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The cataract operation is justly regarded as among the most delicate in surgery. I do not believe that any surgeon, however skilful and experienced, approaches the extraction of a cataract without a certain degree of apprehension and trepidation.
There are two elements in the phenomenon: first, the delicacy of the technic together with the momentous issue involved, namely, the restoration of sight to the blind; second, the possible complications from action of the patient. The surgeon realizes that in spite of all the precautions with which he surrounds the operation, in spite of the highest degree of technical skill, a sudden and often involuntary squeeze of the eye on the part of the patient may absolutely ruin his operation and destroy hopelessly the sight of his patient.
This problem has been attacked in many ways. One popular method is to have an assistant hold the lids apart with lid elevators
Cullom MM. AN EYE SPECULUM FOR USE IN CATARACT EXTRACTION. JAMA. 1932;99(15):1252-1253. doi:10.1001/jama.1932.27410670001012a