[Glabellar transposition flap for medial canthal reconstruction after tumour excision]. / Glabellaschwenklappen zur Rekonstruktion des medialen Lidwinkels nach Tumorexzision.

BACKGROUND: We focussed on the suitability of a glabellar transposition flap for repairing medial canthal defects after tumour excision and also on a satisfactory cosmetic result. PATIENTS AND METHOD: Between July 1994 and November 1999 we supplied 11 patients with a glabellar transposition flap to repair a soft tissue defect in the medial canthal area. 4 patients with a histologically proven basalioma. 5 patients had a recurrence of basalioma, who had first been operated on elsewhere. One patient was suffering from a squamous cell carcinoma and one patient showed a scar epicanthus. In the following we describe the glabellar transposition flap. This method is available for the reconstruction of the medial canthus. We also mention other methods and combinations. RESULTS: No patient required a further operation. Good postoperative cosmetic and functional results were seen in all patients. CONCLUSIONS: The glabellar transposition flap is suitable for reconstructing the medial canthus. Our results suggested that this flap can be applied for the repair of defects measuring up to 30 x 25 mm. This method is also appropriate for deeper defects in this area. The flap is suitable if a patient has a recurrence of tumour.

Transscleral diode laser contact cyclophotocoagulation in the treatment of different glaucomas, also as primary surgery.

PURPOSE: To evaluate the clinical outcome of transscleral cyclophotocoagulation (TSCPC) with the diode laser for different glaucomas, especially as primary surgery. METHODS: A retrospective analysis of 250 TSCPC (193 eyes of 145 patients) with different glaucomas and an average age of 62.6+/-17.1 years. Postoperative follow-up ranged from 6 to 48 months (mean 13.9 months). Most of the patients had primary open-angle glaucoma (POAG) or secondary glaucoma. All eyes were treated with 24-30 spots and 1.4-1.8 W at an exposure time of 2 s using a diode laser with a focussing tip. RESULTS: The mean intraocular pressure (IOP) decreased from 24.6+/-6.7 mmHg before to 19.3+/-5.7 mmHg after operation ( P<0.001). The IOP was successfully controlled (final IOP 10-22 mmHg) in 76.4% of cases after a single or multiple TSCPC treatments. The reductions in maximal IOP and in the number and frequency of administration of antiglaucomatous drugs were also significant ( P<0.001). The best results were obtained among the patients with POAG, in the oldest age group and in those patients without any previous or subsequent glaucoma operations. The proportion of eyes requiring multiple treatments was 21.2%, with an average of 1.3 treatments per eye. There was a complication rate of 14.4%, mostly mild uveitis. Phthisis bulbi occurred in three eyes (1.6%). CONCLUSIONS: TSCPC with the diode laser is a safe, effective procedure to reduce the IOP in the treatment of different glaucomas with few severe complications. It is also suitable for primary surgical treatment.