a filtering scar which augments
whatever results may have been secured in the attempt to open up the
drainage into the canal of Schlemm.

Dr. Wood has referred to several of the many substitutes for iridectomy
that have been proposed, and it is unnecessary to enumerate them again
or to attempt to point out their good or bad features. It is sufficient
to say that for the average operator and the larger per cent of cases,
the operation which is easiest to perform, is attended with the least
risk and offers the best hope of permanent results should be the one of
choice. Sympathectomy has failed to secure a place in ophthalmic
surgery, sclerotomy has not been found adequate, and cyclodialysis is
not sufficiently simple of execution or permanently beneficial in its
results to give it prominence.

Of the operations proposed for the formation of a filtering cicatrix,
those of Elliot and Lagrange are justifiably the most popular. Those of
us who have had the pleasure of seeing the trephining operation done by
Col. Elliot are impressed with the fact that the operation, even in the
hands of its originator, is not, when properly done, uniformly easy of
performance. It does, however, offer the advantage of carrying with it
the minimum amount of risk, and the apparently permanent results secured
justify the ophthalmologist in acquainting himself with the technique of
the operation, for, as pointed out by Sydney Stephenson and others, "the
technique is responsible for success or failure." Furthermore, there is
no sufficient reason why the field of usefulness of the operation should
be confined to the chronic forms of glaucoma, and Col. Elliot
unhesitatingly recommends trephining as safer and more efficient than
any other operative procedures at present employed for the relief of
acute glaucoma.

The success of the Lagrange operation, which, like the Elliot operation,
aims to produce a fistulous communication between the anterior chamber
and the sub-conjunctival area, depends upon securing the removal of a
relatively large section of all of the layers of the scleral and corneal
lip of the wound, so that a permanent opening, covered by the replaced
conjunctival flap, is made. Unlike the trephine operation which was
evolved from it, the Lagrange operation requires the same kind of an
opening of the eyeball as required for a well executed iridectomy, and a
properly placed section entirely in scleral tissue, with a good sized
conjuncti