ter each operation. There were histological
examinations made of the eyeballs in 11 cases, in which the position of
the incision and excision, the development of the scar tissue, and the
appearance of the complications were duly set forth. The operator then
gave a history of over 178 trepanations after the Elliot method and
compares them with the procedure of Lagrange. He concludes that the
Elliot trephining operation is less dangerous, is more likely to be
followed by the development of a cystic scar, and leads to loss of the
eye in only 2.4 per cent of the eyes operated on. In Elliot's cases the
percentage of relapse was more noticeable than in the Lagrange cases
where no iridectomy was done. This observer concludes that the method of
Elliot is to be preferred to that of Lagrange, and that in the former
case iridectomy is an important factor in obtaining a favorable result.
This being the case one cannot truthfully say that trephining alone can
take the place of the old Graefe iridectomy. On the other hand,
trephining may with advantage be employed instead of iridectomy for
cases difficult or dangerous under the latter method.

Whatever difference of opinion was noticeable at the Vienna meeting, all
of those present, especially Meller, the reader of the paper just
quoted, were decidedly of the opinion that the Elliot operation is in
every respect the one best adapted to buphthalmia, or congenital
glaucoma.

In conclusion let me say that the acceptance or rejection of Colonel
Elliot's procedure or any other operation is not to be decided by the
percentage of iritis, secondary cataract, relapses, lost eyes, etc., but
by deciding whether or not his procedure in the various forms of
glaucoma gives the best results, including the preservation of
comfortable eyes. In other words, we are seeking not the operation that
will cure _every_ case of glaucoma but the one which is capable, _in the
hands of the average ophthalmic surgeon_, of relieving or curing _most_
cases of that affection.

Dr. Casey A. Wood's Paper on Operations Other than Scleral Trephining
for the Relief of Glaucoma

Discussion,

ALBERT E. BULSON, JR., M.D.,

Fort Wayne.

Increasing belief in Colonel Elliot's view that trephining should be the
operation of choice in any form of glaucoma, makes it difficult to
consider operations other than trephining in anything but a spirit of
disfavor.

Until recently the decision as to the kind of operati