OPERATIONS FOR CATARACT 147 



petent assistant hold the Hds open with the fingers or 

 retractors. There are objections to this latter method, 

 however, as the hands of an extra person are always 

 in the way, and pressure upon the eyeball may be 

 made, which must, in all cases, be avoided. The 

 conjunctiva of the globe must be grasped with the 

 fixation forceps at a point opposite to the corneal 

 section. The Graefe cataract knife may then be passed 

 in at the corneal margin, sliding it along through the 

 anterior chamber, being careful not to wound the 

 iris, and the counterpuncture made at a point directly 

 opposite, at the margin; carry the blade forward, and 

 with one sweep, if possible, complete the section, fol- 

 lowing the margin all the way as closely as possible. 

 The success of this step depends upon two principal 

 points— the skill of the operator and an exceedingly 

 sharp knife. Each knife should be tested before the 

 operation, and the point should pass through the test- 

 drum head by virtue of its own weight. 



In man the corneal section is usually made upward, 

 passing the knife through the cornea from the external 

 portion in each eye, making the counterpuncture toward 

 the nose. A section of a httle more than one-third of 

 the cornea is usually made. It is better to make a large 

 rather than a too small section, so that the lens can be 

 readily extracted without undue pressure and wound- 

 ing of iris and adjacent structures, when there is less 

 danger of inflammation of these structures following, 



