Removal of the Lens by Irrigation in Congenital Cataract and Traumatic Cataract in Children

Author’s address: Dr. J. G. F. Worst, Oogh. Afd. Acad. Ziekenhuis, Groningen (Netherlands) Instead of discussion followed by linear extraction, it is possible to treat some congenital cataracts and all traumatic cataracts in children by means of irrigation. In this operation the goniotomy needle is used to preserve the anterior chamber. The lens is destroyed, leaving only the posterior capsule, and the lens matter is washed out through a second incision. A short film demonstrating the technique was shown. Discussion Oosterlwis: Would it not be advisable to remove the lens by means of the operation demonstrated in two sittings instead of in one? If discission of the lens is first performed alone, the part of the lens which was clear before the operation becomes opaque and thus more easily seen, and this facilitates the attempt to remove, if possible, all the lens matter. In the second place, the lens matter disintegrates as a result of the primary discission. During the next few days, the swelling resulting from the absorption of aqueous will make the structure of the lens fibres looser, and this will also make the removal of the lens matter easier. Worst replies: We often do perform a preliminary discission.