. Surgery, its principles and practice . FiG. 462. -Removal of Iris in Operation of Iridec-tomy. 880 SURGERY OF THE EYE. merit, are largely the same as those already described in connection withthe operation for cataract (page 870). Modifications of Technic Necessary to Meet Special Indications.—In optical iridectomy a narrow coloboma, if possible, should be placed in-ward, or downward and inward, for example, in central leucoma of thecornea, or in central congenital cataract (page 875), and instead of usingthe iris forceps to withdraw the tissue, a l^lunt or Tyrrell hook may beemployed. Many
. Surgery, its principles and practice . FiG. 462. -Removal of Iris in Operation of Iridec-tomy. 880 SURGERY OF THE EYE. merit, are largely the same as those already described in connection withthe operation for cataract (page 870). Modifications of Technic Necessary to Meet Special Indications.—In optical iridectomy a narrow coloboma, if possible, should be placed in-ward, or downward and inward, for example, in central leucoma of thecornea, or in central congenital cataract (page 875), and instead of usingthe iris forceps to withdraw the tissue, a l^lunt or Tyrrell hook may beemployed. Many modifications of optical iridectomy have been tried,the best of them being that known as precorneal iridotomy, described byAxenfeld, in which the iris is made to prolapse through a small cornealincision, when it is incised with a radial scissor-cut, not excised, and. Fig. 463.—Dressing the Pillars of the Colobom,\ after Iridectomy (after Haab). carefully replaced. There is gradual separation of the cut, making anarrow aperture in the iris. In anti-glaucomatous iridectomy the anterior chamber must be openedby as peripheral an incision as is safe, and it should be at least 2 mm. pos-terior to the apparent corneoscleral junction; otherwise the root of theiris cannot be seized. In acute congestive glaucoma it is usually taughtthat at least one-fifth of the iris should be included in the excised tissue,and it is preferable that the coloboma be made upward. A less extensiveiridectomy, if technically correct, will accomplish equally good purposes,and this is especially true if it is performed for non-congestive or so-called chronic glaucoma. The essential symptoms of that disease, which requires a peripheral OPERATIONS ON SCLERA, CORNEA, AND CONJUNCTIVA. 881 iridectomy for its cure, namely, acute glaucofna, are greatly increased in-traocular tension, s
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