Postoperative inflammatory reaction is infrequent, but if it should occur the usual antiphlogistic treatment of atropin, calomel, ice-pads and leeching should be actively instituted and continued until the eye is absolutely quiet. The operation itself is frequently an antiphlogistic measure, because it relieves iris-tension and traction on the ciliary body. The usual compress of gauze and cotton, covered with a Liebreich patch, may be applied to the eye for the first twenty-four hours and rest in bed enjoined for that period.
IN CONCLUSION.
We have carefully reviewed the history of iridotomy for nearly two centuries, and noted how the pendulum has swung from knife-needle to scissors, and back again. We have learned that Cheselden, the father of iridotomy, originated the method of incision by the knife-needle, which Heuermann modified, and Adams later revived and improved. We have seen how Janin abandoned this procedure and originated the scissors method, which Maunoir greatly improved and caused to hold sway for more than half a century. We have been deeply impressed by the fact that the mature, judicial mind of von Graefe led him to abandon the scissors and revert to the knife-needle method. We have seen how, soon after his death, the great influence of De Wecker had swerved the thought of the ophthalmic world back to the adoption of the scissors method in a greatly improved form.
Whether I have succeeded in citing sufficient facts and arguments to establish my thesis in favor of the knife-needle, or not, I nevertheless submit to the profession my V-shaped method of iridotomy and capsulotomy with a confidence born of twenty years’ successful experience in its use, and with the hope that it may prove equally efficient in the hands of others who will take pains to study and understand the method, and who may have the patience to put it in practice.
FOOTNOTES:
[1] Read in the Section on Ophthalmology of the American Medical Association, at the Fifty-ninth Annual Session, held at Chicago, June, 1908.
[2] Wagner, Karl Wilhelm Ulrich: Inaugural Thesis, Göttingen, 1818. He invented the designation iridotomia, which he formed from the original Greek, ἶρις, ἶριδος (the iris) and τομή (cut).
[3] Cheselden, William: Philosophical Transactions, London, 1728, xxxv, p. 451.
[4] Ibid, abridged, vii, pl. v, Figures 2, 3 and 5.
[5] Sharpe, Samuel: A Treatise on the Operations of Surgery, London, 1739, p. 169.