History of Iridotomy: Knife-Needle vs. Scissors Description of Author’s V-Shaped Method

9781465668837

213 pages

Library of Alexandria

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Overview

To Cheselden has been conceded the honor of being the father and originator of iridotomy. Nearly two centuries have elapsed since he first published the report of his procedure in the Philosophical Transactions for 1728. Ever since that time, his signal success has been acknowledged by all except those who either failed to equal his dexterity, or who were prejudiced by their ambition to originate a new method. A careful review of the medical literature of the century and a half following Cheselden’s announcement can not fail to impress the reader with the great interest attached to operations for the formation of an artificial pupil, which subject was considered second only in importance to that of cataract itself. Not only were a large number of monographs devoted wholly to this subject, but every work on general surgical topics set aside one or more chapters for the discussion of artificial pupil. This is in great contrast to the limited space which modern works on ophthalmology grudgingly yield to this still important subject. It is difficult for us to appreciate the conditions which brought about so large a percentage of cases of pupillary occlusion. Crude surgical procedures, poor operative technic and the utter lack of asepsis often resulted in iridocyclitis or iridochorioiditis. The couching of the lens, the free discission of both hard and soft cataracts, the frequent introduction of the knife-needle through the dangerous ciliary zone, and the bungling efforts at extraction all increased the tendency to inflammatory reaction, while inadequate therapeutics and lack of antiphlogistic measures frequently permitted the deposit of plastic exudate in the pupillary area, thus resulting in membranous occlusion of the pupil.