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CATARACT SURGERY BRouTLS 1633 to occur when using alpha-chymotrypsin but that this increase may be due to the slight increase in mechanical intervention. There seemed to be a slightly higher percentage of cases showing increased opacities in the vitreous in this series than in our previous cases. We feel that the difference was not great enough for us to draw a definite conclusion. There was no increase in the amount of the opacities in any case during the follow-up period.In our series the vitreous face was carefully inspected ovei a period of a year. The appearances were compared with earlier cases of our own and with the descriptions and statistics of previous authors relating to uncomplicated intracapsular extractions without the enzyme.We believe that there is no greater tendency either to bulging forward of the vitreous face or to the appearance of rents and tears in the anterior hyaloid membrane when alpha-chymotrypsin is used.There was no tendency towards deterioration in the vitreous face during the 12 months of the study.Our thanks are due to the nursing and clerical staff of the Croydon Eye Unit for their assistance, and in particular to Mrs. S. Tant, medical secretary.

Compared to before and to nurse and pharmacist prescribers, doctors appear better able to adhere to their regulatory body guidance. Given that all the independent prescribers in palliative care can prescribe the same drugs, consistent regulatory guidance is required.

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