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Elliot's trephining operation has proved of wonderful service in glaucoma and is now one of the recognized procedures in combating that disease. The technic is simple and the results are equally satisfactory compared with those following iridectomy. Moreover, there is but a minimum of optical disfigurement. The main objections are mechanical and can be attributed to the trephine itself. The hand trephine is difficult to steady and keep in the original incision while applying proper downward pressure and rotary motion. The watch-spring type of corneal trephine cannot be controlled accurately, and the small set-screws, for adjusting the cutting points, are apt to catch the conjunctival flap and badly lacerate it.
Therefore I devised the trephine herewith illustrated: A shaft, rotating freely within a rigid housing, is actuated by a flexible shaft at right angles to the main shaft and connected with it by a simple rack-and-pinion bearing. (Fig. 1). The
Gradle HS. NEW SCLERAL TREPHINE. JAMA. 1913;60(26):2045. doi:10.1001/jama.1913.04340260019013
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