Postoperative Cataract Complications by Latent Infections

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No fundic reflex could be seen through the recent iridotomy. Tension was 40 by McLean; transillumination almost black, probably haemorrhage. Under treatment with dionin, atropin, syrup of hydriodic acid, etc., and after a study of the patients general condition, the eye has gradually improved. September 28, 1934, blood count showed red cells, 4,800,000; white cells, 14,200; and neutrophiles, 64 per cent. There was a subacute, non specific prostatitis. May 7, 1935, the eye is now white, tension normal, transillumination clear. If another blood count and examination of prostate demonstrates conditions satisfactory, we will feel satisfied in making another iridotomy, expecting a much better result.

This case may be classified as one of the vague focal infections interfering with and delaying a postoperative convalescence.

COMMENT.

All four of these cases were apparently adequately investigated before entering for intra-ocular surgery. Therefore, there was no way of anticipating the complications which developed postoperatively. The writer wonders whether an intracapsular operation in an or all of these patients might have made any difference in the results which followed. Of the total number of patients coming to cataract operations, there doubtless are a great many who are probably inadequately investigated, particularly from the point of view of general physical conditions, and there must be a certain larger or smaller number of such results as are herein reported.

The large majority of cataract operations are done an patients whose general physical conditions is not good for one or more of several reasons and it is surprising oftentimes how good a surgical result is obtained in the presence of unfavorable circumstances. My answer to an inquiring patient about an anticipated result ion any given cataract operation depends upon the following factors; a healthy eye in an otherwise fairly healthy body, a capable surgeon with experience, and an operation in a hospital accustomed to caring for cataract cases which ought to carry with it very high percentage of good results.

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