Operation. A general anæsthetic is usually desirable. The prolapsed iris should be seized with the forceps and withdrawn from the wound. A second pair of forceps is used to take a fresh hold on the iris, which can usually be drawn out further (Fig. 118). It is then divided as close to the corneal wound as possible. The iris usually flies back into the anterior chamber clear of the corneal wound by its own elasticity, but if it does not do so it should be freed with a spatula. The pupil should be kept subsequently under atropine.
Fig. 118. Prolapse of the Iris through a Punctured Wound of the Cornea. Method of withdrawing the iris by two pairs of iris forceps before removal.
TRANSFIXION OF THE IRIS
Indications. This operation is undertaken in cases of iris bombé when iritis is still present and when an iridectomy would subsequently lead to a drawn-up pupil. It is also of service to evacuate the contents of cysts of the iris (local iris bombé).
Instruments. Speculum, fixation forceps, Graefe’s knife (narrow).
Operation. The knife is entered at the limbus from the outer side directly opposite the occluded pupil. The apex of the iris bombé is transfixed and the point of the knife made to appear above the pupillary area; the iris bombé on the other side of the pupil is then transfixed and the knife is withdrawn.