Ophtalmologie : organe de la Societe francaise d'ophtalmologie最新文献

The authors analyse 24 observations of retinal detachment with macular hole in high myopia. All this patients have been treated by C3F8 internal tamponade. Silicon oil has been only used for recurrences. After a study of vitreoretinal connections, the cause of recurrences are analysed according to echometry, detachment degree and proliferative vitreoretinopathy.

Removal of ten encircling scleral buckles and section with relaxation of nine encircling buckles are displayed. Only episcleral buckles with oval or round silicone sponge exoplants are analyzed. Besides infection (three eyes), removal or section was required because of too tight encircling elements (16 eyes). Anterior buckles created by invagination of encircling elements, without horizontal shortening avoids this risk of constriction.

Having observed a very tight adhesion between the trochlea and the tendon of the obliquus superior bulbi muscle or an increase in tendon thickness posterior to the trochlea in operated patients, the author tried to correct this abnormality using partial trochleotomy and the lysis of the adhesions, followed by the application of Scott-Knapp sutures. The morphological basis of Brown's syndrome, consisting of an obstruction at the level of the trochlea, was demonstrated experimentally by means of an eye motion simulator.

A large french multicenter study has been conducted by 750 ophthalmologists with 5,872 patients with open angle chronic glaucoma or intraocular hypertension. The patients were treated twice a day for a period of six months with Betaxolol eye drops, a Beta-1 betablocker product, and cardioselective. Concerning the total population of patients, 35% had a cardiovascular systemic context, 12.1% had a pulmonary systemic context, 5.2% were diabetic patients. Efficacy, systemic tolerance, visual comfort have been evaluated during the study, for each group of patient. After six months of treatment, intra-ocular pressure of the 5,872 patients has been lowered from 22.61 mmHg to 18.25 mmHg. Patients have reported a global efficacy in 97% of cases, a good systemic tolerance in 91% of the cases. The investigations have reported a global efficacy in 96% of cases and a good systemic tolerance in 91%. Ocular comfort has been reported as acceptable by 89% patients and by 92% of the Investigators. The analysis of the results of the study allows us to say that the Beta-blocker-Beta-1 selective eye drop, can be used in treatment of intraocular hypertension or open angle chronic glaucoma with a high range of efficacy and safety.

X-shaped macular dystrophy with flavimaculatus flecks is individualized of other heredo-macular dystrophies. This aspect was showed in two families with a retinal pigment epithelial dystrophy characterised by an X-shaped yellowish macular lesion and numerus flavimaculatus retinal flecks. Nine members were variously affected. The condition was bilateral, had a dominant inheritance, started in middle age with a slow-developing macular lesion. Visual functions were often minimally disturbed for two or three decades. Relations with others here-domacular dystrophy are discussed particularly with pattern dystrophy.

We study the elimination of two viscoelastic substances from the vitreous cavity: the Hydroxypropyl Methylcellulose and the Sodium Hyaluronate that are potentially vitreous substitutes. We performed gas-vitrectomy in 116 eyes of 58 rabbits. Three days after surgery we performed gas-viscoelastic substance exchange. We analyzed the concentration of Hydroxypropyl Methylcellulose and Sodium Hyaluronate with diphenylamine reaction at different periods: zero, 1 week, 2 weeks, 1 month till 6 months. In both cases the elimination is fast so that 1 week after the intravitreal injection remains only 60.1% of the Hydroxypropyl Methylcellulose and 100% of Sodium Hyaluronate, and two weeks after 38.5% of Hydroxypropyl Methylcellulose and 62.5% of Sodium Hyaluronate. We conclude that both substances have a short half life-time specially in the case of the Hydroxypropyl Methylcellulose.

The toxicity of human interferon alpha 2b in rabbit's vitreous and conjonctiva is studied through electroretinography, echography, angiography and histological examination. Interferon was injected in increasing doses 150,000 UI, 500,000 UI and 1,000,000 UI. The results from examinations in the rabbits are presented and the conclusion is drawn, that good tolerance is achieved, even at higher doses.

The so-called R.K. classic technique gives good results for myopias under 5 diopters. We have performed different modifications of the technique for the 8 incisions--optical zone 3 mm R.K. 8 incisions--O.Z. 3 mm. Downhill incision direction or "American technique" incisions (from the O.Z. towards the limbus). 8 incisions--O.Z. 3 mm + a deepening of 20 microns from a 6 mm O.Z. Repeat operations (Stan Franks Backcutting technique or addition of incisions). 8 incisions--O.Z. 3 mm. Uphill incision direction or "Russian technique" (from the limbus towards the optical zone). This study was carried out with 134 R.K. and shows that we get best results for myopias between 5 to 7 diopters, with the last technique (Uphill incision direction).

The physiopathological features concerning the affected and the fellow eye were considered. As far as the diagnosis is concerned, the test of Bicas, examination of binocular rotations and of versions, and the Maddox double rod test are discussed; the features of a bilateral palsy were stressed. For surgical treatment, the various weakening procedures of the inferior oblique are evaluated. The author's technique for resection of the superior oblique is described.

Our experience of 49 cases with a new monocanalicular silicone stent is described. This is a stent with a "auto-stable" meatic plug which respects the canalicular anatomy. There is no stopping-knot, no palpebral ring as in the bicanaliculo-nasal-intubation. The risk of accidental exteriorization is less important, the risk of stricturotomy is absent. Two types of intubation can be used: monocanaliculo-nasal intubation: the way of putting it in place is the same as the bicanaliculo-nasal one, with a metallic probe. The range of it's use widdens from distal canalicular wounds (2 cases) to common canalicular stenosis (15 cases) and to lacrimo-nasal imperforations (12 cases). In the two last instances, the intubation is made through the superior canaliculus, so that the inferior one is left free. In 13 cases, an intubation was made bilaterally for the same disorder, and a comparison could be done between monocanalicular and bicanalicular intubation. The true monocanalicular intubation, for proximal injuries: grasping the metallic probe inside the nose is no longer necessary. The length of the silicone probe is adaptated intra-operatively. The functional results of monocanalicular intubation are comparable to the results of bicanalicular intubation, especially for monocanalicular injuries (in addition with canalicular sutures) and the lacrimo-nasal imperforation. Incidents were observed especially with the first patients; a strict method is mandatory for avoiding accidents. The use of monocanalicular intubation should be used only for short duration and monocanalicular disorders. In other cases, bicanalicular intubation remains the good choice.