CATARACT. 369 



in discission, and empty the soft parts of the cataract by means 

 of Daviel' s spoon (Fig. 80, c). Any remnants of the cut capsule 

 which may not be removed at the time are left to be reabsorbed. 

 If during the operation we observe prolapsus of the iris, we must 

 try to restore it to its position by means of Daviel' s spoon (Fig. 

 80, c). If this is not possible, we may cut it off close to the 

 wound of the cornea. 



It is very evident that linear extraction is only to be performed 

 in cases of complete softening of the lens. This may be recog- 

 nized by total opacity of the lens and alteration of the iris, and 

 also when the anterior capsule is pushed toward the cornea. 



Lobular Extraction. Lobular extraction is indicated in 

 shrunken cataract, which is generally senile, where the lens has 

 prolapsed into the anterior chamber and where discission will only 

 produce an imperfect result— that is to say, where reabsorption of 

 the lens does not progress properly. It is performed in the fol- 

 lowing manner : 



Make an incision into the cornea exactly as in linear extraction, 

 by means of Graefe's cataract knife, but it must be enlarged to 

 8 or 10 mm. After that the capsule of the lens is split by the 

 discission needle, the fluid of the anterior chamber is allowed to 

 escape, and at the same time the lens must be detached by means 

 of an even, but not too energetic, pressure upon the other side of 

 the eye from the wound, and by means of the spoon the lens is 

 scooped out of the opening. The consecutive treatment is the same 

 as in linear extraction. 



Dislocation of the Cataract. This operation, which has been 

 abandoned lately on account of the impairment of the choroid 

 membrane and retina, was performed in the following manner: 



By means of a bent or straight needle pushed through the scle- 

 rotic membrane, and at other times through the cornea, steady 

 pressure was made on the upper part of the lens, and it was 

 pushed down into the lower posterior part of the vitreous chamber 

 of the eye. 



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