Expression of Cataract

(the suppuration among them), with good ultimate vision in two, one had iritis, in two floating opacities were found in the vitreous, and in two the eyes became red and irflamed after the seventh day and the wound opened up along its length, healing finally with incarceration of the iris. There were two to three astigmatism in most of the cases. In three cases the results were ideal and these were cases in which the iris was tremulous before operation, i.e., the cataract was overripe. The visual results were better on the average than in an equal number of extractions recorded so soon after operation. Dr. Cheney emphasizes the importance of keeping the cases under observation for some time and points out that his three most unfavourable cases would have been classed as favourable results had they been discharged on the sixth day. " As to the gravity of vitreous losses in cataract extraction," Dr. Cheney remarks : "a separation of the retina undoubtedly occurs sooner or later iu a certain per cent, of the eyes, and, though I cannot recall any such case in my experience, it is probably not for the reason that I have been more fortunate than others, but rather that the patients have passed from observation. A loss of vitreous in an uncomplicated senile cataract is certainly not good surgery. In the majority of cases it should be classed as a surgical bungle. A new operation which adds to the per cent, of vitreous losses must show very great advantages over the old to make its general application desirable." While inclined to think that a small per cent, of lenses may with advantage to the patient be expressed in capsule, Dr. Cheney will " do very little more pioneer work in attempting to determine ti'e cases best adapted to this operation," and he ends by quoting Smith against himself : " There is virtue in knowing when to quit and in letting well enough alone."