T-cut in the bottom of the scleral pocket in combined cataract and glaucoma surgery.

PURPOSE: To determine whether radial transsection of the inner lamina of the phaco tunnel (T-cut) allows intraocular pressure (IOP) control in cases of co-existing cataract and glaucoma and to evaluate the results of this glaucoma triple procedure. SETTING: Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. METHODS: In a prospective study, a T-shaped incision in the tunnel floor was performed in 43 eyes (Group A); 48 eyes (Group B) had phacotrabeculectomy (phacoemulsification and trabeculectomy of a 3.0 x 2.0 mm tissue block). RESULTS: At the end of a minimum follow-up of 24 months in Group A (range 24 to 30 months) and of 28 months in Group B (range 28 to 44 months), there was no significant difference in the extent of IOP reduction between groups. Intraocular pressure was well controlled (< or =20 mm Hg) without antiglaucoma therapy in 27 eyes (62.8%) in Group A and 30 (62.5%) in Group B. Eleven eyes (25.6%) in Group A and 14 (29.2%) in Group B achieved an IOP of 20 mm Hg or less with antiglaucoma therapy. Five eyes (11.6%) in Group A and 4 (8.3%) in Group B required surgical revision. Complications included hypotony (Group A, 5 eyes; Group B, 3 eyes), hyphema (Group A, 8 eyes; Group B, 6 eyes), malignant glaucoma (Group B, 1 eye), in-the-bag hematoma (Group B, 1 eye), and fibrin exudation (Group B, 1 eye). CONCLUSION: Phacoemulsification with a T-cut in the tunnel floor was a safe and effective combined procedure and, in this regard, equivalent to phacotrabeculectomy.

[Differential diagnosis and therapy of gigantopapillary conjunctivitis]. / Zur Differentialdiagnose und Therapie der gigantopapillären Konjunktivitis.

If wearers of contact lenses present with secretion and incompatibility of the contact lens, simple ectropionation of the upper eyelids often is sufficient to diagnose a giant papillary conjunctivitis as the cause. This form of papillary hypertrophy affecting wearers of both hard and soft contact lenses is morphologically similar to vernal conjunctivitis, which should be considered in cases of corneal ulceration resistant to therapy. The histological difference between the two forms of papillary hypertrophy is that contact lens-induced giant papillary conjunctivitis shows remarkably less eosinophilic infiltration of the papillary stroma. Both forms of papillary hypertrophy seem to be based on a complex immunologic reaction.