Journal Francais D Ophtalmologie最新文献

Objective: To compare the corneal topographic parameters and ocular surface parameters of ocular rosacea (OR) patients across skin subtypes of the disease and healthy controls.

Methods: This prospective study included 180 eyes of 90 OR patients and 60 eyes of 30 healthy controls. Among the OR patients, 30 had phymatous (60 eyes), 30 had erythematotelangiectatic (60 eyes) and 30 had papulopustular skin types (60 eyes). We measured the mean keratometry (Kmean), maximum keratometry (Kmax), thinnest corneal thickness (TCT), central corneal thickness (CCT) and corneal volume (CV) with a topography device (Sirius, Italy). Additionally, we measured tear-film breakup time (TBUT), Meiboscore and Schirmer's test from all participants. We compared parameters across OR skin groups as well as with controls.

Results: Kmean and Kmax were significantly steeper in the OR group compared to controls (p<0.05). We found significant correlations between "Kmean-Kmax", "CV-TCT", "CV-CCT", and "TCT-CCT" in both groups, while significant correlations between "age-Kmean", "age-Kmax", and "Meiboscore-Kmax" were present only in OR patients. When patients were divided into subgroups according to their skin subtypes, the papulopustular and phymatous subgroups had steeper Kmean and Kmax compared to the erythematotelangiectatic and control groups (P<0.05). The papulopustular subgroup had lower CCT, lower TBUT and higher Meiboscore compared to the phymatous, erythematotelangiectatic and control groups but lower TCT compared to controls (P<0.05). In addition, there were significant correlations between "Kmax-CV", "Kmax-TCT", and "Kmax-meiboscore" only in the papulopustular subgroup (P<0.05).

Conclusion: It appears that the corneas of OR patients are steeper than those of healthy controls; corneal thinning and abnormalities of ocular surface parameters are more pronounced in papulopustular skin types.

Purpose: To investigate the morphologic and functional outcomes of nanosecond subthreshold (ST) laser treatment for patients with chronic central serous chorioretinopathy (CSC).

Methods: In this prospective study, 44 patients were treated with the ST nanosecond laser with a follow-up period of 12 months. All target variables were measured at 1, 3, 6 and 12 months after the first laser treatment.

Results: This study showed a significant improvement in macular sensitivity (MS), a significant reduction in central macular thickness (CMT) as well as a significant reduction in subretinal fluid height (SRF) after 3 months of treatment. The subfoveal choroidal thickness (SFCT) was significantly reduced after 12 months of treatment. However, the best-corrected visual acuity (BCVA) (logMAR) did not change significantly at any time during the study. A high proportion of patients (85%) showed complete resolution of SRF after 12 months, indicating a positive response to treatment in the majority of our patients.

Conclusion: This study showed statistically significant functional improvement in MS as well as significant anatomical reduction in CMT, SFCT and SRF height in CSC patients treated with ST nanosecond laser therapy. Patients with higher SRF at baseline required repeated laser treatments to achieve complete resolution of the SRF.

Purpose: To analyze the outcomes and frequency of complications after Descemet's membrane endothelial keratoplasty (DMEK) and evaluate the parameters associated with the occurrence of these complications.

Methods: A multicenter retrospective study of 143 DMEK procedures performed consecutively by five surgeons between June 2018 and March 2021 was performed. Surgeon-specific surgical and graft characteristics were also assessed. Data on best-corrected visual acuity (BCVA), central pachymetry, and endothelial cell density (ECD) were collected at one, three, six, and 12months. Postoperative complications and secondary procedures (rebubbling and regrafting) were also recorded.

Results: The mean BCVA at one year was 0.17 logMAR (±0.19). There was a mean hyperopic shift at one year of +0.26 diopters. The mean pachymetry at one year was 526μm (±53). The mean ECD at one year was 1164cells/mm² (±479). Graft detachment occurred in 51% of the procedures and was significantly associated with the performance of an intraoperative iridotomy (OR=2.8) [95% CI: 1.2-6.6]. Rebubbling occurred in 34% of the procedures, and a new graft was performed in 21% of cases.

Conclusion: Performing a peripheral iridotomy during DMEK is a significant risk factor for graft detachment. DMEK significantly improves patients' vision and restores normal pachymetry.