. The principles and practice of surgery. re skill and adroitness. This method differs from the one previously described only in that theupper two-fifths—more or less, as the size of the lens may require—ofthe cornea is chosen for the flap. To prevent the eye from rolling up,the conjunctiva may be seized below the centre of the ball, with theforceps, and held by the assistant. AVilliams, of Boston, has beenable to prevent the insinuation ofthe lower lid beneath the flap, inthe lower flap section, by closingthe wound in the cornea with a de-licate silk Modified Linear Extraction—Periph
. The principles and practice of surgery. re skill and adroitness. This method differs from the one previously described only in that theupper two-fifths—more or less, as the size of the lens may require—ofthe cornea is chosen for the flap. To prevent the eye from rolling up,the conjunctiva may be seized below the centre of the ball, with theforceps, and held by the assistant. AVilliams, of Boston, has beenable to prevent the insinuation ofthe lower lid beneath the flap, inthe lower flap section, by closingthe wound in the cornea with a de-licate silk Modified Linear Extraction—Peripheric Linear.—This method,devised by Von Graefe, and ap-proved by Wells, Bowman, Noyes,Knapp, and very many other oph-thalmologists, is in reality a modi-fication of both the flap and linearoperation. The operation is divi-ded into four processes, namely:incision, iridectomy, laceration of the capsule, and extraction of the lens. The instruments required areNoyes speculum, fixation or mouse-tooth forceps, Graefes narrow- Fig. Graefes Modified Peripheric Linear Extraction. 1 Diseases of the Eye, by Henry W. Williams, Ophthalmic Surgeon to the City Hospital,Boston, 1867, p. 193. 572 CATAEACT. bladed knife, an iris forceps, scissors, a sickle-shaped needle, a sharp anda blunt hook, and a spoon. The patient being under the influence of an anaesthetic, the lids areopened by Noyes speculum—an instrument to which most operators nowgive the preference—while the ball is secured in position by the fixationforceps, as represented in the accompanying wood-cut; the operatorthen introduces his knife in the sclerotica, one-third or half a line backof the cornea, and about two lines above the horizontal diameter of theeye; the point is at first directed a little downwards and backwards, butwhen the sclerotica is fairly transfixed, it must be elevated and carried toa point in the sclerotica directly opposite its point of entrance; thecounter-opening being made, the edge is incl
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