Postoperative intervention is a frequent occurrence after modern glaucoma surgery. This requires intensive postoperative follow-up and is a labour-intensive undertaking. Despite interventions in our group of patients, IOP in the intervention group was always higher than in the group that required no intervention.

24-H phasing offers little advantage over daytime phasing in the identification of IOP fluctuations or peaks in patients progressing despite acceptable clinic IOP readings. Daytime phasing is likely to be more cost-effective than 24-h phasing.

Aim To evaluate patients' preferences of surgeon to perform their cataract surgery if given a choice between consultant and trainee. Methods A questionnaire based patient satisfaction survey was conducted in a large University Teaching Hospital in the UK. One hundred and eighty patients undergoing first eye cataract surgery between January and March 2006 were asked a number of set questions on their preferences regarding the surgeon performing the operation. Primary outcome measure was the patient's preference for who would perform their cataract surgery (consultant or trainee). Results Overall, 126 (70%) accepted that trainee surgeons should operate as part of their training. Only 102 (81%) of these (57% of the total) would be happy to be operated on themselves by a supervised surgical trainee. Ninety-eight (78%) patients objected to being operated on by a trainee if they were to be unsupervised. One hundred and forty-two (79%) patients stated they would choose to wait longer for their surgery if it meant that a consultant would perform their operation. This preference was held significantly more strongly among patients who had been listed for surgery from a consultant's clinic rather than from the pooled 'cataract clinic' (P ¼ 0.048). One hundred and forty-four (80%) patients thought they should be told the name and designation of the surgeon who was to perform their operation. Conclusions Patients undergoing their first cataract procedure appear to have a preference for their named consultant to perform their surgery. If 'patient choice' extends to the choice of operating surgeon, then there are clear implications for the training of future UK ophthalmologists.

Aim To determine whether early bleb leak after MMC trabeculectomy affects intermediate intraocular pressure (IOP) outcome. Methods Retrospective case note review. All cases of MMC trabeculectomy with at least 1-year follow-up were included. Cases where a bleb leak occurred within the first month were identified. All cases without an early bleb leak formed the control group. Patient demographics and clinical factors were analysed to determine any factors predisposing to bleb leakage. IOPs were compared for 1 year postoperatively and final follow-up. Results A total of 119 trabeculectomies were included. Of these 27 (22.7%) had an early bleb leak. The remaining 92 cases formed the control group. Mean age of cases was 70.7 years. Mean follow-up time was 19.5 months. Mean time of detection of the bleb leak was 9 days (range 1-21 days). Four cases (14.8%) were managed by primary resuturing. Thirteen cases (48.1%) were managed conservatively with a bandage contact lens. Ten cases (37.0%) resolved with expectant management. There was no statistically significant difference between the two groups with regards to IOP measurement at any time point. Intervention rates were similar with regards to bleb massage, 5-fluorouracil injection, and needling revision. No factors were identified between the two groups that predisposed to bleb leaks occurring. Conclusion Our data suggest that early bleb leak is not a poor prognostic indicator for intermediate bleb survival and IOP control in patients undergoing MMC trabeculectomy. No additional bleb manipulations compared with the control group were required to achieve a satisfactory IOP outcome.

Our data suggest that a primary trabeculectomy augmented with a low dose of MMC is a safe and effective procedure for IOP reduction in patients with a low risk of trabeculectomy failure.