Transactions . of Desmarres and of McReynolds, with the advantage,however, in favor of the Desmarres method in that itentails no loss of tissue. Or they have embodied some modeof excision. It will be remembered that pterygium occursmost often after middle life, in eyes that have been for yearsafflicted with conjunctivitis; hence, there is always presenta degree of atrophy of the affected membrane, and in ourintervention, instead of increasing the deficiency we might Beard: A N^ew Operation for Pterygium. 619 perhaps better strive to lessen it, as did the late Dr. Hotz,by means of a Thiersch gr
Transactions . of Desmarres and of McReynolds, with the advantage,however, in favor of the Desmarres method in that itentails no loss of tissue. Or they have embodied some modeof excision. It will be remembered that pterygium occursmost often after middle life, in eyes that have been for yearsafflicted with conjunctivitis; hence, there is always presenta degree of atrophy of the affected membrane, and in ourintervention, instead of increasing the deficiency we might Beard: A N^ew Operation for Pterygium. 619 perhaps better strive to lessen it, as did the late Dr. Hotz,by means of a Thiersch graft. The procedure which the one under discussion mostnearly resembles is that of Prof. Herman Knapp, yet thedifferences are sufficiently essential, as the following descrip-tion will show: Technic /w pterygium.—The two conjunctival incisionsdo not follow the borders of the pterygium, but are muchless divergent. They begin just where the border crossesthe limbus and are carried to the bottom of the nasal cul-. Fig. 1.*—The operation as applied to pterygium. The heav}- lines showthe conjunctival incisions. The dotted lines indicate how the sliding flaps arebrought together to cover the defect. The caruncle is represented as drawnout by the pterygium. desac but slightly diverging. One remembers that theseincisions include only one layer of conjunctiva, that is, theydo not go through the two layers which comprise the borderfolds of the pterygium. The neck of the growth, togetherwith the subconjunctival connective and elastic tissue, isloosened from the sclera by the small curved blunt-pointedscissors. A narrow curved blunt-pointed bistoury is passedthrough—in at the lower incision, out at the upper, with its *Through an error, the speculum is put in wrong; i. e., with the handlesover the nose. 620 Beard: A New Operation for Pterygium. edge toward the limbus. The body of the pterygium isgrasped by broad-jawed forceps, and its head, inclusive of athin shaving of the substantia
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