17,1 Velarde: Corneal Paracentesis 75 
knife is introduced on the outer and lower quadrant near the 
limbus penetrating the anterior chamber. The knife comes 
out on the lower and inner quadrant near the limbus on the 
opposite side, producing an incision along the lower border of 
the cornea about 10 millimeters long, similar to a cataract in- 
cision. This produces an extensive area for drainage of the 
thick pus in the anterior chamber. By a careful manipulation 
with a small horn spatula, or with iris forceps, the contents 
of the anterior chamber are evacuated. This is later followed 
by washing the anterior chamber with 2 per cent boric acid 
solution, or sterile water, using a fine curved cannula until all 
pus and necrotic materials are removed. The ulcer of the cornea 
is cauterized with thermocautery. Atropin, one to two drops 
of 2 per cent solution, is instilled, and hot moist compress is 
applied. 
Postoperative treatment.—The patients are treated at least 
once daily after operation. The eyes are examined and the 
dressings changed every day. Atropin is instilled whenever 
necessary. Special attention is given to the examination of the 
iris so that adhesions may not take place. Finely powdered 
iodoform is sprinkled on the ulcerated cornea whenever neces- 
sary. If pus forms again in the anterior chamber and its evac- 
uation is necessary paracentesis of the cornea is again made. 
Result of the operation.—The result of this treatment is very 
satisfactory. Of the twenty-two cases operated upon for corneal 
paracentesis two have completely recovered, nineteen were im- 
proved, and one was not improved at all by the treatment. The 
two cases of recovery left the hospital with perfectly normal 
eyes and normal vision. Of the nineteen improved, twelve cases 
have improved vision and the corneal lesions terminated in 
leucoma. Some of these cases can be submitted to iridectomy 
for artificial pupil, although they were then too premature to 
be submitted to such operation. Seven of the improved cases 
have negative vision with plastic iritis, seclusio et oclusio pup- 
illae ; but the corneal lesions were healed up, except in two cases, 
which were discharged against the physician’s advice. The 
unimproved one showed no sign of improvement and the in- 
fection of the eye continued to extend deeper, terminating in 
panophthalmitis. This case was eviscerated. 
The usual result of infected injuries to the cornea is panoph- 
thalmitis. From 1911 to the end of 1919, 174 cases were evis- 
cerated and 149 enucleated, or a total of 323 eyes which were 
removed from the orbit in the Eye, Ear, Nose, and Throat 
