Text-book of ophthalmology . d the swelling and resorption cometo a standstill. The cause of this commonly lies in a union of the capsularwound, which takes place to such an extent that the aqueous no longercomes into contact with the lens fibers. In either case the indication is torepeat the discission, in doing which one may proceed more boldly than inthe first operation and make an extensive opening in the capsule. 866. Contraindications.—Discission is contraindicated—1. In elderlypersons whose lenses already have a nucleus, and whose eyes, moreover, donot bear well the swelling of the lids
Text-book of ophthalmology . d the swelling and resorption cometo a standstill. The cause of this commonly lies in a union of the capsularwound, which takes place to such an extent that the aqueous no longercomes into contact with the lens fibers. In either case the indication is torepeat the discission, in doing which one may proceed more boldly than inthe first operation and make an extensive opening in the capsule. 866. Contraindications.—Discission is contraindicated—1. In elderlypersons whose lenses already have a nucleus, and whose eyes, moreover, donot bear well the swelling of the lids. 2. In subluxation of the lens, a condi-tion which is recognized by the tremulousness of the latter. In this case dis-cission is impracticable on technical grounds, since the lens being insuffi-ciently fixed in its place would recede before the discission needle. 3. Whenthere is# considerable thickening of the capsule of the lens, as in this casethe discission needle would cause luxation of the lens before it could tear. 990 TEXT-BOOK OF OPHTHALMOLOGY through the capsule. 4. In the presence of posterior synechia?, whichrender the dilatation of the pupil by atropine impossible. In such a casean iridectomy would have to precede the discission. (b) Discission of Membranous Cataracts (Dilaceration) 867. The discission of membranous cataracts is not made with theview of effecting their resorption, since shrunken cataracts no longer containmuch or any matter capable of being absorbed. On the contrary, theirobject is to make a free opening in the cataractous membrane by tearing itye apart, and for this reason it had better becalled dilaceratio cataractse. [The name is notapplicable to the operation with the knife-needle,or Graefe knife, which is a cutting not a tearing(see page 991).—D.] The operation may be per-formed either through the cornea or through thesclera.[Fig. 45i.—incision with the In the operation through the cornea (kera- Knife-needle in Soft Pri- . . , . mary a
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