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3
HISTORY OF IRIDOTOMY.
KNIFE-NEEDLE VS. SCISSORS—DESCRIPTION OF AUTHOR’S
V-SHAPED METHOD.1
S. LEWIS ZIEGLER, A.M., M.D., Sc.D.
Attending Surgeon, Wills Eye Hospital; Ophthalmic Surgeon,
St. Joseph’s Hospital.
PHILADELPHIA.
To Cheselden has been conceded the honor of beingthe father and originator of iridotomy. Nearly twocenturies have elapsed since he first published the reportof his procedure in the Philosophical Transactions for1728. Ever since that time, his signal success has beenacknowledged by all except those who either failed toequal his dexterity, or who were prejudiced by theirambition to originate a new method.
A careful review of the medical literature of the centuryand a half following Cheselden’s announcementcan not fail to impress the reader with the great interestattached to operations for the formation of an artificialpupil, which subject was considered second only in importanceto that of cataract itself. Not only were a largenumber of monographs devoted wholly to this subject,but every work on general surgical topics set aside one ormore chapters for the discussion of artificial pupil.This is in great contrast to the limited space which modernworks on ophthalmology grudgingly yield to this stillimportant subject.
It is difficult for us to appreciate the conditions whichbrought about so large a percentage of cases of pupillaryocclusion. Crude surgical procedures, poor operativetechnic and the utter lack of asepsis often resultedin iridocyclitis or iridochorioiditis. The couching of the4lens, the free discission of both hard and soft cataracts,the frequent introduction of the knife-needle throughthe dangerous ciliary zone, and the bungling efforts atextraction all increased the tendency to inflammatoryreaction, while inadequate therapeutics and lack ofantiphlogistic measures frequently permitted the depositof plastic exudate in the pupillary area, thus resultingin membranous occlusion of the pupil.
For the sake of historical completeness, and in orderto better emphasize the special domain of iridotomy, Iwill mention briefly the various methods that have beenemployed in making an artificial pupil. These are:
(1) BU KİTABI OKUMAK İÇİN ÜYE OLUN VEYA GİRİŞ YAPIN!
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