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Glaucoma patients with thin central corneal thickness are more likely to be found at an advanced stage of the disease and among those with normal-tension glaucoma and black African ancestry. Underestimation of intraocular pressure by Goldmann applanation tonometry could be one causative factor.

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between the sclera and the conjunctival flap, taking care not to expose the cut back edge of the conjunctival flap to the 5-FU soaked sponge. A typical sponge measured 6 mm (length) by 2 mm (width) by 1 mm (thickness). The sponge was removed, resoaked, and replaced every minute up to 5 minutes. The area was then rinsed with 20 ml of balanced salt solution over a period of 30-60 seconds through a Southampton irrigating cannula. Only after this was completed was a third to a half thickness rectangular scleral flap (4 mm by 3 mm) dissected and raised to the limbus. This was to minimise any intraocular penetration of 5-FU. A block of tissue measuring approximately 3 mm by 1 mm was resected and a peripheral iridectomy performed. The flap was then sutured down with four 10/0 nylon sutures. The back edge of the conjunctival incision was closed in a single layer with 10/0 nylon suture. All patients received postoperative topical dexamethasone metasulphobenzoate 0 1% eye drops four to six times a day and chloramphenicol eye drops four times a day.Eyes were examined on at least day 1, week 1, month 1, 3, 6, and 9 and intervals in between if clinically indicated. Postoperative observations and measurements included visual acuity, intraocular pressure (Goldmann applanation tonometry), slit-lamp biomicroscopy, and fundal examination. ResultsSurgery was performed on 34 eyes of 33 patients with intraocular pressure uncontrolled on maximally tolerated medical therapy. The causes of glaucoma in the eyes are listed in Table 1

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