Effects of terrestrial dissolved organic matter on a bloom of the toxic cyanobacteria, Raphidiopsis raciborskii.

The concentration of coloured terrestrial dissolved organic matter (tDOM) from vegetation appears to be increasing in lakes in some regions of the world, leading to the term brownification. The light attenuating effect of coloured tDOM on phytoplankton growth has been a major focus of attention, but the phytotoxic effects of tDOM, particularly on cyanobacterial blooms, are less well understood. This mesocosm study tested whether coloured tDOM, leached from the leaves of a Eucalyptus tree species, inhibited a naturally occurring bloom of the toxic cyanobacterium, Raphidiopsis raciborskii, in a reservoir over a 10 day period. The study found that tDOM leachate, measured as dissolved organic carbon (DOC), inhibited photosynthesis and growth of both R. raciborskii, as well as species present at lower densities, i.e. other cyanobacteria and diatoms. However, the effect was greater at higher tDOM input loads. The photosynthetic yield (Fv/Fm) of cyanobacteria decreased rapidly in treatments with 5.9 and 25 mg L-1 DOC addition, compared to the control (reservoir water with background DOC concentration of 6.85 ± 1.09 mg L-1). tDOM had no measurable effect in the 2 and 3.3 mg L-1 DOC addition treatments. By day 5, cell densities of cyanobacteria, including R. raciborskii, and diatoms, in treatments with 5.9 and 25 mg L-1 DOC addition were significantly lower than the control with no tDOM addition, and this effect continued throughout the experiment. This is despite the leachate addition increasing phosphate concentrations which counteracted the low background concentrations of phosphate. Light attenuation and dissolved oxygen (DO) levels were also affected by the tDOM addition, but were only significantly lower in the 25 mg L-1 DOC treatment compared with the control. DOC, dissolved organic nitrogen (DON) and dissolved organic phosphorus (DOP) concentrations all decreased in the tDOM addition treatments over the first 3 days, as the microbial cell densities increased. The components of the tDOM that decreased over time were determined by 1H NMR spectroscopy in the 25 mg L-1 DOC treatment. After 5 d, the relative concentrations of fatty acids, sugars and gallic acid decreased by around 60%, while concentrations of flavonoids and myo-inositol decreased by 45 and 35% respectively. This study suggests that phytotoxic compounds in tDOM can suppress cyanobacterial blooms, despite the increased nutrient inputs. This has implications for predicting the future likelihood of cyanobacterial blooms in lakes and reservoirs with climate-change driven changes in flow events, and other changes in the amount and types of vegetation cover. Revegetation of riparian zones, resulting in increased tDOM into waterways, may also be beneficial in reducing cyanobacterial blooms.

Challenges and Opportunities for Integrating Dealloying Methods into Additive Manufacturing.

The physical architecture of materials plays an integral role in determining material properties and functionality. While many processing techniques now exist for fabricating parts of any shape or size, a couple of techniques have emerged as facile and effective methods for creating unique structures: dealloying and additive manufacturing. This review discusses progress and challenges in the integration of dealloying techniques with the additive manufacturing (AM) platform to take advantage of the material processing capabilities established by each field. These methods are uniquely complementary: not only can we use AM to make nanoporous metals of complex, customized shapes-for instance, with applications in biomedical implants and microfluidics-but dealloying can occur simultaneously during AM to produce unique composite materials with nanoscale features of two interpenetrating phases. We discuss the experimental challenges of implementing these processing methods and how future efforts could be directed to address these difficulties. Our premise is that combining these synergistic techniques offers both new avenues for creating 3D functional materials and new functional materials that cannot be synthesized any other way. Dealloying and AM will continue to grow both independently and together as the materials community realizes the potential of this compelling combination.

The role of rectus muscle myectomy in the management of large-angle strabismus for Graves' ophthalmopathy.

PurposeRetrospective noncomparative case series to investigate the role of rectus muscle myectomy for the treatment of large-angle strabismus in patients with Graves' ophthalmopathy.Patients and methodsData from 47 consecutive patients with Graves' ophthalmopathy who underwent complete myectomy for large-angle strabismus (strabismus greater than 25 prism diopters (PDs)) were collected retrospectively. Pre- and postoperative deviations in primary and reading position were measured in PDs. Postoperative deviation of <5 diopters in primary gaze and functional binocular vision in central 30° field were considered as successful surgical outcomes.ResultsPatients undergoing complete myectomy of the restricted muscles in large-angle strabismus achieved a 78.7% success rate after the first surgery. Reoperation performed on seven patients resulted in 85.7% success rate in reoperation group. The overall success rate was 91.5%. The mean efficacy of the isolated rectus muscle myectomy was 34.3±7.7 PDs.ConclusionsThe complete rectus muscle myectomy technique is effective and predictable in the treatment of large-angle strabismus in patients with Graves' ophthalmopathy.

Effects of diethyl maleate on aryl hydrocarbon hydroxylase and on 3-methyl-cholanthrene-induced skin tumorigenesis in rats and mice.

Topical administration of diethyl maleate (DEM) and L-methionine sulfoximine (MS) reduced the L-glutathione (GSH) levels in kidneys, livers, and skin of inbred BALB/c mice. Topical administration of DEM to BALB/c mice also increased the latency period before development of skin tumors that were induced by 3-methylcholanthrene painting. Similar treatment with MS also increased the latency period, though the delay was not as striking as that observed after DEM administration. Furthermore, DEM, which was believed to be specific in its action in reducing tissue GSH, was also capable of inhibiting aryl hydrocarbon hydroxylase (AHH) both in vitro and in vivo. Cyclohexene sulfide, another "specific" inhibitor of GSH transferase, inhibited AHH activity as well. Accordingly, the blockade of AHH by DEM may have been partly responsible for the increased latency time in the skin tumorigenesis experiments.

Aryl hydrocarbon hydroxylase in mouse mammary gland.

The specific activity of aryl hydrocarbon hydroxylase in the mammary gland has been measured in six different mouse strains comprising both mammary cancer susceptibility and resistance, under basal conditions, and after pretreatment of the mice with 3-methylcholanthrene (3MC). No correlation was observed between the ease of 3MC-enhanced mammary tumorigenesis and the basal or induced specific activity of aryl hydrocarbon hydroxylase. Furthermore, it was shown that in the AKR/J and A+/Ki mice, only minor enhancement in aryl hydrocarbon hydroxylase was seen upon injection of 3MC. The C57BL/6J and C3Hf/He Tex mammary glands responded the most in this regard. It was also shown that the inability of the AKR/J or A+/Ki mice to respond was not due to their inability to absorb 3MC from the peritoneal cavity and transmit the polycyclic hydrocarbon to the mammary gland.

Inability of vitamin A deficiency to alter benzo(a)pyrene metabolism in Syrian hamsters.

Syrian golden hamsters were placed on a control or vitamin A-deficient diet. When their serum vitamin A content was significantly reduced, i.e., to less than 10% of controls, the hamsters were killed and lung aryl hydrocarbon hydroxylase activity and metabolism of benzo(a)pyrene were determined. The benzo(a)pyrene metabolite profile was similar with control and A-deficient systems, and only few quantitative differences were noted. Addition of beta-retinyl acetate to the in vitro incubations did not substantially affect benzo(a)pyrene metabolism.

π Berry phase and Zeeman splitting of Weyl semimetal TaP.

The recent breakthrough in the discovery of Weyl fermions in monopnictide semimetals provides opportunities to explore the exotic properties of relativistic fermions in condensed matter. The chiral anomaly-induced negative magnetoresistance and π Berry phase are two fundamental transport properties associated with the topological characteristics of Weyl semimetals. Since monopnictide semimetals are multiple-band systems, resolving clear Berry phase for each Fermi pocket remains a challenge. Here we report the determination of Berry phases of multiple Fermi pockets of Weyl semimetal TaP through high field quantum transport measurements. We show our TaP single crystal has the signatures of a Weyl state, including light effective quasiparticle masses, ultrahigh carrier mobility, as well as negative longitudinal magnetoresistance. Furthermore, we have generalized the Lifshitz-Kosevich formula for multiple-band Shubnikov-de Haas (SdH) oscillations and extracted the Berry phases of π for multiple Fermi pockets in TaP through the direct fits of the modified LK formula to the SdH oscillations. In high fields, we also probed signatures of Zeeman splitting, from which the Landé g-factor is extracted.

Interleukin-8 is induced in skin equivalents and is highest in those derived from psoriatic fibroblasts.

Interleukin-8 (IL-8) may be important in psoriasis as it is expressed in the stratum granulosum, attracts polymorphonuclear cells, and stimulates angiogenesis and keratinocyte mitogenesis. To study intrinsic cutaneous factors in psoriasis, we constructed skin equivalents from psoriatic or adult control fibroblasts with normal foreskin keratinocytes. IL-8 levels were measured in supernatants by enzyme-linked immunosorbent assay and in skin equivalents by immunohistochemistry and in situ hybridization. IL-8 was highly induced in skin equivalents compared to cells grown alone. Epidermal stratification varied among fibroblast lines and was correlated with IL-8 levels, but lesional and nonlesional psoriatic skin equivalents from the same donor were similar. Six fibroblast lines (two psoriasis lesion and four normal) supported only monolayers, while 12 lines (seven psoriasis lesion and five normal) produced stratification. Mean IL-8 levels were significantly lower in dermal equivalents of the first group than the second (0.78 +/- 0.40 vs 3.93 +/- 2.83 ng per ml, mean +/- SD, p = 0.01, analysis of variance). Significantly more IL-8 was secreted by psoriatic than normal fibroblast skin equivalents over 14 d (p = 0.015) with greatest differences at 1 and 4 d. Psoriatic IL-8 levels peaked first and remained increased. IL-8 protein and mRNA were initially strongest in dermal fibroblasts, and at the dermal-epidermal interface. Diffuse epidermal expression was replaced by accentuation in the stratum granulosum. Psoriatic skin equivalents were thicker, had more intense IL-8 staining, and developed invagination. We hypothesize that an IL-8 paracrine loop between fibroblasts and keratinocytes may play a key role in epidermal regeneration in the skin equivalent, in normal wound healing, and in the determination of an intrinsic psoriatic wound-healing phenotype.

Inhibition of the replication of native and 3'-azido-2',3'-dideoxythymidine (AZT)-resistant simian immunodeficiency virus (SIV) by 3-nitrosobenzamide.

The 3-nitrosobenzamide (NOBA) drug abolishes SIV replication sharply at 20 microM concentration when CEM x 174 cells are preincubated for 1 h with the drug prior to viral infection. Treatment of CEM x 174 cells with 20 microM NOBA resulted in the inhibition of the synthesis of the DNA sequence coding for the gag gene, as determined by the PCR technique. Cell viability was directly proportional to the antiviral action of NOBA. Replication of AZT-resistant SIV 23740 in MMU 23740 cells in vitro was suppressed by NOBA in a concentration-dependent manner without significant effects on cell viability. Reverse transcriptase activity of SIVmac239 was unaffected by NOBA up to 800 microM concentration. Preincubation of two SIV strains with NOBA completely abolished their infectivity in human PHA-PBL cells. Replication of two strains of SIV in PHA-PBL cells was also inhibited by NOBA.

Incidence of perihepatic adhesions in ectopic gestation.

OBJECTIVE: To compare the incidence of perihepatic adhesions in patients undergoing surgery for ectopic pregnancy with the incidence in patients undergoing elective laparoscopic sterilization. Fitz-Hugh-Curtis syndrome is a perihepatitis that usually occurs as a complication of pelvic inflammatory disease. Perihepatic adhesions may be an aftereffect of the acute hepatic episode, and because the cause of ectopic gestation is thought to be salpingitis, women with an ectopic gestation may also have a higher prevalence of coexisting perihepatic adhesions. METHODS: We reviewed charts of 97 women who had undergone laparoscopy or laparotomy for ectopic pregnancy (study group) and 116 women who had laparoscopic sterilization (control group). We recorded all perihepatic, pelvic, or abdominal adhesions that were documented at the time of surgery. Medical histories and sites of adhesions in the two groups were compared. RESULTS: The incidence of perihepatic adhesions was 14% in the study group compared with 3% in the control group (P < .01). For the total patient population, a history of pelvic infection correlated positively with the presence of perihepatic adhesions (P < .01), and the study (ectopic) group had a higher incidence of previous pelvic infection. CONCLUSION: Compared with control subjects, significantly more women with ectopic pregnancies had perihepatic adhesions. In women who have history of pelvic infection or ectopic pregnancy, physicians should inquire about long-term right upper quadrant pain. The inclusion of lysis of perihepatic adhesions in the preoperative consent form may be useful.

Male infertility. Evaluation and nonsurgical therapy.

Male infertility is a complicated and often poorly understood pathologic process. The cause of a man's infertility frequently remains unknown even after a thorough evaluation. Many of the currently available medical therapeutic options are empirical and lack documentation of efficacy. New diagnostic tests are emerging that may help define some previously obscure causes of infertility. Only when these abnormalities have been clearly identified will more specific and cost-effective treatment regimens be instituted.

Assessment of anterior chamber flare and cells after laser in situ keratomileusis.

PURPOSE: To determine the presence of anterior chamber flare and cells after laser in situ keratomileusis (LASIK) for the correction of myopia. SETTING: Hermann Eye Center and the University of Texas Medical School, Department of Ophthalmology and Visual Science, Houston, Texas, USA. METHODS: Forty-three eyes of 23 consecutive patients ranging in age from 24 to 62 years had LASIK for myopia. All surgeries were performed by a single surgeon using a VISX Star laser and the same technique. Patients received no preoperative antiinflammatory medications. Postoperatively, all patients were instructed to use 1 drop of ofloxacin (Ocuflox) and 1 drop of fluorometholone 0.1% (FML) in the operated eye 4 times daily while awake for 7 days. At baseline and postoperative days 1, 7, and 28, anterior chamber flare was measured and cells were counted using a Kowa laser flare meter (FM-500) and laser cell counter (LC-500), respectively. RESULTS: Flare and cells increased significantly on day 1 (P <.0001 for both flare and cells) and returned to preoperative levels by day 7. No statistically significant correlation was detected between the amount of inflammation and the number of laser pulses (P =.2922) or the ablation time (P =.8383). CONCLUSIONS: A significant increase in anterior chamber inflammation occurred during the first 24 hours after LASIK. Inflammation levels then subsided to preoperative levels by day 7 with steroid use. Anterior chamber inflammation did not appear to correlate with the duration of the ablation or the number of laser pulses.

Epithelial healing rates with topical ciprofloxacin, ofloxacin, and ofloxacin with artificial tears after photorefractive keratectomy.

PURPOSE: To determine whether corneal epithelial healing differs after the use of topical ciprofloxacin alone, topical ofloxacin alone, or topical ofloxacin with artificial tears in patients having photorefractive keratectomy (PRK). SETTING: Department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston, Houston, Texas, USA. METHODS: Eighteen patients (6 women, 12 men) with moderate myopia (-1.50 to -6.00 diopters [D]) had standardized PRK. Patient age ranged from 25 to 62 years. The 28 eyes (16 right, 12 left) were randomized into 3 treatment groups: ofloxacin alone, n = 9 eyes; ciprofloxacin, n = 9 eyes; and ofloxacin with Refresh Plus, n = 10 eyes. The drugs were administered immediately after surgery and then every 6 hours. Video recordings of the corneal wounds stained with fluorescein were performed at 8:00 AM and 4:00 PM using a video slitlamp camera with a cobalt-blue light until the wound completely healed. The videotaped images were recorded and analyzed by a computer planimetry program. Wound areas were recorded and compared among the 3 drugs. The square-root transformation was applied to the wound area to obtain a constant healing rate. Statistical comparisons were analyzed using an analysis of variance test. RESULTS: Mean recovery time was 82.67 hours +/- 14.42 (SD) in the ofloxacin eyes, 120.89 +/- 34.05 hours in the ciprofloxacin eyes, and 76.80 +/- 19.30 hours in the ofloxacin with Refresh Plus eyes. Mean healing rate was 0.66 +/- 0.17 hours, 0.54 +/- 0.16 hours, and 0.67 +/- 0.15 hours, respectively. The healing rate was significantly higher in the ofloxacin with Refresh Plus eyes than in the ciprofloxacin eyes (P < .0001). There was no significant difference between the ofloxacin eyes and the ofloxacin with Refresh Plus eyes (P = .42). CONCLUSION: Ofloxacin with Refresh Plus and ofloxacin alone had a more positive effect on epithelial healing than ciprofloxacin. The ciprofloxacin eyes were significantly more prone to impaired or delayed wound healing and to the development of corneal haze.

cGMP mediates corpus cavernosum smooth muscle relaxation with altered cross-bridge function.

We tested the prevailing paradigm that relaxation of corpus cavernosum smooth muscle (CCSM) and penile erection depends upon nitric oxide-induced elevation of myoplasmic cGMP and reduced Ca2+-dependent myosin regulatory light chain phosphorylation levels. This hypothesis invokes a reversal of normal activation pathways. Upon stimulation with 250 microM phenylephrine, phosphorylation of the 20 kD myosin regulatory light chains of rabbit or human CCSM increased approximately 4-fold coincident with contraction. Removal of the agonist was followed by a slow reduction in cross-bridge phosphorylation and force to basal levels. The NO donor, sodium nitroprusside elicited a dose-dependent increase in tissue [cGMP] associated with a rapid relaxation in the continued presence of phenylephrine, although cross-bridge phosphorylation remained significantly elevated. Thus the NO-cGMP inhibitory pathway in CCSM is not simply a reversal of excitatory signal transduction mechanisms. An unidentified mechanism contributes to relaxation by decreasing the rate of cross-bridge recruitment through phosphorylation.

Efficacy of preoperative versus postoperative ketorolac tromethamine 0.5% in reducing inflammation after cataract surgery.

PURPOSE: To compare the efficacy of 30 minute preoperative versus 1 day postoperative administration of ketorolac tromethamine 0.5% ophthalmic solution (Acular) in reducing anterior chamber inflammation after cataract surgery. SETTING: The Hermann Eye Center, The University of Texas Health Science Center-Houston, Texas, USA. METHODS: Fifty eyes of 48 consecutive patients scheduled for phacoemulsification with intraocular lens implantation were included. Before surgery, patients were randomly assigned to start the study drug 30 minutes preoperatively or 1 day postoperatively. No other antiinflammatory agents were used intraoperatively or postoperatively. Main outcome measures were flare and cell counts. RESULTS: Preoperative and postoperative flare and cell counts did not differ significantly between the 2 treatment groups at any time. Both groups showed significant increases in flare (P =.0001) and cells (P =.0001) 1 day postoperatively. Flare and cells returned to baseline levels by day 28 in both groups. There was no significant difference at any time between the 2 groups in the change from the preoperative level of inflammation. CONCLUSIONS: There was no difference between administering ketorolac 30 minutes preoperatively versus 1 day postoperatively in reducing inflammation.

The Houston Vision Assessment Test (HVAT): an assessment of validity. The Cataract Outcome Study Group.

PURPOSE: Cataract surgery is one of the most successful procedures in medicine, and outcome is typically measured by a single factor - improvement in visual acuity. Health-related functional outcome testing, which quantifies the patient's self-reported perception of impairment, can be integrated with objective clinical findings. Based on the patient's self-assessed lifestyle impairment, the physician and patient together can make an informed decision on the treatment that is most likely to benefit the patient. METHOD: A functional outcome test (the Houston Vision Assessment Test - HVAT, copyrighted 1990, 1992) was evaluated in a cataract population of 149 patients from seven study centers. Test results were correlated with objective ophthalmic endpoints. The HVAT divides an estimated total impairment into subcomponents of Visual Impairment (correctable by cataract surgery) and non-visual Physical Impairments (co-morbidities not affected by cataract surgery). RESULTS: In this prospective study, the average Visual Impairment score improved by 19 points (65%) following cataract extraction (the mean HVAT Visual Impairment score was 29 points before surgery and 10 points at 5 months post-surgery, a change of 65%). Physical Impairment remained unchanged by surgery. Visual acuity was a poor predictor of Visual Impairment. CONCLUSIONS: The HVAT has 11 simple questions. It may be self-administered and is available on the Internet: http://www.DHAC.com. The physician may err if his decision in favor of cataract surgery is based only on visual acuity. The HVAT has the potential to guide the decision-making process between patient and physician.

The ontogeny of nuclear aryl hydrocarbon hydroxylase.

The ontogeny of rat liver nuclear aryl hydrocarbon hydroxylase (AHH) ws studied. AHH which was barely detectable in 18--20 day fetal rat liver nuclei increased rapidly post-partum reaching a value which was over 200 times greater than the fetal liver specific activity. Nuclear AHH was induced upon administration of 3-methylcholanthrene (3-MC) to rats. The level of induction was dependent upon the age of the rat. Thus, the highest induced nuclear AHH specific activity was observed in the 3--4-week-old rat, i.e., 50--70 g in weight. The greatest fold increase in nuclear AHH after 3-MC administration was observed in the 6--8 g, or 1--2-day-old rat. Fetal rat liver nuclear AHH was also induced after 3-MC administration to the dam. The basal and induced levels of AHH were compared in nuclei and microsomes from 1--2 and 10--12-day-old rats. In the former, the ratio of the microsomal to nuclear AHH was 1.4 and 1.8 under basal and induced conditions, respectively.

Aryl hydrocarbon hydroxylase in mouse mammary gland: in vitro study using mammary cell lines.

The effects of 3-methylcholanthrene (MCA), 5,6-benzoflavone (betaNF), 7,8-benzoflavone (alphaNF) and pregnenolone 16alpha-carbonitrile (PCN) upon aryl hydrocarbon hydroxylase (AHH) were determined in primary mammary gland epithelial cell cultures prepared from the C3Hf-/Ki mouse. MCA elevated AHH activity by 3--4 fold after 24 h of treatment; alphaNF produced a 50% inhibition. The specific activity of AHH in these cells was elevated by 6 h after exposure to MCA; enzyme activity was still maximally elevated after 48 h. The effects of MCA were also investigated in a group of mammary cell lines, one of which was derived from a control virgin mouse, the MCG V14; 3 of which arose from mammary tumors, MCG T10, MCG T14 and MCG T19; and 2 of which were sublines developed from hyperplastic alveolar nodules, HAN-1 and HAN-2. Induction was seen in all lines at 24 h, with the MCG T14 being the most responsive and the HAN-2, the least. Although the MCG T19 tumor cells did respond in culture, when implanted in the mouse, the AHH of the subsequent tumor was not elevated upon administration of MCA in vivo.

Comparison of antibiotic drops placed in the conjunctival cul-de-sac to antibiotic ointment applied to the lid margin in reduction of bacterial colonization on the lid margin.

PURPOSE: To compare the efficacy of antibiotic drops placed in the conjunctival cul-de-sac to antibiotic ointment applied to the lid margin in reduction of bacterial colonization on the lid margin. METHODS: A randomized, prospective, single-masked study was conducted on 19 patients with culture-proven colonization of bacteria on the lid margins. Ophthalmic eligibility criteria included the presence of > or =50 colony-forming units/mL (CFU/mL) of bacteria on both right and left lids. Each patient received one drop of ofloxacin in one eye every night for one week, followed by one drop once a week for one month. In the same manner, each patient received bacitracin ointment (erythromycin or gentamicin ointment if lid margin bacteria were resistant to bacitracin) to the lid margin of the fellow eye. Quantitative lid cultures were taken at initial visit, one week, one month, and two months. Fifteen volunteers (30 lids) served as controls. Lid cultures were taken at initial visit, one week, and one month. RESULTS: Both antibiotic drop and ointment reduced average bacterial CFU/mL at one week and one month. Average bacterial CFU/mL reestablished to baseline values at two months. There was no statistically significant difference between antibiotic drop and ointment in reducing bacterial colonization on the lid margin. CONCLUSION: Antibiotic drops placed in the conjunctival cul-de-sac appear to be as effective as ointment applied to the lid margins in reducing bacterial colonization in patients with > or =50 CFU/mL of bacteria on the lid margins.

Bleb window cryopexy for the management of oversized, misplaced blebs.

PURPOSE: To describe a new technique for revising oversized blebs after trabeculectomy. METHODS: A chart review of consecutive patients undergoing bleb window cryopexy was conducted. Patients with symptomatic oversized blebs were candidates for the technique, regardless of the intraocular pressure. Under topical anesthesia, the bleb was incised and a 3 mm x 3 mm conjunctival window was removed using 0.12 forceps and Vannas scissors. Light cryotherapy was applied to the sclera through the window. A soft bandage contact lens was then placed for compression, and a patch was applied. All patients were given antibiotic drops the first day after surgery. Topical corticosteroid drops were used to minimize postoperative inflammation. Outcome measures included relief of symptoms, adequate control of intraocular pressure, and restoration of filtering bleb function without further antiglaucoma medication or surgical bleb revision. RESULTS: Nine patients met the inclusion criteria. All patients had flattening of the bleb with symptomatic relief within 2 weeks. No loss of bleb function occurred. One patient developed aqueous misdirection after the procedure. CONCLUSION: Early results showed that bleb window cryopexy is safe and effective. This minimally invasive technique can be useful for selected patients with large. symptomatic, overhanging blebs.