is left in place. Therefore, in extracapsular cataract extraction, the major portion of the
lens is removed but some remnants of the lens tissue remain.
c. Precautions After Surgery. After surgery, the patient is usually kept at bed
rest for a short period, then gradually allowed to ambulate, depending on postoperative
conditions. All patients are generally cautioned not to stoop over, lift heavy objects, or
strain themselves physically. This warning is maintained during the time when the
wound is healing.
1-16. PROCEDURES IN THE TREATMENT OF GLAUCOMA
a. General. In glaucoma, there is increased tension or pressure within the eye.
Increased intraocular pressure may lead to hardening of the eyeball and blindness.
Glaucoma may result from iritis or from trauma.
b. Operative Procedures. The various operations used are aimed at reducing
tension in the eye by improving intraocular drainage of fluid. The operation performed
depends upon several factors, one being the status of the glaucoma (acute, subacute,
(1) Iridotomy. This is incision of the iris. The operation is done to create a
communication between the anterior and posterior chambers and thus relieve the acute
phase of the attack of glaucoma.
(2) Iridectomy. This is excision of part of the iris. A sector of the iris is
removed to increase drainage and relieve tension on the eye.
(3) Iridencleisis. This is the formation of an artificial pupil. A fistula is
created to provide an outlet for aqueous humor. The iris is incised through an incision
at the corneoscleral junction. The free ends are brought out and covered with
(4) Trephine. An opening is made by inserting a trephine through the
cornea at the corneoscleral junction and cutting through the globe down to the posterior
layer of corneoscleral tissue. The trephine is then removed and an iridectomy is
performed. The surgeon may perform a trephine operation as the first surgical
procedure in the treatment of glaucoma.
(5) Cyclodialysis. A new drainage channel is constructed from the anterior
chamber so that aqueous humor drains into the suprachoroidal space. This operation is
often done as treatment for glaucoma following cataract extraction.
1-17. PROCEDURES ON THE CORNEA
a. Repair of Laceration. A flap of the conjunctiva is used to seal off the tear.