Extraction of Cataract with- 
out Iridectomy. 
Report of One Hundred Cases, with 
Remarks. 
CHARLES STEDMANBULL, M. D., 
PROFESSOR OF OPHTHALMOLOGY IN THE UNIVERSITY OF 
THE CITY OF NEW YORK J SURGEON TO THE NEW 
* YORK RYE AND EAR INFIRMARY J CON- 
SULTING OPHTHALMIC SURGEON TO 
st. luke's hospital. 
REPRINTBD FROM 
Oe Neto ¥ovfe fHetoca! JFournal 
for November 2, 1889. Reprinted from the New York Medical Journal 
for November 2, 1889. 
EXTRACTION OF CATARACT WITHOUT IRIDECTOMY. 
HE POUT OF ONE HUNDRED CASES, WITH REMARKS* 
By CHARLES STEDMAN BULL, M. D., 
PROFESSOR OF OPHTHALMOLOGY IN THE UNIVERSITY OF THE CITY OF NEW YORK; 
SURGEON TO THE NEW YORK EYE AND EAR INFIRMARY ; CONSULTING 
OPHTHALMIC SURGEON TO ST. LUKE'S HOSPITAL. 
Within the last three years the old method of the ex- 
traction of cataract without iridectomy, which was formerly 
devised and practiced by the French surgeon Daviel, and 
called by him " simple extraction," has been revived by 
Panas, Wecker, and others, and has been in many quarters 
hailed with all the eclat of a new operation. Most of the 
modern French authors report very enthusiastically in its 
favor, but none of them have as yet given us any detailed 
or conclusive statistics in regard to the results obtained, nor 
any comparative statements as to the advantages of the 
"simple operation " over those of the so-called "linear ex- 
traction with iridectomy " devised by von Graefe, and prac- 
ticed almost universally with great success for the last 
twenty-five or thirty years. 
The ideal operation for the extraction of cataract is un- 
doubtedly the removal of the lens in its capsule through a 
corneal section, and without wound or excision of the iris; 
* Read before the New York State Medical Association, September 
27, 1889. 2 
EXTRACTION OF CATARACT 
and the restoration of sight in this manner, with the preser- 
vation of a round and movable pupil, is certainly to be re- 
garded as one of the greatest of operative achievements. 
Sufficient time has now elapsed since the revival of the 
old " simple operation " to enable us to draw some conclu- 
sions as to the merits of this method of operating and the 
results obtained, in so far as the ultimate vision is con- 
cerned ; and the writer now presents to the association for 
their consideration his own experience in one hundred cases 
of extraction of cataract by the simple method without 
iridectomy. 
As a firm believer in the value of antiseptics in ophthal- 
mic surgery, the reporter deems it wise to give in detail all 
the steps which he considers necessary in the operation, 
from the preparation of the patient for the operation to the 
final testing of the vision and the discharge of the case from 
observation. 
Preparation of the Patient.-If the patient be a hos- 
pital case, he should have a bath of the entire body the day 
before the operation, special attention being paid to the 
cleansing of the hair and beard with soap and water. This 
is not considered necessary in the case of a private patient. 
On the day of operation the patient's face should be care- 
fully washed with soap and water, and just before the opera- 
tion the face should be laved with Panas's solution of the 
biniodide of mercury, or with a solution of mercuric bichlo- 
ride (1 to 5,000), or with a saturated solution of boric acid, 
and the latter solution should be used for irrigation of the 
conjunctival cul-de-sac. The patient should be placed in the 
bed which he is to occupy throughout the entire course of 
treatment, so as to avoid all unnecessary moving about. This 
precaution reduces to a minimum the dangers which may 
arise from prolapsed iris, opening of the wound, loss of 
vitreous, haemorrhage, etc. WITHOUT IRIDECTOMY. 
3 
After the necessary local anaesthesia has been produced 
by a few drops of a five-per-cent, solution of cocaine hydro- 
chloride, the conjunctival cul-de-sac is again thoroughly irri- 
gated with the boric-acid solution, and the patient is then 
ready for the operation. 
The instruments have previously been cleansed and 
sterilized in boiled water, and have been placed in a bath of 
absolute alcohol. From this bath they are taken wet as they 
are wanted for the operation. The hands of the operator 
and of the assistant, if he has any, are carefully cleansed 
with soap and water, and then washed with a solution of 
sublimate (1 to 2,000). Some operators prefer Panas's solu- 
tion for purposes of cleansing and irrigation ; this consists 
of mercuric biniodide, 0'05 gramme ; alcohol, 20 grammes ; 
and distilled water, 1,000 grammes. 
The surgeon should sit behind his patient, and should 
operate on the right eye with the right hand and on the 
left eye with the left hand. In this way he is never in 
his own light. If he is not naturally ambidextrous, he 
should strive to make himself so. A speculum is then in- 
troduced to hold the lids open, and the eyeball is firmly 
grasped with a fixation forceps, the latter being made to 
seize the conjunctiva and subconjunctival tissue over the 
insertion of one of the straight muscles of the eye. 
A straight, narrow knife, somewhat more slender than 
the cataract knife of von Graefe, is then introduced on the 
temporal side in clear cornea, near the limbus, and is passed 
quickly across the anterior chamber, horizontally in front of 
the iris, and is brought out at a corresponding point in clear 
cornea on the nasal side, and the incision is then completed, 
if necessary, by a to-and-fro movement. The length of the 
incision should involve about two fifths of the circumference 
of the cornea. 
Some operators, in completing the corneal incision, make 4 
EXTRACTION OF CATARACT 
a small conjunctival flap as a protection against secondary 
infection from the conjunctival cul-de-sac. I never make 
such a flap if it can be avoided, as I regard it as a useless 
complication unless the patient has a chronic conjunctivitis 
or dacryocystitis; and it undoubtedly increases the danger 
from primary infection by enlarging the wound. In mak- 
ing the corneal section, care should be taken to pass the 
knife quickly across the anterior chamber and thus com- 
plete the section as rapidly as possible. This prevents al- 
most entirely the escape of aqueous humor, and there is but 
little danger that the iris will fall over the edge of the knife 
and be divided. 
If the iris prolapse outside of the wound as soon as the 
section is completed, it is better to restore it to its place in 
the anterior chamber before opening the capsule. The cap- 
sulotome or angular cutting needle is then introduced and 
carried well behind the inferior margin of the sphincter of 
the iris, and the capsule is then lacerated by a T-shaped in- 
cision or, better, by a quadrilateral one, care being taken 
to avoid wounding the iris. 
The extraction of the lens now follows. This is effected 
by pre.-sure on the eye above the wound and counter-pressure 
on the lower portion of the cornea with a spatula or rubber 
spoon. This causes a gaping of the wound and a revolu- 
tion of the lens upon its horizontal axis, the upper margin 
of the lens coming forward and presenting in the wound. 
A brief continuance of this pressure and counter-pressure 
causes the extrusion of the lens and a more or less exten- 
sive prolapse of the iris. It is perhaps safer to remove the 
speculum before this manoeuvre is attempted, so as to avoid 
as far as possible the danger of prolapse of the vitreous. 
This should always be done in cases of complicated cataract, 
especially when the suspensory ligament is defective and 
the vitreous disorganized, or the lens partially dislocated. WITHOUT IRIDECTOMY. 
5 
The next step-a very important one-is the removal of 
the remnants of soft lens matter or cortex, if there are any, 
from the anterior chamber. This is best done by pressure 
with the fingers upon the eyeball through the closed lids; 
or by curette, or spoon, or spatula, by repeated slow move- 
ments of the instrument over the cornea from below upward 
toward the wound; or by repeated and continuous rotarv 
massage of the lids upon the eyeball. These manoeuvres 
should be accompanied by frequent irrigation of the con- 
junctival cul de-sac, and even of the anterior chamber, by a 
warmed saturated solution of boric acid or by Panas's fluid. 
Tt is very rarely necessary to introduce any instruments 
into the anterior chamber. 
The next step is the replacing of the prolapsed iris. If 
the iris has not spontaneously reduced itself during the 
manipulations employed for removing the lens fragments 
from the anterior chamber, it may be readily replaced 
or reduced by a gentle stroking with a smooth probe or 
spatula. If on reduction of the prolapsed iris the pupil is 
neither central nor round, some surgeons consider it ad- 
visable to do an iridectomy at once, so as to avoid the ne- 
cessity of doing it later. But it is much better to so choose 
your cases for simple extraction as to exclude all such cases 
as may possibly necessitate an iridectomy. 
For irrigation of the anterior chamber any small lac- 
rymal syringe may be used, but it should always be steril- 
ized and kept exclusively for the purpose. The nozzle 
should be introduced between the lips of the wound, and 
the fluid used should be injected very slowly and gently 
and in small quantities. 
The final steps in the operation before the application 
of the bandage are a careful irrigation of the lids and con- 
junctival cul-de-sac with the boric-acid solution and the in- 
stillation of a few drops of a solution of eserine sulphate 6 
EXTRACTION OF CATARACT 
(half a grain to the ounce) into the cul-de-sac, or the appli- 
cation of an ointment of eserine of the same strength. 
This causes a contraction of the pupil, and thus aids in 
preventing a secondary prolapse of the iris. 
The lids of both eyes are then closed, carefully and 
smoothly covered with a wad of antiseptic cotton, and a 
double roller flannel bandage applied over both eyes. 
The after-treatment varies somewhat with the nature of 
the case and the temperament of the patient. The patient 
is to be kept in bed on an average for three or four days, 
lie is allowed to sit up while eating and to rise from bed 
to satisfy the calls of nature. The room need not be dark- 
ened. It is my custom usually to remove the bandage and 
dressing on the next day, but without opening the eyes. 
The edges of the lids are to be gently cleansed with a satu- 
rated solution of boric acid or a solution of mercuric bi- 
chloride (I to 5,000), and a drop of a solution of eserine 
sulphate is to be introduced. If there is much mucous 
secretion or any swelling of the lids, the lids are opened, 
the eyeball and conjunctival cul-de-sac are carefully irrigated 
with the boric acid solution warmed, and then the eye is 
carefully inspected. If, on the contrary, the lids look well, 
the eye is not inspected until the fourth or fifth day, but 
the dressings are renewed and the lids cleansed daily. If 
on the fourth or fifth day the pupil is round and central, 
the eye is carefully cleansed, and, if the wound has closed 
throughout, the bandage is discontinued except at night, 
and then is used only on the operated eye. The eye not 
operated upon is usually left uncovered after the second 
or third day. If the pupil is round and central and the 
wound closed, but circumcorneal injection or pain is pres- 
ent, a weak solution of atropia should be used at once 
several times a day until both these symptoms have sub- 
sided. WITHOUT IRIDECTOMY. 
7 
A few words now in regard to the accidents which may 
occur in the course of the operation : 
1. The iris may fall upon the edge of the knife in its 
passage across the anterior chamber, and may be wounded 
or excised as the corneal section is completed. This acci- 
dent may happen to any surgeon. The rapid passage of 
the knife across the anterior chamber to its point of exit in 
the cornea on the opposite side, and the avoiding of any 
undue pressure on the eyeball by the fixation forceps, will 
go far toward preventing the occurrence of this accident. 
The rapid completion of the corneal section also aids in this 
endeavor. Should the iris be cut or excised in this first 
step of the operation, an iridectomy must be done at once, 
and the artificial pupil thus made clean and smooth. 
2. Prolapse of the Vitreous.-This may occur at any 
period during the operation, and is always a misfortune 
In the hands of a careful operator it is usually slight, and 
need not interfere with the usual careful manipulations for 
causing the extrusion of the lens. Any portion of vitreous 
that remains in the wound after the lens has been removed 
must be cut off, and great care must then be exercised in 
any manoeuvres undertaken for extracting the remains of 
cortex from the anterior chamber. It is well, also, in such 
cases, to avoid all irrigation of the anterior chamber, as it 
will be very apt to increase the loss of vitreous. Should 
the vitreous prove to be fluid and the prolapse extensive, 
the lens should be removed at once, either with the blunt 
hook or spoon, and the eyelids at once closed temporarily 
for a few minutes. Then the iris should be replaced, eser- 
ine instilled, and both eyes closed with the usual antiseptic 
dressings and bandage. 
3. More or Less Extensive Haemorrhage into the Anterior 
Chamber.-This may be in great part prevented by avoid- 
ing the conjunctival flap. If the haemorrhage comes from a 8 
EXTRACTION OF CATARACT 
wounded iris, the latter is to be smoothly excised, and then 
the further steps of the operation are to be interrupted un- 
til the haemorrhage has been controlled and the blood, as 
far as possible, removed from the anterior chamber, as its 
presence interferes with the proper opening of the capsule 
and the removal of the lens. 
Complications or Anomalies of the Healing Pro- 
cess.-There are several of these complications, which will be 
considered in the order of the frequency of their occurrence : 
1. Posterior synechiae or adhesions of the posterior sur- 
face of the iris to the remains of the anterior capsule of the 
lens. These are very common, and are in many case fili- 
form or thread-like in character. They rarely obstruct the 
pupillary area. They are caused by the edges of the lacer- 
ated anterior capsule coming in contact with the pupillary 
margin of the iris, which has already been bruised in the 
passage of the lens through the pupil. These adhesions oc- 
cur independently of any actual iritis. 
2. Iritis, usually of the mild, plastic type, and very 
often involving only a segment of the circumference of the 
iris. This is best combated by a weak solution of atropine 
and warm applications. 
3. More or Less Complete Obstruction of the Field of the 
Pupil by the Opaque or Thickened Posterior Capsule of the 
Lens.-This is a very qommon complication of the healing 
process, and usually requires some operative interference 
-such as discission or some more serious surgical pro- 
cedure, to be described later. 
4. A more or less irregular pupil, usually oval, caused 
by a puckering of the iris in the upper part of the angle of 
the anterior chamber, without there being any actual ad- 
hesion or incarceration of the iris tissue in the lips of the 
corneal wound. For this there seems to be no remedy of 
any actual value. WITHOUT IRIDECTOMY. 
9 
5. Incarceration of the iris in the corneal wound, or else 
merely anterior synechia;, a more or less marked adhesion 
of the iris to the inner lips of the wound. The use, once or 
twice a day, of a drop or two of a half-grain solution of 
eserine sulphate sometimes succeeds in breaking these ad- 
hesions, though more frequently it does not succeed; and 
it may prove disadvantageous by causing irritation of the 
iris, and thus increase the chances of posterior synechiae. 
6. Secondary Prolapse of the Iris.-If this occurs early 
and it can not be reduced, it should be cut off as neatly as 
possible, and the edges gently stroked into place in the an- 
terior chamber. If the wound has already partially closed 
and the prolapse of the iris is a late occurrence, it is better 
to leave it undisturbed by any manipulation. This second- 
ary prolapse of the iris is almost always of traumatic origin, 
from some sudden jar or displacement of the bandage on 
the part of the patient, and its prevention depends largely 
on careful nursing. Great care in operating and the rigid 
exclusion of all unsuitable cases-such as rigidity of the 
iris, prolapse of the vitreous, dislocation of the lens, or un- 
manageable patients-will all undoubtedly aid in reducing 
the cases of secondary prolapse of the iris to a minimum. 
7. Capsulitis, or Inflammation of the Capsule of the 
Lens.-This is almost always of the mildly plastic charac- 
ter, and is usually associated with the mild form of iritis. 
Should it prove to be of the suppurative type, it is almost 
invariably accompanied by a purulent inflammation of the 
iris and infiltration of the tissue of the cornea in the vicin- 
ity of the wound, and is always the result of secondary in- 
fection from without. 
8. Suppuration of the Lips of the Wound in the Cornea. 
-This is always the result of secondary infection, and, if 
not combated at once, may end in total loss of the eye 
from suppurative panophthalmitis. Its cause is usually some 10 
EXTRACTION OF CATARACT 
chronic inflammation of the palpebral conjunctiva or lacry- 
mal sac, and it should be treated at once by a removal of 
the dressings and bandage, frequent irrigation of the wound, 
eyeball, and cul de-sac with a hot solution of mercuric bi- 
chloride (1 to 5,000), and prompt cauterization of the en- 
tire length of the wound by the galvano-cautery. This 
may be repeated daily, if the surgeon deem it necessary, as 
long as it seems to influence the course of the suppurative 
process. If the latter increases in extent, in spite of hot 
applications and the cautery, the latter docs no good, and 
should be discontinued. 
Secondary or After-Operations.-An important fac- 
tor in the restoration of good visual acuity in cases of cataract 
extraction is the performance of what are called secondary 
or after operations. These are usually of two kinds: 1. 
Discission or laceration of the posterior capsule. 2. Excis- 
ion of a piece of thickened capsule or of a piece of mem- 
branous tissue, composed of thickened capsule and the 
products of inflammatory exudation. The gain in sight 
from a secondary operation is often very great. 
1. Discission or laceration of the posterior capsule is 
very often, perhaps in the majority of cases, necessary, but 
sometimes is dangerous. It is a delicate operation, requir- 
ing great nicety in manipulation, good judgment and per- 
fect sight on the part of the surgeon, a sharp knife-needle, 
and a good light. It is sometimes necessary to employ 
the electric light in this delicate operation. The capsule 
may be lacerated by a simple stop-needle with a double 
cutting edge, but by far the best instrument is a slender, 
sharp, curved knife-needle, with a sharp point and a curved 
cutting edge, shaped something like a sickle. This is 
plunged through the cornea on either side, near the limbus, 
and the capsule is then lacerated by a single vertical or 
transverse stroke of the blade, or, if necessary, a crucial in- WITHOUT IRIDECTOMY. 
11 
cision is made through the capsule. Under cocaine, this 
may be done by a good operator without the employment 
of fixation forceps, and this is an advantage, as all undue 
pressure upon the eyeball is thus avoided. The danger of 
the operation is proportionate to the density and duration 
of the pupillary capsular membrane. A capsule which is 
not thickened by the products of inflammation can be lacer- 
ated easily and without danger; but pseudo-membranous 
opacities resulting from iritis or iridocyclitis must be ap- 
proached with caution. This leads to a brief consideration 
of the second variety of after-operation. 
2. Excision of a Piece of Thickened Capsule or of a 
Pseudo membrane, and its Removal from the Field of the 
Pupil and the Interior of the Eye.-This may be done by 
making an incision in the cornea near the limbus, and em- 
ploying the narrow cataract knife or Beer's triangular knife 
to cut out a triangular piece of the opaque membrane, and 
its removal by Tyrrell's blunt hook, or by the introduction 
of Wecker's knife-scissors through the corneal wound, and 
the excision and removal of a triangular piece of membrane. 
This is an extremely delicate, somewhat difficult, and dan- 
gerous operation, as the operation may set up a fresh attack 
of iritis or iridocyclitis, with possibly subsequent closure of 
the gap made by the knife, or somewhat rapid phthisis bulbi 
or atrophy of the globe. 
Some variations in the general technique of the opera- 
tion of extraction of cataract without iridectomy have been 
proposed by different surgeons. Banas always employs an 
alcoholic solution of the biniodide of mercury as an anti- 
septic fluid for the irrigation of the anterior chamber. Some 
writers have used a solution of mercuric bichloride (1 to 
10,000) for the same purpose. Knapp found that when 
small quantities of the latter were employed there was no 
reaction, but that the injection into the anterior chamber of 12 
EXTRACTION OF CATARACT 
moderate quantities was followed by more or less transient 
opacity, appearing in patches on the posterior surface of the 
cornea. He has therefore abandoned its use in favor of 
Panas's fluid or a saturated solution of boric acid. 
Most surgeons make the incision in the cornea in its 
upper section, and this is undoubtedly wise, as the chances 
of secondary prolapse of the iris or loss of vitreous are much 
diminished, and because the corneal scar, if there be any, is 
partially concealed by the norma] position of the upper 
lid. 
Another modification of the technique of the operation 
as described in this paper is in the manner of opening the 
capsule, which consists in lacerating the capsule with the 
point of the cataract knife while making the corneal incis- 
ion. This is the revival of a method practiced many years 
ago by Wenzel and other German surgeons, the capsule be- 
ing split horizontally in the upper portion of the pupillary 
space. It was thought that it simplified the operation of 
extraction, and it certainly demands one instrument the less. 
It is a difficult manoeuvre to perform, and may cause the 
corneal wound to be irregular and even ragged, and thus 
protract the healing process. If the capsule were thick, the 
knife would probably fail to penetrate it, and there would 
be some danger of causing rupture of the zonule and dislo- 
cation of the lens. It would be a very difficult manoeuvre 
if the pupil were narrow and the anterior chamber shallow, 
and the iris would probably be wounded in such a case. In 
the opinion of the writer, this method of opening the cap- 
sule should be abandoned. 
Comparison of the Two Methods of extracting Cataract, 
with and without Iridectomy.-The advantages of simple 
extraction without iridectomy are as follows : 
1. It preserves the natural appearance of the eye, a cen- 
tral, circular, and movable pupil. WITHOUT IRIDECTOMY. 
13 
2. The acuteness of vision, other things being equal, is 
greater than after the old operation. 
3. Eccentric vision and orientation are much better than 
by the old operation. 
4. Small particles of capsule are not so likely to be in- 
carcerated in the wound, and thus act as foreign bodies and 
excite irritation. 
5. The necessity of after-operations is probably not so 
great as after the old operation. 
The disadvantages of simple extraction are as follows : 
1. The .technique of the operation is decidedly more dif- 
ficult. The corneal section must be larger in order that the 
extrusion of the lens may be facilitated, as the presence of 
the iris acts as an obturator or obstacle to its passage. The 
corneal section must be performed rapidly so as to avoid the 
danger of the iris falling on the knife and being excised. 
The cleansing of the pupillary space and the posterior 
chamber is much more difficult than after the old opera- 
tion. 
2. Posterior synechiae, secondary prolapse, and incar- 
ceration of the iris are more frequent than after the old 
operation. 
3. The operation is not applicable to all cases. This 
objection, however, applies to all operations. 
Indications for performing Iridectomy.-The indications 
for performing an iridectomy in cases of cataract extraction 
may be formulated as follows : 
1. When the vitreous is fluid or the zonula is ruptured, 
causing non-presentation of the lens and prolapse of the 
vitreous. 
2. Insufficient length of the corneal section with pro- 
lapse of the iris. 
3. Bruising of the iris during the operation. 
4. A stiff, unyielding sphincter iridis. 14 
EXTRACTION OF CATARACT 
5. Irreducible prolapse of the iris after the completion 
of the operation. 
A few words in regard to the wisdom of the employment 
of general antiseptic rules. 
1. The removal and exclusion, as far as is possible, of all 
bacteria by the employment of unirritating, aseptic fluids 
for all purposes of cleansing and irrigation, the best of these 
beintr boiled water or boiled boric-acid solution. 
2. The employment, whenever necessary, of some really 
valuable antiseptic solution, such as chlorine-water, mercuric 
bichloride, or silver nitrate, the indications for their use 
being the appearance of the slightest muco-purulent secre- 
tion from the conjunctiva, or cloudiness of the lips of the 
wound. 
3. The fearless employment of the galvano-cautery to 
the whole length of the corneal wound, if the lips of the 
wound show any signs of infiltration. 
4. The performance of the operation with the most ex- 
treme neatness and accuracy, and with the minimum of 
traumatism. 
5. Endeavor to obtain primary union of the wound by 
careful removal from between the lips of the wound of all 
foreign substances, and by perfect coaptation of the edges, 
and the maintenance of the most complete immobility of the 
organ possible until the wound is firmly closed. 
Of the one hundred eyes on which this operation of the 
" simple extraction " of cataract was performed, useful vision 
was regained in all save one. This case was that of a patient 
whose eye had been rendered entirely blind by frequent at- 
tacks of irido-chorioiditis, and the lens was removed simply 
to allay the severe pain, and possibly to aid in quieting the 
inflammatory process. Not a single eye was lost from sup- 
puration. 
Fifty-two of the patients were males and forty-eight WITHOUT IRIDECTOMY. 
15 
were females. The youngest patient was thirteen years old 
and the oldest was eighty-seven. The complications exist- 
ing were as follows : Corneal macula or opacity in nine 
cases, broad arcus senilis in nine cases, old chorio-retinitis 
in six cases, chronic Bright's disease in five cases, chronic 
bronchitis and asthma in four cases, diabetes mellitus in 
two cases, dilated and immovable iris from a contused 
wound in two cases, conjunctivitis and marginal blepharitis 
in two cases, irido-chorioiditis and blindness in one case, 
posterior synechiae from old iritis in one case, pulmonary 
phthisis in one case, and hypertrophy and valvular disease 
of the heart in one case. 
The reduction of the prolapsed iris after the extraction of 
the lens occurred spontaneously in fifty-six cases, and the 
iris was replaced by the spatula in forty-four cases. In 
eighty-three cases there was neither incarceration nor 
secondary prolapse of the iris. In fifty-three cases there 
were no posterior synechiae or adhesions of the iris to the 
lacerated capsule. In forty-seven cases these adhesions 
were present, and in ten of these they were due to plastic 
iritis. 
The healing process was normal in eighty-six cases, 
though in some the process was very slow, especially in the 
closure of the external lips of the wound. 
Iritis of the mild plastic type occurred in ten cases, and 
retraction of the iris toward the ciliary processes in three 
cases. There was loss of corneal epithelium in two cases, 
and " striped " keratitis in one case. The wound be- 
came infiltrated in three cases, necessitating the use 
of the galvano-cautery. Chorioiditis and hyalitis oc- 
curred in two cases, and irido-chorioiditis with occlusion 
of the pupil also in two cases. Capsulitis followed in one 
case. 
The accidents which occurred during the operation were 16 
EXTRACTION OF CATARACT. 
as follows: 1, loss of vitreous in thirteen cases; 2, haem- 
orrhage into the anterior chamber in two cases; 3, com- 
plete collapse of the cornea in two cases; 4, dislocation of 
the lens in three cases; 5, the lens was removed with the 
blunt hook in five cases. 
The duration of the treatment varied from eleven 
days, the shortest period, to forty-seven days, the longest 
period. 
Secondary or after operations were done in fifty-three 
cases-discission or laceration of the capsule in fifty cases, 
and excision of a piece of capsule or pseudo-membrane in 
three cases. 
The resultant degree of vision in the one hundred cases 
was as follows: In six cases, ; in thirteen cases, ; in 
twenty-four cases, ; in twenty-two cases, in twenty- 
one cases, in ten cases, in two cases, ; counting 
fingers at several feet in one case. No perception of light 
in one case, eye previously blind for many years. | No. 
X* 
o 
CD 
0 
bD 
Nature 
of 
cataract. 
Complica- 
tions. 
Operation. 
Reduc- 
tion of 
iris. 
Healing process. 
Second'ry 
prolapse 
cr incar- 
ceration 
of ins. 
Poste- 
riorsy- 
nechiae. 
Duration of 
treatment. 
Pri- 
mary 
vision. 
Secondary operation. 
Ulti- 
mate 
vision. 
1 
F 
68 
Senile, hard. 
Broad arcus 
L. E., prolapse of vitreous 
By spat- 
"Striped " keratitis ; 
None. 
One. 
Days 
23 
20/200 
Discission of poste- 
rior capsule 4 weeks 
later. 
20/50 
L. E. 
senilis. 
at moment of capsuloto- 
my ; lens removed by 
ula. 
slow healing of lips of 
wound. 
hook ; collapse of cornea; 
haemorrhage into ante- 
rior chamber. 
M 13 
Traumatic 8 
mos. before ; 
Tremulous 
iris ; dilated 
pupil. 
Normal, except slight loss 
of vitreous after extra- 
Sponta- 
Normal. 
None. 
Two. 
15 
20/50 
20/40 
neons. 
R. E. 
sion of lens. 
3 
F 
26 
Traumatic; 
blow f'm cork 
None. 
Normal. 
Sponta- 
Normal. 
None. 
None. 
18 
20/100 
20/70 + 
neons. 
3 mos. ago; 
R. E. 
4 
M 
21 
Traumatic 4 
None. 
Normal. 
Sponta- 
Normal. 
None. 
None. 
20 
20/1C0 
Discission of thick- 
20/70 
L. E. 
Senile, hard; 
R. E. 
neons. 
ened capsule 3 wks. 
5 
F 
70 
Corneal 
macula. 
Normal. 
By spat- 
Norma). 
None. 
None. 
21 
20/200 
later. 
20/70 
ula. 
6 
F 
22 
Traumatic ; 
R. E. 
None. 
Normal. 
By spat- 
Normal. 
None. 
None. 
24 
20/100 
20/100 
ula. 
• 
F 
55 
Hard, nu- 
clear ; R. E. 
None. 
Considerable soft lens 
matter carefully evacu- 
ated by pressure; irregu- 
Sponta- 
neous. 
Slow. 
None. 
Two. 
26 
20/200 
Discission 4 wks. 
later. 
20/20 
lar coaptation of lips 
of wound. 
s 
M 
60 
Senile & trau- 
matic ; R. E. 
None. 
Normal. 
By spat- 
ula. 
Slow. 
None. 
None. 
22 
15/200 
Discission 3 wks. 
later. 
Discission 2 wks. 
later. 
Discission 4 wks. 
later. 
20/70 
9 
M 
42 
Traumatic ; 
R. E. 
Incipi'nt cata- 
r'ctinoth.eye. 
Normal. 
Sponta- 
neous. 
Normal. 
None. 
None. 
16 
20/100 
20/50 + 
10 
M 
62 
Traumatic ; 
R. E. 
Ant. polar cat. 
in L. E. for 
Normal. 
By spat- 
ula. 
Slow. 
None. 
None. 
22 
10/200 
20/100 + 
many years. 
11 
M 
65 
Hard, senile. 
Aphakia in 
L. E. with 
old chorioid- 
Prolapse of vitreous at 
once; lens dislocated 
downward and inward, 
By spat- 
ula. 
Slow ; iritis. 
None. 
Several. 
28 
8/200 
Laceration of dense 
membrane 6 wks. 
later. 
20/70+ 
itis. 
and removed in its cap- 
sule bv blunt hook. 
12 
M 
38 
Traum'tic, nu- 
clear; L. E. 
None. 
Normal. 
Sponta- 
Slow; iritis. 
None. 
Several. 
26 
20/200 
20/50- 
neons. 
13 
M 
70 
Hard, senile; 
R. E. 
Broad arcus 
senilis. 
Prolapse of vitreous ; re- 
traction of iris ; lens dis- 
By spat- 
ula. 
Very slow ; opacities 
and membrane in 
None. 
One. 
38 
10/200 
Discission 5 wks. 
later. 
20/100 
loc. downward, and re- 
moved in its capsule with 
spoon ; loss of consider- 
vitreous. 
able vitreous. 
14 
F 
7.8 
Hard ; R. E. 
Traumatic ; 
R. E. 
None. 
Incipient cat.; 
L. E. 
Normal. 
Normal. 
By spat. 
Normal. 
None. 
Two. 
23 
20/70 
20/40 
F 
40 
Sponta- 
neous. 
Normal. 
None. 
One. 
15 
20/70 
Discission 4 wks. 
later. 
20/40 + 
16 
M 
47 
Traumatic ; 
None. 
Normal; much soft cor- 
By spat- 
Irido-cyclitis; dense 
None. 
Several. 
47 
3/200 
20/200 + 
20'40 
17 
18 
19 
F 
68 
R. E. 
Hard ; L. E. 
Hard ; L. E. 
Hard ; R. E. 
Hard; L. E. 
None. 
None. 
None. 
R. E. ; phthi- 
sis bulbi lol- 
tex ; free irrigation of 
anterior chamber. 
Normal. 
Normal. 
ula. 
By spat. 
membrane in pupil. 
Normal. 
None. 
None. 
16 
20/70 
gular piece of mem- 
brane 3 wks. later. 
r 4V 
Ml45 
By spat. 
Slow. 
None. 
None. 
24 
20/103 
20/50 
20/50 
20/50 + 
Normal. 
By spat. 
Normal. 
None. 
None. 
22 
20/200 
04 
Normal. 
By spat- 
Wound healed on 3d 
None. 
One. 
19 
20/70 + 
ula. 
day ; on 9th day loss 
lowing ex- 
of epithelium from low- 
traction of 
er half of cornea ; this 
cataract 15 
was regenerated in 3 
21 
22 
mos. before. 
days under bandage. 
F 66 
F70 
Hard ; R. E. 
Hard; R. E. 
None. 
None. 
Normal. 
By spat. 
Slow. 
None. 
Two. 
19 
20/100 
20/70 + 
Normal. 
By spat. 
Slow. 
None. 
None. 
22 
20/100 
Discission 3 wks. 
20/70 + 
23 
M 65 
Hard : R. E. 
Old chorioid- 
itis. 
Normal. 
By spat- 
Corneal epithelium 
None. 
Two. 
14 
20/230 
later. 
20/200 + 
ula. 
raised by clear fluid in 
spots, like those ia 
keratitis bullosa. 
24 
M 46 
Hard; L. E. 
Macula cor- 
Normal. 
Sponta- 
Normal. 
None. 
None. 
16 
20/100 
20/70 
26 
nese. 
neons. 
M 17 
Traumatic ; 
R. E. 
None. 
Normal; post, capsule 
torn by needle. 
Sponta- 
Normal. 
None. 
Two. 
12 
20/50 + 
20/36 + 
26 
neons. 
M 60 
F 54 
Hard; L. E. 
Hard ; L. E. 
None. 
Old chorioid- 
itis. 
Corneal 
macula. 
Normal. 
By spat. 
Slow. 
None. 
None. 
20 
20/100 + 
20/50 + 
20/100 + 
20/70 + 
Normal. 
By spat. 
Slow ; iritis. 
None. 
One. 
16 
21/200 
28 
F 55 
Hard ; R. E. 
Normal. 
By spat- 
Normal. 
None. 
None. 
22 
20/10C + 
29 
ula. 
M 
27 
Semi-hard. 
Irido-chori- 
Norma] ; iris separated 
By spat- 
Normal. 
None. 
Several. 
14 
0 
Blind eye. 
oiditis, blind 
from its adhesions to cap- 
ula. 
eye ; great 
sule throughout entire 
30 
pain. 
circumference of pupil. 
M 58 
Hard ; L. E. 
None. 
Normal. 
Sponta- 
Normal. 
None. 
None. 
16 
20/100 
Discission 3 wks. 
2 0/40- 
SI 
F 
63 
Hard ; R. E. 
Chronic con- 
junctivitis, but 
little sccret'n. 
Normal. 
neor.s. 
Sponta- 
neous. 
Normal. 
Iris incar- 
cerated. 
None. 
13 
20/70 + 
later. 
20/50 + 
M 
61 
Hard ; L. E. 
None. 
Normal. 
Spar ta- 
Norma). 
Iris incar- 
None. 
14 
20/50 
20/40+ ■ 
64 
Hard ; L. E. 
neons. 
cerated. 
33 
lu 
Chronic 
Bright's dis- 
Profuse haemorrhage into 
Sponta- 
Very slow ; outer lips 
of wound long patu- 
Iris incar- 
None. 
32 
20/200 
20/70 
ant. chamb , rendering 
neons. 
cerated. 
34 
56 
Hard ; R. E. 
ease. 
operation very pretractid. 
Ions. 
F 
None. 
Normal. 
Sponta- 
Normal. 
Iris incar- 
None. 
12 
20/100 
20/40 + 
63 
Hard ; R. E. 
Chronic 
neons. 
cerated. 
M 
Complete collapse of 
Sponta- 
Very slow ; outer lips of 
wound long patulous. 
Iris incar- 
None. 
30 
15/200 
Discission 2 wks. 
20/100 
62 
Hard ; L. E. 
Bright's uis. 
cornea. 
neons. 
cerated. 
later. 
Broad arcus 
senilis. 
Normal. 
Sponta- 
Normal. 
Iris incar- 
None. 
13 
20/70 
20/40- 
64 
Hard; R. E. 
neons. 
cerated. 
37 M 
None. 
Normal. 
Sponta- 
Normal. 
No incar- 
Two. 
12 
20/50- 
Discission 2 wks. 
20/30 + 
38 
57 
Hard ; L. E. 
Faint corneal 
neons. 
ceration. 
1- 
Normal. 
By spat- 
Normal. 
No incar- 
Three. 
16 
20,100 
Discission in 3 wks. 
20/50- 
39 
Hard ; L. E. 
macula. 
ula. 
ceration. 
F 
69 
Broad arcus 
Patient very hard to man- 
By spat- 
Very slow. 
Iris incar- 
One. 
29 
20/200 
Discission 2 wks. 
20/40- 
41 
58 
Hard nu- 
cleus ; soft 
se. ilis; 
Bright's ( is. 
age ; prolapse of vitreous 
and partial disloc. of lens. 
ula. 
cerated. 
later. 
M 
Pulmonary 
phthisis. 
Normal. 
Sponta- 
neous. 
Normal. 
No incar- 
ceration. 
None, 
14 
2 750 + 
Discission 3 wks. 
later. 
20/20- 
cortex; R.E. 
41 
M 
66 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
No incar. 
None. 
11 
20/56 + 
Discission 2 w. later. 
20/20 
F 
51 
Hard ; L. E. 
Chronic 
Normal. 
Sponta- 
Slow ; protracted gap- 
Iris puck- 
One. 
26 
23/100 + 
Patient would not 
20/50- 
Bright s dis- 
neons. 
ing cf ext. lips of 
er'd & pu. 
consent to a discis- 
I 
Hard ; R. E. 
ease. 
wound. 
not centr'l 
43 
70 
Very broad 
Slight loss of v itreous ; 
By spat- 
Normal, but rather 
Iris incar- 
None. 
19 
20/200 + 
Discission 1 month 
20/50 + 
arcus senilis ; 
some fragments cf cor- 
ula. 
slow. 
cerated. 
later. 
mark'd senil. 
tex left in anterior 
of patient. 
chamber. 
44 
F 
Hard; R. E. 
None. 
Normal. 
Sponta. 
Normal. 
No incar. 
One. 
12 
20/50 
20/30 1 No. | 
1 Sex. | 
1 Age. | 
Nature 
of 
cataract. 
Complica- 
tions. 
Operation. 
Reduc- 
tion of 
Lis. 
Healing process. 
Se^nd'ry 
prolapse 
or incar- 
ceration 
of iris. 
Poste- 
rior sy- 
nechiae. 
Duration 11 
treatment. 
Pri- 
mary 
vision. 
Secondary operation. 
Ulti- 
mate 
vision. 
45 
M 
49 
Semi-hard ; 
Very unruly 
Normal, but protracted. 
Sponta- 
Normal. 
No incar- 
None. 
Days 
16 
20/70 
Discission 3 wks. 
20/40- 
L. E. 
patient. 
neons. 
ceration. 
later. 
46 
M 
58 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
No incar. 
One. 
13 
20/40- 
20/30- 
47 
F 
66 
Hard ; L. E. 
Old choroid- 
Slight loss of vitreous. 
By spat- 
Normal. 
No incar- 
Three. 
20 
20/200 
Discission 1 mo. lat- 
20/70 
itis in R. E. 
ula. 
ceration. 
er; chorioiditis found 
after discission. 
48 
AI 
53 
Hard; R. E. 
None. 
Normal. 
Sponta. 
Normal. 
No incar. 
None. 
14 
20/40- 
20/30 
49 
F 
75 
Hard ; R. E. 
Chronic bron- 
Vitreous prolapsed as seo- 
By spat- 
Iiitis and inliltration 
4No incar- 
Dense 
43 
Light. 
Removal of large ir- 
20/ICC + 
chitis, asth- 
tion was comnleted; lens 
ula. 
of lips of wound ; hot 
ceration. 
false 
regularly triangular 
ma, and naso- 
removed by blunt hook 
water, atropia, and 
membr. 
piece of iris and 
pharyngeal 
without opening the cap- 
galvano-cautery, the 
block'g 
false membrane by 
catarrh. 
sale ; large amount of 
latter applied twice. 
entire 
Wecker's scissors. 
vitreous lost. 
pupil. 
Two. 
50 
F 
50 
Hard : R. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
12 
20/50 + 
Discission 10 d. later. 
20/30- 
51 
F 
42 
Semi-hard ; 
Chorio-retin- 
Sponta- 
Normal. 
None. 
One. 
15 
20/200 
Discission 2 wks. 
20/70 + 
L. E. 
itis syphilitic i 
in R. E. 
neons. 
later. 
52 
F 
61 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
Three. 
18 
20/70- 
Discission U d. later. 
20/30 + 
53 
M 
.-8 
Haid ; L. E. 
None. 
N.rmal. 
Sponta- 
Normal. 
None. 
None. 
12 
20/70 + 
Declined anv after- 
20/40- 
neons. 
operation. 
54 
M 
59 
Hard ; L. E. 
None. 
Normal. 
By sp it. 
Normal. 
None. 
None. 
14 
20/70- 
Discission8 d. later. 
20/40 
55 
F 
64 
Hard ; R. E. 
Slight macula 
Normal. 
By spat- 
Slow. 
Iris incar- 
None. 
22 
20/100 
20/70 + 
or cornea. 
ula. 
cerated. 
56 
F 
70 
Hard ; L. E 
Broad arcus 
Normal. 
By spat- 
Slow, especially in ex- 
Iris incar- 
None. 
24 
20/70 
L'iscission 4 wks. 
20/10 
senilis. 
ula. 
ternal lips of wound. 
cerated. 
later. 
57 
M 
48 
Tra'm'ticfr'm 
Iris moderate- 
Slight loss of vitreous. 
By spat- 
Normal; iris contract- 
No incar- 
Two. 
20 
20/70- 
Discission 6 wks. 
20/30 
contusion; no 
ly dilated 
ula. 
ed under eserine. 
ceration. 
later. 
wound of cor- 
and immov- 
nea ; L. E. 
able. 
59 
AI 
63 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
14 
20/50 
20/40 
59 
AI 
57 
Second'y, fol- 
Several 
Normal, but somewhat 
By spat- 
Slow iritis. 
None. 
Several. 
22 
20/200 
Free discission 5 
29/50 
low'g repeat- 
posterior 
protracted. 
ula. 
wks. later. 
ed attacks of 
synechiae. 
syphilitic irit- 
is ; R. E. 
60 
F 
78 
Hypermature; 
R. E. 
Br'd arc. sen.; 
chron. bronch. 
Normal. 
By spat- 
ula. 
Very slow. 
Incarcera- 
t'n of iris. 
None. 
24 
20/100 
20/70- 
61 
F 
60 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
One. 
16 
20/70 + 
Discission 2 w. later. 
20/40 + 
62 
M 
56 
Hard ; L. E. 
None. 
Normal. 
Sponta- 
Normal. 
None. 
Two. 
15 
20/70 
Declined any fur- 
20/50 + 
63 
neons. 
ther operation. 
M 
68 
Hard ; L. E. 
Corn'l mac'la. 
Normal. 
Sponta. 
Normal. 
No incar. 
One. 
12 
20/200 
Discission 4 w. later. 
20/70- 
64 
F 
59 
Hard ; R. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
Two. 
15 
20/50 + 
23/40 
65 
F 
62 
Hard : R. E. 
None. 
No.mal. 
By spat. 
Normal. 
None. 
One. 
17 
20 200 + 
Discission 3 w. later. 
20/50 + 
66 
AI 
71 
Hard ; R. E. 
Broad arcus 
Normal. 
By spat- 
Slow. 
Iris puck- 
None. 
29 
29/160 
Discission 5 w. later. 
20/50 + 
senilis. 
ula. 
e.'d upw. 
€7 
M 
50 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
10 
20/50 
20/40 
68 
F 
36 
Soft; L. E. 
None appar- 
Normal. 
Sponta- 
Normal. 
None. 
Two. 
16 
20/70 + 
Discission 2 wks. 
20/40 + 
ent. 
neons. 
later. 
69 
F 
61 
Hard : R. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
One. 
17 
20/200 h 
Discission 4 w. later. 
20/70 + 
70 
M 
72 
Hard ; R. E. 
Chr. bronch. 
Slight loss of vitreous. 
By spat- 
Very slow ; patient can 
Iris incar- 
None. 
30 
29/200 
Discission 2 mos. 
20/100 + 
and asthma. 
, ula. 
not lie down at all. 
cerated. 
later. 
71 
F 
87 
Hyperma- 
Chronic bron- 
Normal. 
By spat- 
Very slow; the external 
No incar- 
Several. 
27 
Count- 
None deemed ad- 
Fingers 
ture ; R. E. 
chitis ; cata- 
ula. 
lips of the wound not 
ceration 
ing fin- 
visable. 
counted 
ract well ad- 
healing for four wks.; 
some irhis and consid. 
of iris,but 
gers at 
at three 
vanced in 
some p'k- 
one ft. 
feet. 
L. E. 
pain ; a slow intiam. 
ering of 
process in chorioid and 
the folds 
vitreous continuing for 
of the iris 
several weeks. 
upward. 
72 
F 
61 
Hard : R. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
Two. 
16 
20/70 
Discission 3 w. later. 
20/40 + 
73 
Al 
57 
Hard ; L. E. 
None. 
Normal. 
Sponta- 
Normal. 
Ir. puck'd 
None. 
18 
20/100 
Discission 4 wks. 
20/50 + 
neons. 
upw., but 
no adhe. 
later. 
74 
M 
59 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
14 
29/50 + 
Discission 2 w. later. 
20/20- 
75 
F 
63 
Hard ; R. E. 
Chronic hy- 
Retraction of iris ; loss 
By spat- 
Violent iri lo-cyclitis, 
None. 
Almost 
30 
Percep- 
One mo. later divis'n 
20/70 
pertrophy 
of vitreous ; lens re- 
moved with hook. 
ula. 
with plastic exudation. 
c'mpl'te 
tion of 
of the iris & pseudo- 
and valvular 
entirely blocking the 
adhes'n 
light. 
memb. in a diagonal 
disease of 
pupil. 
of iris 
direction downward 
the heait. 
to cap 
and outward with 
sule. 
narrow knife. 
76 
F 
52 
Hard ; L. E. 
Central mac- 
Normal. 
Sponta- 
Normal. 
None. 
None. 
12 
20/100 
20/70- 
ula of cornea. 
neons. 
77 
M 
70 
Hyperma- 
Broad arcus 
Normal. 
By spat- 
Iritis of mild type. 
None. 
Several. 
17 
20/100 
Discission 4 wks. 
20/40 
ture ; R. E. 
senilis. 
ula. 
later. 
78 
Al 
76 
Hyperma- 
Chron. bleph- 
Loss of vitreous. 
By spat- 
Iritis. 
None. 
Several. 
22 
20/209 
Declined operation. 
20/100 
ture ; R. E. 
aro-adenitis. 
ula. 
79 
AI 
70 
Hard : R. E. 
Patient very 
Retraction of iris toward 
Sponta 
Infiltration of lips of 
Prolapse 
Several. 
29 
20/200 
Discission 5 wks. 
20/70 + 
feeble and 
ciliary processes, and 
neons. 
wound, and some hy- 
of iris on 
later. 
badly nour- 
lens removed with 
popyum on 3d d.; free 
irrigat'n of ant. cham. 
eighth 
ished. 
difficulty. 
day, and 
and application of gal- 
left undis- 
vano-cautery to whole 
turbed. 
length of wound. 
80 
F 
64 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
15 
20,70 + 
20/40- 
31 
F 
69 
Hard ; L. E. 
Corneal mac. 
Normal. 
Bv spat. 
Normal. 
None. 
None. 
16 
20^209 
Discission 3 wks. 
20/100 +■ 
82 
Al 
51 
Semi hard ; 
Diabetes mel- 
Normal. 
Sponta- 
Slow. 
None. 
One. 
18 
20/50- 
20/E0 + 
R. E. 
litas. 
neons. 
later. 
83 
F 
58 
Hard ; B E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
12 
20/40- 
Discission 3 w. later. 
20/30 + 
81 
M 
65 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
14 
2070 + 
20/30 + 
85 
AI 
54 
Semi-bard ; 
Diabetes mel- 
Normal. 
Sponta- 
Slow. 
None. 
None. 
23 
20/100 
Discission 2 wks. 
20/50 + 
L. E. 
litus. 
neons. 
later. 
86 
AI 
42 
Traumatic ; 
C'ntus. of eye- 
Normal. 
By spat- 
Iritis. 
None. 
Several. 
19 
20/70 + 
20/50 + 
R. E. 
ball f'm blow. 
ula. 
Discission on 17th 
87 
M 
46 
Traumatic; 
None. 
Normal. 
Sponta- 
Normal. 
None. 
None. 
11 
20/50- 
20/20- 
L. E. 
neons. 
day after extraction. 
88 
F 
68 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Slow. 
None. 
Two. 
26 
20/70 + 
Discission 3 wks. 
20/50 
89 
F 
52 
Immature in 
Chronic 
Normal. 
Sponta- 
Iritis. 
None. 
Several. 
23 
20/200 + 
20,70 
B. E. 
Bright's dis. 
neom. 
later. 
90 
M 
60 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
16 
20/50 
Declined operation. 
20/40 
91 
F 
(3 
Hard ; R. E. 
Feeble 
Normal, with slight loss 
By spat- 
Infiltration of wound on 
Incarcera- 
None. 
29 
20/200 
20/70- 
patient. 
of vitreous. 
ula. 
3d day ; galvano-cau- 
tion of 
tery at orifice. 
iris. 
92 
Al 
59 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
One. 
14 
20/50- 
Discission 2 w. later. 
20/40 + 
93 
F 
64 
Hard ; L. E. 
None. 
Normal. 
By spat. 
Normal. 
None. 
None. 
16 
20/100 
20/50 + 
94 
F 
71 
Hard ; R. E. 
Cornea] 
Normal. 
By spat- 
Slow. 
Incarcera- 
None. 
20 
20/200 
20/100 
macula. 
ula. 
t'n of iris. 
95 
Al 
59 
Hard ; R. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
14 
20/100 + 
Discission 3 w. later. 
20/40 + 
96 
F 
10 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
None. 
16 
20/70 + 
Discission 4 w. later. 
20/30 + 
97 
F 
66 
Hard ; L. E. 
None. 
Normal. 
Sponta. 
Normal. 
None. 
Two. 
17 
20/100 + 
Discission 2 w. later. 
20/50 + 
98 
F 
61 
Hard ; R. E. 
None. 
Normal. 
By spat- 
Slow. 
Iris incar- 
None. 
29 
20/70 + 
Declined any fur- 
20/50 
ula. 
cerated. 
ther operation. 
99 
AI 
>6 
Hard; R. E. 
N one. 
Normal. 
Sponta. 
Sponta. 
Normal. 
None. 
None. 
13 
20/70 + 
Discission 4 w. later. 
20/20- 
100 
AI 
>9 
Hard ; L. E. 
None. 
Normal. 
Normal. 
None. 
None. 
15 
29/50- 
Discission 3 w. later. 
29/20 © ® REASONS WHY 
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