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With all of the current interest worldwide in Italian coffee, little has been said about the coffee roasting machinery which Italians are using. In recent years, more than anything else, [...]

Surgeons who treat patients with glaucoma are often challenged with the management of conjunctival wound leaks following trabeculectomy. Loss of bleb function, hypotony, and shallowing of the anterior chamber can occur. Various modalities of treating a conjunctival leak include resuturing or use of a pressure patch, bandage contact lens,1 conjunctival patch,2 tissue adhesive,2 or glaucoma shell tamponade.3 We describe a case in which argon laser burns were used to seal a conjunctival wound leak. We present it here to add to the armamentarium of the surgeon managing this problem. REPORT OF A CASE. —A 62-year-old man underwent trabeculectomy with a limbal-based conjunctival flap and a limbal-based partialthickness scleral flap. The scleral flap was closed with two releasable 9-0 nylon sutures passed through the conjunctiva outside the incision. The conjunctival incision was closed with a running 10-0 nylon suture on a BV130-4 needle. Postoperative management was complicated

IN REPLY. —We welcome the comments of Keller and To. Krypton laser is not as readily available to most ophthalmologists as is argon laser. Regardless of which laser is used, in addition to minimizing power and duration of applied laser energy, enlarging the spot size will reduce the amount of energy delivered to any given site.

We describe two cases of persistent bleb leak with hypotony after argon laser suture lysis (ALSL). One case occurred 16 days after trabeculectomy using intraoperative mitomycin C, and the other, 16 weeks after trabeculectomy. We wish to alert other practitioners to the slowed healing of conjunctiva after trabeculectomy involving mitomycin C.1-3In each patient, a cellulose sponge soaked in a 0.5-mg/mL solution of mitomycin C was placed between the episclera and the conjunctiva for 4 minutes after the trabeculectomy flap had been outlined, but before it had been dissected.See also pp 1069, 1072, and 1150. REPORT OF CASES.—CASE 1. —A 60-year-old man had sustained blunt trauma with displacement of the superior haptic of the posterior chamber intraocular lens, angle recession, and sustained elevation of intraocular pressure that was unresponsive to maximum medical therapy. Three weeks after the injury, he underwent trabeculectomy with repositioning of the lens