with a
quiet uveitis or an iridokeratitis, when the patient exhibits traces of
old synechiae, or where there is danger of their re-formation, I do not
hesitate to use atropia as long as the wound of operation has not
healed.

To the present time I have done 72 operations of the sort and have seen
no reason to alter the opinion of it expressed in the article mentioned.
Whatever objection may in the future arise--and I freely confess that
it _seems_ to be fraught with the dangers that many of my colleagues
have pointed out as probable--I have so far not seen a single case of
infection of the wound of operation. While I believe the
anti-glaucomatous results to be excellent, I may also claim that the
operation is of the simplest character; and it is easy of performance
and the resulting filtration-scar is large and (perhaps) more permeable
to the changed intra-ocular fluids than the quicker healing wounds of
the usual Lagrange and Elliot procedures.

It is regarded by most operators as desirable that there should not be
long delayed healing of the operative wound, and the fact that the
conjunctiva covers the incision is often spoken of as an advantage,
partly because it shields the large open area produced by the Lagrange
incision from infection.

My experience of this modified operation continues to be that it is
necessary to clear the neighborhood of the operation wound entirely of
conjunctiva. If the down-growth of epithelium into the operative wound
is permitted the effects are by no means as pronounced, and the eventual
lowering of tension is not as permanent as they otherwise would be.

Another matter: I am satisfied that the delayed filling of the wound by
connective tissue is desirable in most cases of _chronic_ glaucoma. A
complete drainage of the intra-ocular fluids that results from long
delayed union of the wound edges, allows the interior of the eye to
regain, as far as possible, the _status quo ante_. On the other hand the
comparatively early closure of the wound (or the termination of _free_
drainage and minus tension) tends to re-establish the _status
glaucamatosus_. Whether these desirable results are to be realized or
not will, of course, depend upon a future experience larger than I have
yet had. This modification of the Lagrange operation seems to be a
radical one and I do not expect its adoption until the results of an
extended trial are carefully recorded and reported.

Quite recently several op