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 conjunctival flap, are elements which enter into the ultimate success or failure of the procedure. Aside from the dangers incident to a wide incision in the neighborhood of the ciliary body and the possibility of accident to the lens or vitreous body, or of intra-ocular hemorrhage, there is for the average operator the added difficulty and danger in removing a piece of sclera of the exact size required. The technique of the operation is even more difficult and exacting than in the performance of the trephine operation, and it also compares unfavorably in safety.