Usually there is soine discomfort for several hours after the operation. Should this continue and be at all marked, the bandage should be removed and the eye inspected. At times great relief will be given by gently pulling down the lower eyelid and giving exit to an accumula tion of tears or by allowing a faultily placed eyelash to escape into proper position. If the eyeball appears the least injected and the slightest signs of iritis be present, atropine should be im mediately instilled into the conjunctival Suppuration may appear, usually taking place before the third or fourth clay, and is traceable to infection, generally from lacrymal disease. In a few instances it is dependent upon a lack of nutrition to the eye. If it is due to the former, it is best combated by cau terization of the edges of the incision, the instillation of sulphate of atropine, the use of hot compresses, and attention paid to the general health.
An eye whose lens has been removed is termed aphakic, and, in order that its vision may be useful, it must be pro vided with an artificial lens correspond ing in relative strength to the crystalline lens that has been removed, plus a cylin drical one to correct any astigmatism resulting, from cicatrization of the cor neal incision. To this artificial lens must be added a convex spherical one of two or three dioptres' strength for use during near work. As cicatrization is usually not completed until four to six weeks after the operation, it is better to postpone ordering glasses until at least that time.
Corneal measurements after extraction of cataracts: Conclusions from an ex amination of 59 cases:— 1. Two weeks after the flap-extraction of cataract there is corneal astigmatism varying from 1.75 D. with rule to 22.0 D. against rule.
2. The greatest amount of this astig matism disappears in the following four to six weeks.
3. It is slowly reduced for six months, after -which it seems there are no further changes.
Bearing these facts in mind, it is evi dent that an accurate estimation of the ultimate glasses cannot be made at tbe end of two weeks. A. O. Pfingst (Ar chives of Ophthal., July, '96).
Case of extraction of cataract in which union was delayed for twenty days. It
finally took place, however, with good vision. G. C. Harlan (Trans. Amer. Oplith. Soc., '98).
Analysis of a series of 500 consecutive operations for primary cataract, per formed between June 22 and November 2, 1901, a period of nineteen weeks, in the Government Ophtlialtnic Hospital, at -Madras. All but 36 of these operations were done on the Saturdays of this period. making an averag-e of 27 opera tions for each operating day. On an average of from 12 to 16 patients were operated upon in an hour. In making a section in the sclero-corncal margin, tbe author endeavors to graduate the section according to the size of the lens. Each patient was inspected and dressed daily after the operation. As little in terference with the parts as possible is made after operation. Atropine is used as a routine measure on the third morn ing after operation, provided there is no contra-indication; the sound eye i S un bound on the fifth morning,, the eye operated upon is released on the seventh day if all is going well, and the patient is discharged at this time to report as an out-patient. Stress is laid on the importance of treating any complication that may be present prior to operation. This applies even to slight congestion of the conjunctiva. The author presents an interesting analysis of the complica tions and of tne results obtained in these cases, and closes with the warm commendation of McKeown's irrigating apparatus, which, he states, reduced the vitreous losses in this series to 2 per cent.; by emptying the capsule and chamber of debris it has minimized the need for subsequent capsulotomy and has enabled the author to dispense with the introduction of instruments into the eye after the escape of the nucleus; it is of great value in clearing the cham ber of fluid; by- gently and evenly re placing the iris, it has been most valu able and it has expedited recovery, inas much as it has left behind so little cortex to be absorbed; another advan tage which it possesses is that of ren dering operation possible in very imma ture cataracts. Elliot (Lancet, Nov. 8, 1902).