The scar of the operation wound can be seen in the lower
part of the illustration, close to the ciliary body. Notice the folds
into which the detached retina has been dragged by the shrinking
inflammatory exudate. A tongue, consisting of the posterior surface of
the iris, was stripped back at the time of operation, and can be seen
attached posteriorly to the front of the hyaloid body.
Fig. 12: Specimen No. 61.--A small dark Morgagnian nucleus lies
impacted in the lower angle of the anterior chamber, which is largely
filled by a flocculent coagulated exudate. Notice the coagulated
subretinal exudate, and the cyst in the outer wall of the lower part of
the retina.
Fig. 13: Specimen No. 108.--The capsule of a Morgagnian lens lies
impacted in the angle of the anterior chamber; it had contracted no
adhesions. The vitreous body is represented by a fine cone of exudate,
which stretched forward from its apex at the optic nerve to a broad
base at the ora serrata.
Fig. 14: Specimen No. 50.--A large Morgagnian cataract floated free in
the vitreous chamber. The retina is extensively detached.
Fig. 15: Specimen No. 136.--A large hard laminated lens lies lightly
imprisoned in the inflammatory exudate which formed in the vitreous
body. A long curved scar can be seen over the ora serrata at the
temporal side of the specimen.
[Illustration: PLATE II.
Fig. 10 (No. 8).--Lens dislocated between cil. body and sclera.
Fig. 11 (No. 44).--Left eye, lower half.
Fig. 12 (No. 61).--Left eye, temporal half.
Fig. 13 (No. 108).--Right eye, nasal half.
Fig. 14 (No. 50).--Right eye, lower half.
Fig. 15 (No. 136).--Left eye, upper half.]
=Backward Dislocations.=--Dislocations backward are the rule, and very
wide variations are found both in the completeness and in the direction
of the displacement.
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