Fourteen operations of the lens in high myopia (in addition to twenty-four al ready reported). Cases all terminated favorably and showed inerensed acuity of vision, with no further increase of myopia nor progress of myopic changes in the Nadi's. Vacher (Ann. d'Ortil., '96).
Removal of the lens for high myopia performed in 11-1 eyes during the past f r .1- 0n–it Ifni roveinent ZIA 1 ...I - III 1111` 11,11.11 1W1111y, generally .• • r t of filthy months. The • r I It ;Its., of myopia is perina ? 1,• e ail, -fed, but the operation does t . T. rti c security against fur . .. T 1111 t I \ t.1111 /II 1I1C elioroid, nor sub - 1, 1.t el, ta,hinent of the retina, al tl latter is not to be ascribed tiv to the operation. but is - nt ii the nature of the malady.
f tl e 114 eyes, astigmatism was noted 1, f re the op, rat ion in but 2 (of the same -ut . After operation it was present it :15 instances. Von Ilippel (Deut. med.
1\ 11, NO. 25, '97).
The extraetion of the transparent lens i- I. =tined to hold its place in ophthalmic surfnry as a means of treatment of high n yopia where glasses do not atTord proper a--,stance. Panas (Arch. d'Opbtal., Feb., '97 .
0) cratien does not benefit inyopcs hav ing lcss than 11 D., while Sehweigger's ea-e of 33 1). is the highest thus far re ported as having undergone operation. After removal of the lens there is noticed a diminution of the myopia in most cases of from 16 to 13 dioptres, and this greater the higher the myopia. A myope of 7 D. n ay be found to have become hyper metropic G.G D.: and in Schweigger's pa tient there remained only 13 D. after the removal. A fluid vitreous or a choroidal atrophy is not found to contra-indicate, although it would be better not to inter fere if a staphyloma should invade the macula. This procedure is especially ap plicable to children and young adults; Tut von Hippel and Sattler have been satisfied uith their results in patients as old as sixty-four, and others have oper ated smeess:fully on patients between the ages of thirty-five and fifty. Discussion, Briti-h Med. Assoc. (Boston Med. and Surg. Jour., Jan. 6, '98).
Fukala introduced the treatment of ex cessive myopia by the removal of the lens. The advantage of this kind of treatment is recognized, but its danger—loss of the eye from ha•morrhage and detachment of the retina—limits the indications to those in which the expected gain in sight gr,•atly outweighed the risk. Herman Knapp (N. Y. Med. Jour., Jan. 8, '98).
Sixteen eases of extraction of crystal line lens in high myopia: Upward of fifteen dioptrcs; detachment of retina nel er met with, but marked improve ment of vision never obtained. Simple
extraction performed, all of the lens pos sible being removed. Three days later the wound is opened and remaining masses removed. Later, if necessary, the capsule is extracted. Vignes (Jour. of Ophth., Otol., and Laryn., Apr., '93).
One hundred and forty-two cases of ex traction of crystalline lens in high my opia: Sight markedly improved in 35 per cent. Stationary in 10 per cent. Eye lost in 2 per cent. by infective and glau comatous complications and in 3 per cent. by detachment of the retina. Darier (Jour. of Oplith., Otol., and Laryn., Apr., '93).
One hundred and sixty-two cases of ex traction of crystalline lens in high my opia: Free crucial incision made in cap sule ith a very thin von Graefe knife. To remove lens a long, narrow blade used as a spatula. Loss of vitreous not feared, as very satisfactory results obtained after it has occurred. Operation should not be performed WI4en vision can be improved with glasses sufficiently to enable patient to work. Perfect emmetropia obtained in cases varying from 12 to 23 dioptres. Enkala (Jour. of Ophth., Otol., and Laryn., Apr., '93).
Removal of the transparent lens for high degrees of myopia is theoretically most excellent, but, on account of tbe in flammatory risks, is to be abstained from. Kenneth Scott (Lancet, Sept. 24, '98).
The removal of the crystalline lens for high degrees of myopia is warranted under the following conditions: The myopia should be of more than 15 D.; when no serious change is present in the retina; when the patient is under forty years of age. An eye should not be oper ated upon when tbe vision of the other eye is !,-,mod. E. Fuchs (Wiener klin. Woch., Feb. 9, '99).
Extraction of the soft lens without irideetomy preferred because the length of time required is in some cases less than one-third that required by the first procedure. There is less danger of ad hesions forming between the iris and the zonula, and also of setting up ft low grade of iridocyclitis from continued pressure of the lens on the ciliary body. Haight (Jour. Amer. Med. Assoc., July 15, '99).
Immediate extraction preferred to dis cission. The operation should not be undertaken before twelve years of age nor after forty, nor when there is good vision in one eye. Pierre Dolbeau (Gaz. Hehdom. de M(Id. et de Chir., July 22, 1900).