Text-book of ophthalmology . nea. P, section for paracentesis; a, prolapse of the iris. It is evident thatperipheral; b, central lip of the wound. ,, , , - , . 1 H the opening must be of a certain size for the iris to enter it at all. Again, if the aperture is circular—as is the case, for ex-ample, after perforation of an ulcer of the cornea has taken place—prolapse of the iriswill assuredly not fail to develop. On the other hand, wounds with a valvular closure,such as those made with the lance knife, display a comparatively slight liability toinclusion of the iris. We therefore try to anticip
Text-book of ophthalmology . nea. P, section for paracentesis; a, prolapse of the iris. It is evident thatperipheral; b, central lip of the wound. ,, , , - , . 1 H the opening must be of a certain size for the iris to enter it at all. Again, if the aperture is circular—as is the case, for ex-ample, after perforation of an ulcer of the cornea has taken place—prolapse of the iriswill assuredly not fail to develop. On the other hand, wounds with a valvular closure,such as those made with the lance knife, display a comparatively slight liability toinclusion of the iris. We therefore try to anticipate the occurrence of perforation of anulcer by making paracentesis with the lance knife, in order to avoid prolapse of the irisand the anterior synechia that results from it. Prolapse of the iris may occur not only during the operation but afterward may, for example, have succeeded in avoiding the development of prolapse duringthe operation, or have removed it if it has developed; and yet on the next day, when. EYE OPERATIONS IN GENERAL 923 we change the dressing, we may find the iris prolapsed into the wound. This occur-rence is due to the fact that the recently agglutinated wound has reopened, and themoment this took place the same conditions favoring prolapse of the iris were suppliedas at the instant of the operation itself. Prolapse of the iris and its incarceration in the operation wound must be avoidedat. any cost. If we are dealing with wounds in which there is but little tendency toprolapse, it is sufficient to replace carefully any iris that may have prolapsed duringthe operation. But if the section is of such a character that the iris is apt to be pushedinto it (as, for instance, is the case with a large scleral section), the reposition of theiris affords no security against prolapse; this may, and very often will, take place sub-sequently! In these cases the only resource is excision of the iris. How does this avertprolapse? perhaps because all th
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