The results show it is safe to review patients 2 hours after uneventful phacoemulsification and omit the next-day review. This enhances patient acceptance of true day-case cataract surgery as it eliminates the need for an inpatient stay and transport on the following day. It also improves utilization of hospital resources. A larger study will help confirm the conclusions of this study.

Kettering SUMMARYPurpose: The purpose of the study was to assess the value of perioperative intraocular pressure (lOP) measurement in trabeculectomy as a predictor of drainage and related complications in the early post operative period.Methods: A prospective study was undertaken of 42 eyes (39 patients) followed up after trabeculectomy for the first post-operative month.Results: Analysis of the change in lOP in the first post operative month showed that at 1 month tbe pressure in all cases tended to similar values irrespective of the mean perioperative lOP. Early shallowing of the anterior chamber was, however, associated with a significantly lower perioperative lOP, although there was no significant difference in lOP at 1 month in these cases. Conclusions:The perioperative lOP appears to be effective in predicting anterior chamber shallowing in the first post-operative month with good sensitivity and specificity, but has little value as a predictor of the lOP at 1 month.Flat or shallow anterior chambers with persistent hypotony were complications frequently seen in the full-thickness filtering procedures and led to the development of trabeculectomy in the late 1960s. 1 . 2 Whilst trabeculectomy certainly appears to have fewer of these complications there is still a problem of unpredictable drainage in the immediate post operative period ? A Insufficient drainage, usually due to a tight scleral flap or occlusion of the trabeculectomy site by the iris From:

Over recent years the British Government has pursued a policy encouraging the integration of primary and secondary health care. This drive to promote the efficient delivery of primary care at local centres has seen the forging of co-operative alliances between various healthcare practitioners. A notable development has been the growth of optometric practice-based schemes for monitoring the eyecare of diabetic patients. This paper reports on the first twelve months operation (April 1995-March 1996, inclusive) of such a 'collaborative care' scheme operating in the Kettering Health Area of Northamptonshire. With the co-operation of their general medical practitioner (GMP) and under the case-review of the hospital-based specialist, diabetic patients attended participating optometric practices for an annual sight test and eye examination including mandatory fundus assessment under mydriasis. A brief 'ticked menu' report was subsequently forwarded to the patient's GMP for filing or action as necessary. A copy was also sent to the hospital clinic to enable updating of the diabetic patient database and for the authorisation of the supplementary fee payable to the examining optometrist. An audit of the first year of operation has indicated that those 92% of optometrists in the locality who participated in the programme logged 34% of the projected diabetic population of the Kettering Health Area. Of these individuals, 10.8% were identified as requiring referral for ophthalmological assessment, including 0.7% who needed urgent intervention. Approximately 80% of the referrals were assessed in the Ophthalmology Clinic within the twelve month timeframe of this first year audit; one-third of these patients received treatment and/or a second review over this period, the net outcome being that one-half of the original referrals were returned to the programme for continued routine annual screening. The scheme has received a funding allocation for a further financial year, with the possibility of its extension county-wide being kept under review.

SUMMARY Refraction was performed at frequent, regular intervals for six months following routine intracapsular cataract extraction. Patients were divided into two groups, those whose limbal sections were closed with 8-0 virgin silk or with 9-0 nylon. The stabilisation of refraction was observed, and the most suitable time to prescribe 'first glasses' was estimated retrospectively. In the silk group this was found to be at three months in the nylon group at four months. However, results in the latter were less predictable with greater variation.This report was undertaken to determine the rate of stabilization of refraction following intracapsular cataract extraction, with the aim of improving efficiency of the 'first glasses' prescription.Many authorities recommend prescribing glasses when serial refraction shows no significant change. If this procedure is followed carefully, it may require frequent clinic visits. Hence first glasses are often prescribed after a fixed postoperative period of about two months. This has been the practice for several decades, during which surgical practices and patient expectations have changed greatly.Glasses prescribed too early, before refraction has stabilised, may cause disappointment and unnecessary expense for the patient; too late prescription may prolong disability and frustration.Changes in corneal curvature following cataract surgery have been recognised for over a century, having been first described by Donders' in 1864. Many other workers have since investigated the nature of postcataract astigmatism. The effects of the following factors have been studied: type,2' depth,' and number' of sutures, pre-or postplaced sutures,6 wound placement,' and size of wound.8 Change of corneal curvature as a function of time has also been considered.In 1935 Groenholm' reported keratometric studies on 200 eyes following cataract extraction without sutures and with one or two sutures. The initial high degree of astigmatism at 10 days was found to be halved at two months. Particular attention was paid to resultant astigmatism and frequent regular keratometry was not included.Floyd"' reported on a total of 47 eyes following