Revue internationale du trachome et de pathologie oculaire tropicale et subtropicale et de sante publique : organe de la Ligue contre le trachome avec la collaboration de l'International Organization against Trachoma et des organisation...最新文献

This study reports the results of the evolution of ocular pressure, glaucoma excavation and complications after trabeculectomy particularly cataracts observed in 47 cases of chronic glaucoma. Our chronic glaucomas are frequent in male with an average of age of 60,5 years. Normalisation of ocular tension has been obtained in 87.23% of cases. However in 10.53% of cases, an adjuvant medical treatment has been necessary. Ocular pressure figure raised up progressively after trabeculectomy to reach some limit from which it remains stable. The best ocular pressure control has been observed first in glaucoma with opened angle, then in post traumatic glaucoma. Visual acuteness was improved in 20.27% of cases. Trabeculectomy has involved a relief, a disparition of pain in all the cases. The main late complication observed is opacification of eye lens in patients aged more than 70 years old.

2,600 patients (1,416 females and 1,244 males) were consulted in the lone eye department of the Western Province of the Republic of Cameroon during the one-year period from 1st March 1991 to 29th February 1992. 176 or 7% (68 females and 108 males) were found to be blind in both eyes (bilateral blindness); while a further 202 or 8% (79 females and 123 males) were found to be blind in one eye (unilateral blindness). The main causes of bilateral blindness were: cataract (43.2%), glaucoma (20.4%), uveitis (8.5%), onchocerciasis (8.5%), cortical and visual pathway dysfunction (7.4%), and others (12%). The main causes of unilateral blindness were: trauma (37.6%), cataract (27.7%), glaucoma (10.9%), uveitis (5.9%), amblyopia (3.9%), non-onchocerciasis keratopathy (2.9%), neoplasm (2%), onchocerciasis (1.5%), and others (7.4%). Possible ways on how to combat these various causes of blindness are discussed. There is no ready explanation for the male predisposition to blindness in this series of patients.

Three years of private urban practice of ICE with implantation of IOL in the AC, made us think this technique should be extended to the rural populations. Conclusions about the indications and the technique have been stressed so that better results can be reached.

The treatment of xerosis [dry eye] registered a major advance with the diversion of Stenon's canal to the conjunctival sac, as proposed by Filatov-Chevaliev in 1951. This operation, however cannot be undertaken, unless the salivary secretion is normal. In Sjogren's syndrome, where salivation is equally deficient, extra-corporal irrigation remains the unique solution. The setting required for the continuous supply of artificial tears, however, present serious problems: the installation and location of a reservoir, creation of a smooth working, portable mechanism of propulsion as well as the tubular conduction to the eye, without risk of injury to the latter. The creation of a subcutaneous canal paved with oral mucosa, temporal to the outer canthus, as proposed by Charleux, provided the solution for the last point: the safe instillation to the eye. Whereas the numerous devices proposed so far to ensure a constant and dosable supply of artificial tears, have not given full satisfaction in practice. The simplified setting, above described, consisting of a saline unit placed high in the fez, has given proof of efficiency; the irrigation of the eye depending here on gravity, the motor and its multiple risks are eliminated. Accessibility, easy manipulation and the local guise of the proposed setting renders it particularly acceptable to the patient in the East.

Between 1987 to 1992, 3,309 eyes had been operated on during the seventeen missions realized in Morrocco, by the Morroccan Itinerant Ophthalmologist Association. To prevent postoperative infectious endophthalmitis, asepsis was rigorous and local antibiotics prophylaxis were administered preoperatively, during surgery and postoperatively. Ophthalmic solutions (gentamicin, norfloxacin, or ofloxacin) were used. Six (6) eyes in our study developed infectious endophthalmitis (1.8). The fluoroquinolones are a new class of antibacterial agents with considerable potential in the treatment of ophthalmic infections. A systematic antibioprophylaxis with fluoroquinolones, is licit in itinerant surgery.

Immunofluorescence detection of C. trachomatis requires trained personnel because the threshold between positive and negative reaction is not obvious. Patients antibodies must cover EB and thus prevent binding with Mab. This problems have stimulated research on Chlamydiae probes DNA hybridization technology was applied and the specificity of the detection of CT was improved. Moreover, a polymerase chain reaction amplification of a fragment of about 1,200 bp of the M.O.M.P. gene followed by restriction endonuclease digestion with selected enzymes allows differentiation of serovars. This method seems to be promising for epidemiologic studies.

TELC is a chronic allergic conjunctivitis which affects young children. The aetiology which is usually incriminated is dust, dryness or ultraviolet rays. The main symptoms of TELC are: severe pruritus, brownish pigmentation of the conjunctiva, papillae on the upper palpebral conjunctiva, severe limbitis with Trantat's spots, and finally corneal attack with risk of blindness. Treatment basis is made up with sodium chromoglycate and corticoids. We gathered the epidemiological data of TELC in the South of Benin and their links with the meteorological data (pluviometry, temperature, relative dampness rate, sun radiance and middle evaporation), from 1983 to 1992. There are two peaks of exacerbation for TELC: in March and in August. There is a good two months moved correlation between TELC and pluviometry; a positive correlation with temperature during the first peak and a reversed correlation during the second peak. Peaks of TELC are not linked with hours of sunshine rates.

186 cases of pterygium were operated, in the Dr G. Berniac's department of ophthalmology, in the West Indies, at the Hospital of Lamentin, by several surgeons, between January 1, 1988 and December 31, 1990. All of them were operated according to an original technic which included the resection of the pterygium and was followed by a conjunctival autograft. Then the authors compare the results of their series to different series of the literature. The simple resection of the pterygium with a conjunctival autograft seems to be an excellent surgical technic as for its simplicity as for its low rate of recurrences.