In Scandinavia, pseudo-exfoliative glaucoma accounts for approximately one half of cases of open-angle glaucoma (Aasved, 197I) and displays a number of characteristic features that distinguish it from simple glaucoma. The intraocular pressure (IOP) is usually higher and the prognosis poorer. These eyes also display characteristic changes in the anterior ocular segment, including deposition of pigment, flakes, and amorphous material.The medical therapy of pseudo-exfoliative glaucoma is often insufficient and we have therefore chosen to study a microsurgical approach. This paper presents the results of trabeculectomy in 52 eyes. MethodThe surgical technique followed that described by Watson (I969). An operating microscope (Zeiss Op-Mi 7) was used in all cases. Peroral intake of I001-50 ml. 50 per cent glycerine 30 min. before surgery was used for reduction of the IOP.Conventional retrobulbar anaesthesia and akinesia was administered. A large, full conjunctival flap was fashioned with an incision parallel to the corneo-scleral limbus. In the I 2 o'clock position a half-thickness limbus-based scleral flap measuring 4 x 6 mm. was prepared. The lamellar dissection in the anterior direction passed the limbus and entered the corneal tissue. All bleeding vessels were cauterized. The incision into the anterior chamber was placed immediately in front of Schwalbe's line in clear corneal tissue. As a rule the basal iris prolapsed and was perforated with release ofaqueous whereafter spontaneous reposition of the iris took place.A radial cut backwards from the right end of the corneal incision divided the trabecular band, Schlemm's canal, and the scleral spur. The next cut was made in the sclera parallel to and just behind the scleral spur. The uveal meshwork was separated from the trabecular band with open scissors and the trabeculectomy block was then released by a second radial cut at the left end of the corneal incision.A broad basal iridectomy was carried out corresponding to the trabeculectomy and the scleral trapdoor was sutured with virgin silk, using two stitches. The conjunctiva was closed with a running 6-o silk suture. i per cent atropine eye-drops and i per cent chloramphenicol ointment were instilled before padding. The patient was allowed up after dressing on the first post-operative day and discharged on the sixth day.Atropine drops were continued for 5 weeks but no routine steroid therapy was given.