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Ultrasound axial length measurements were obtained on infants under a birthweight of 1500 g or 32 weeks gestation undergoing screening for retinopathy of prematurity (ROP). A total of 496 readings were obtained on 171 infants between 32 and 41 weeks post-conceptual age. Other details recorded were maximum stage of acute ROP, birthweight, gestational age, sex, and biparietal and occipitofrontal head diameters. The relationship of these variables to axial growth of the eye was examined using analysis of covariance with a repeated measures approach. Mean axial length increased from 15.27 mm to 16.65 mm in the left eye during this period. Following adjustment for repeated readings a growth rate of 0.18 mm/week was obtained for both eyes. Male infants were found to have longer axial lengths despite correction for birthweight, gestation and head size (p < 0.0001 right and left). Higher stages of acute ROP were also associated with shorter axial length (p < 0.05 for all stages of both eyes) but the rate of growth during the study period did not demonstrate significant differences between stages. Stage 3 infants reaching the threshold for cryotherapy had shorter axial length than stage 3 infants not receiving treatment. The effect of prematurity on the growth of the eye and the significance of these findings with respect to the subsequent development of refractive errors in premature infants are discussed.

Adjunctive chemotherapy with Mitomycin C (MMC) has been used in an attempt to modulate the wound healing response in glaucoma filtration surgery. A consecutive series of 20 eyes from 18 patients undergoing trabeculectomy with MMC intraoperatively was studied. Sixteen cases were considered high risk regarding surgical success and 4 patients with low tension glaucoma (LTG) required lower intraocular pressure (IOP) to prevent further visual field loss. Surgical technique involved the use of a limbal-based conjunctival flap and MMC 0.2 mg/ml applied via a sponge (under the scleral flap) to both scleral and conjunctival surfaces for 5 minutes. The mean follow-up period was 12.7 months (range 3-24). There were 17 successful eyes. Of these, 14 are high pressure glaucoma eyes with a mean pre-operative IOP of 30.9 +/- 10.9 mmHg and a mean postoperative IOP of 15.3 +/- 5.2 mmHg (p = 0.001). The remainder of the successful cases include 4 patients with LTG with a mean preoperative IOP of 17.8 +/- 0.5 mmHg and a mean postoperative IOP of 6.8 +/- 0.7 mmHg (p = 0.001). Serious complications included chronic repeated bleb leaks (n = 2) and scleral necrosis (n = 2). There was one case of hypotonous maculopathy. These results are comparable with those of other studies. Despite a relatively low dose of MMC serious side-effects were encountered. Management of these complications is described, and how these effects may be prevented by altering scleral exposure to MMC. In addition a possible explanation for the serious side-effects of MMC-treated trabeculectomies is presented.