CORNEAL PARACENTESIS 
By Dr. HERMINIO VELARDE 
Traumatic injuries to the eyes are very frequently observed 
among the working class in this country. They are usually 
produced by direct traumatism, either by sticks or other sharp 
objects, or by the entrance of small, foreign bodies into the con- 
junctival sacs. Such injuries inflicted upon the cornex, pro- 
ducing destruction of the corneal epithelium, are invariably 
infected by the numerous organisms present in the conjunctiva 
and especially in the diseased lachrymal sacs. They produce 
ulcus corneze serpens with hypopyon and perforation and, 
invading the deeper and delicate structures of the eyes, cause iri 
docyclitis, uveitis, infection of the vitreous humor, and panoph- 
thalmitis. The usual termination is the total loss of vision and 
atrophy of the eyeball. 
Many patients have come to the hospital with eyes completely 
destroyed, and either evisceration or enucleation is then impera- 
tive. It is certainly very sad that so many eyes have met their 
fate this way. It is for this reason, and because of so many 
apparently hopeless cases whose eyes have to be saved, that 
we are obliged to employ the different methods of treating them, 
including corneal paracentesis. 
The operation which will be discussed with you to-day is not 
altogether a new one and, in fact, the opening of the anterior 
chamber of the eyeball was resorted to in ocular surgery long 
before the period of antiseptic medicine. It was probably first 
publicly recommended by Nuck in 1698. But due to many fail- 
ures in those days, probably because of the lack of a proper 
knowledge of asepsis, the operation was abandoned, and in 
1862 many surgeons, among them Sperine and Rigaud-Landrau, 
actually opposed the method. The English ophthalmologists 
were also against this method of treatment in those days, but 
later they-accepted evacuation of the aqueous humor as the best 
treatment for inflammation of this region of the eyes, and in 1840 
Mackensie, Middlemore, and Tyrrel made use of the method. 
Wardrop, in the Edinburgh Medical and Surgical Journal, rec- 
ommended this treatment in all cases of hypopyon. Carel pub- 
lished an excellent article on the treatment of corneal ulcers 
71 
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