We present the results achieved in 26 cases of trabeculectomy combined with intraocular lens implantation after extracapsular surgery in eyes with open-angle glaucoma. Phacoemulsification was performed in nine cases, planned extracapsular cataract extraction in 17. In 23 eyes, a posterior chamber lens was implanted; in three eyes an anterior chamber lens was used because of a ruptured posterior capsule. After a follow-up period ranging from four to 29 months, the postoperative results were satisfactory in all eyes treated. The patients achieved postoperative intraocular pressure of 20 mm Hg or less. In 28% of the cases, however, additional antiglaucomatous medication is required. Given proper indications and present-day surgical techniques, this combined procedure provides effective one-time treatment for cataract and glaucoma patients as well as optimal visual rehabilitation.

Collagen types in normal human and keratoconus corneas were separated by salt fractionation and thermal gelation in the pepsin-soluble fraction of the lyophilized tissues. Peptic digestion indicated no significant differences between normal and keratoconus corneas. Further collagen characterization was performed using SDS-PAGE. Collagen concentration were determined via hydroxyproline. Soluble collagens from normal human cornea represent 85% collagen type I, maximally 10% collagen type III and 5% collagen type V. Soluble collagens of keratoconus corneas consist of 90% type I collagen and maximally 5% type II and type V collagen.

Cataract surgery is the most common elective surgical procedure undertaken in elderly people. In many European countries and in the USA cataract surgery is normally a day-case procedure without an overnight stay in hospital, unlike the situation in Austria where fewer than 2% of patients are day cases. However, there is a lack of prospective studies on patients' need for and acceptance of day-case surgery. The aim of our study was therefore to evaluate patients' demand and suitability for outpatient surgery, based on analysis of preoperative questionnaires on availability of family and/or social support and on preoperative ophthalmologic examination. Among 500 consecutive patients with cataract, 154 (41.8%) chose a day-case procedure and 256 (58.2%) preferred inpatient admission. Patients preferring full admission were older (mean age 76.4+/-8.1 vs. 72.73+/-9.5 years, P<0.001), had worse visual acuity (0.55+/-0.20 vs. 0.66+/-0.23, P<0.001), were more likely to be female (63.9% vs. 47.0%, P=0.001), to live more than one hour away from the hospital (26.5% vs. 12.5%, P<0.001) and have no carer at home (43.0% vs. 6.5%, P<0.001). Patients favoring day-case surgery were more likely to be able to attend an ophthalmologic check-up 24 h after surgery (96.7% vs. 59.6%, p<0.001). The majority of patients indicated a preference for inpatient care, but this may be a reflection of their previous hospital experience and a matter of custom in the elderly population. Information, education and better organization of after-surgery services could help increase the attractiveness of cataract surgery as an outpatient procedure in Austria. Our findings could also be relevant to day-case services in medical care in general.

Our experience with 14 patients with renal cell carcinoma and solitary distant metastasis is reported. The treatment of choice is tumor nephrectomy and surgical removal of the metastasis simultaneously or within a short period of time. The average survival time with this treatment is 18.5 months (maximum 4 years, minimum 2 months).

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