The rupture of the zonule in intracapsular cataract extraction; a new method.


THE rupture of the zonule (zonula Zinnii) of the crystalline lens is the sine qua non of intracapsular cataract extraction. It is the purpose of this paper to record some personal observations and experiences and to add them to existing knowledge of the best means of rupturing the zonule in various types of eyes with their different cataracts and zonules. The finding of a fairly large percentage of resistant zonules in the author's surgical experience is accounted for by the fact that the greater proportion of the cataracts operated upon are in the immature stage. In this period, both the capsule and the zonule are more nearly normal and resistant than in mature or hypermature cataracts when both capsule and zonule may be quite fragile. The author's system of intracapsular cataract surgery will be further explained and his new method for direct rupture of the zonule in difficult cases by stripping it from its attachment to the lens capsule will be elaborated upon. Applied swrgical anatomy. The zonule.-The zonule may be defined as the suspensory ligament of the crystalline lens. It consists of homogeneous glass-like fibres covered by a delicate lamella on their anterior surface, 'taking their origins from the ciliary body, and from the ora serrata where their arrangement undoubtedly accounts for its serrated appearance. The principal fibres run in the ciliary valley and by their early presence and strong formation account for the alternation of ciliary processes and valleys. Termination and insertion is made by the fibres splitting and diverging to fuse with the zonular or most superficial portion of the anterior lens capsule and with the capsule itself in its equatorial portion. In the living, normal eye with the zonule surrounded by aqueous, the lamella being of the same index of refraction as the aqueous, is invisible even with the magnifications possible with the slit-lamp microscope. Only when the eye is opened as in surgery or in the dissection of the fresh specimen is the lamella visible when exposed to the air, and then only when properly illuminated, best with parallel rays of incident light and

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@article{Kirby1949TheRO, title={The rupture of the zonule in intracapsular cataract extraction; a new method.}, author={Dr Brian Kirby}, journal={The British journal of ophthalmology}, year={1949}, volume={33 1}, pages={3-21} }