286 
DEPARTMENT OF SURGERY. 
gium is narrow the operation is simple and very successful. 
The object in every case is to thoroughly remove all the growth 
from the cornea, and this is done by beginning to dissect it at 
the apex, and grasp it with a pair of forceps, and with gentle 
traction separate it from the anterior limiting membrane ( Rev ., 
XXV.,p. 208). If all of the diseased tissue is not removed in 
this way, the remnants must be scraped out with a sharp knife 
and let the denuded space near the cornea cicatrize, which gen¬ 
erally leaves no opacity. The actual cautery has been recom¬ 
mended by some operators in removing diseased tissue, but 
would not recommend it when knife will answer the purpose. 
During the last few years, electro-cautery has also been used 
for this purpose, but cautery used for such purposes is not an 
advisable surgical procedure. When the wedge shaped structure 
is removed, the conjunctiva must be loosened along the edges and 
the edges brought as near to each other as possible by the careful 
application of sutures. After the wound has been well washed 
with a boric acid solution, normal salt solution or with steril¬ 
ized water, the eye should be closed with sterilized lint, gauze 
or cotton and bandage applied over the eye, and over this a 
hood should be securely fastened. The wound may be redressed 
every day and the stitches allowed to remain as long as they do 
not irritate, which is generally three or four days. When the 
stitches are removed it is not necessary to dress the wound, but 
the eye must be kept clean by washing it occasionally ; the 
patient must be kept in a place where the light is not too bright. 
It is not advisable to keep such patients in a very dark place 
during convalescence. 
Operation for Symblepharon .—Symblepharon is the adhesion 
of the eyelid to the eyeball, or to each other. This condition is 
generally a congenital anomaly, 
but may follow neglected wounds 
of the eyelids or diseases which 
involve the inner surface of the 
eyelid. The condition is observed 
in various forms; those which 
adhere to the eyeball usually in¬ 
volve the lower lid ; those in which 
both eyelids unit ^ankyloblepharon) 
seldom adhere to the globe. The 
most common of these conditions 
is the union of the lids at the exter¬ 
nal angle {blephrophymosis ), which lessens the palpebral opening. 
Fig. 53. 
SYMBLEPHARON. 
