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

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.Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.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).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).Phacoemulsification with a T-cut in the tunnel floor was a safe and effective combined procedure and, in this regard, equivalent to phacotrabeculectomy.