Combined Trabeculectomy

Should there be a larger Role for the Suprachoroidal Space in Glaucoma surgery? Combined Trabeculectomy/Cyclodialysis with Healon retained & augmented with 5FU : “ Influences & Innovations”.

Lateral Thinking in Glaucoma Surgery

A unique case history of a young woman, who was operated for glaucoma, for the third time, in both eyes. Prof. A. C. (Tony) Molteno is on record as saying that the only procedure that will work in such third time cases is a Molteno or similar valve. This lady is believed to maybe be the only case ever of a Scheie’s procedure augmented with: (1) Posteriorly directed tunnels on both sides of the superior rectus muscle - (2) Retained Healon in both the anterior chambers and the two tunnels & - (3) 5FU. After having been continuously on eye drops from 1980-1997, she is now drop free with low normal pressures for nearly 20 years, and with no further progressive visual field loss during all that time.

Manual Small-Incision Cataract

A history of manual small-incision cataract surgery from its origins in the 1980s to it being today the most widely performed surgical procedure in the third world.

Negative Vertical Astigmatism

An analysis of the effects of negative vertical astigmatism with respect to the visions of twenty patients, who had undergone cataract and lens implant surgery.

Removal tumour 1

A case history of a Fibrous Histiocytoma of the Conjunctiva, a locally malignant non-metastatic tumour which recurred twice after apparently complete surgical excision, but was cured in 1982 by immunotherapy.

Removal tumour 2

A case history of a rapidly growing squamous cell carcinoma, which was treated and cured by a 2000 year old Indian procedure. A large amount of lower lid was excised and the resultant wound was allowed to heal by granulation alone, yielding a brilliant cosmetic result. There was no suturing performed, no rotation of flaps occurred, and no skin grafts were undertaken.

Removal tumour 3

A case history of a large limbal squamous cell carcinoma-in-situ, which was excised using “Gerard Crock’s Contact Lens Corneal Cutter”, which, in turn, had been specifically designed for corneal graft surgery. This yielded an excellent result with negligible astigmatism.

Suture Repair of Involutional Entropion

Progress in Medical Science and development of new surgical techniques is largely due to the interaction of new ideas and new technology. There is a temptation to be concerned only with the present and the future, and to ignore the past. However it is important to recognise that brilliant ideas can go into disrepute, because they pre-date by many years the necessary technology to bring them to full fruition. The suture repair of involutional entropion is such an idea! The procedure is simple, quick and bloodless and ideal for use with local anaesthetic in rooms, but even more so an absolute boon when treating severely demented, bedridden patients in institutions.