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ABSTRACT: In cases of high intraocular pressure, the patient's hypertension must first be confirmed and its characteristics delineated with a diurnal IOP curve or at least several different measures. Central corneal thickness should be measured, since a thin cornea is a risk factor of progression toward glaucomatous neuropathy. Later, the optic nerve head and retinal nerve fibers should be tested (HRT, GDx, and OCT), to determine whether the ocular hypertension is associated with other findings, and visual field analysis should be carried out (standard automated perimetry, blue-yellow perimetry, FDT), completed by a search for associated risk factors. Therapeutic decisions will be based on this workup, keeping in mind that in the majority of cases, monitoring and information are sufficient but necessary; treatment should, however, be initiated in cases of ocular hypertension with a high risk of progression.
Journal francais d'ophtalmologie 07/2005; 28 Spec No 2:2S13-2S16. · 0.51 Impact Factor
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La Revue de Médecine Interne 10/2003; 24(9):621-2. · 0.61 Impact Factor
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ABSTRACT: One of cataract surgery's current imperatives involves refraction: the power of the lens implant must be calculated as accurately as possible. Here we present a new method of biometric ocular measurement using the partial optical consistency interferometer.
This investigation studied the axial length measurement of 100 eyes. Five measurements were taken with a classic echobiometric contact technique using the ultrasonic mode; 5 others were taken with the infrared noncontact technique (IOL Master, Zeiss Humphrey). The latter technique is based on interferometric biometry with optical consistency and measurements were taken with an infrared luminous ray. With extreme rapidity and no contact, the device provides a complete biometry, including axial length, keratometry, and anterior chamber depth. It includes a built-in computer.
Comparing the ultrasonic and infrared measurements emphasizes the precision and particularly the high reproducibility of the infrared method. The standard deviations of the samples were significantly lower for the 100 measurements. Its limitations depends on the type of cataract since success was not obtained for certain posterior subcapsular opacities.
This new method of performing a biometry with a partial consistency interferometer contributes a number of advantages: speed, its noninvasive nature with no contact, the high reproducibility of the exam, as well as precise measurements as shown by the difference in the standard deviations of the two methods.
Biometry using the optical consistency interferometer seems to be a reliable, reproducible, and precise technique that brings great precision for the calculation of the power of the intraocular implant in cataract surgery.
Journal Français d Ophtalmologie 01/2002; 24(10):1060-6. · 0.51 Impact Factor
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ABSTRACT: Several new classes of ocular hypotonia medications have recently become available. These include the topical treatments carbonic anhydrase inhibitors, the alpha-2 agonists, the prostaglandin analogues, and a fixed combination of beta-blockers and carbonic anhydrase inhibitors. With an equal or superior efficacy than beta-blockers, these new treatments must be reconsidered as first-line therapy in glaucoma. The long-term safety profile of antiglaucomatous drugs plays an important role in the new trends of medical treatment. These data, better known and detailed over time by clinical experience, are changing our habits and advancing therapeutic strategies for a more effective treatment, better suited to the individual, thus allowing the best quality of life possible.
Journal Français d Ophtalmologie 01/2002; 24(10):1095-9. · 0.51 Impact Factor
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ABSTRACT: To determine the lidocaine diffusion space, we compared lidocaine aquous humor concentration in topical anesthesia with 1% lidocaine intracameral injection and in peribulbar anesthesia with 2% lidocaine prior phacoemulsification.
A gas chromatography technique of analyzing 100 microliters aqueous humor was used to detect the presence of lidocaine prior to phakoemulsification cataract surgery in two groups of patients: group A: after peribulbar anesthesia with 10 ml 2% lidocaine, group B: after 1% tetracaine topical anesthesia and 0.5 ml intracameral injection of 1% preservative-free lidocaine. The intracameral volume was estimated mathematically in group B. Endothelial cells loss was analyzed in two groups with non contact specular microscopy.
Lidocaine was detected in aqueous humor with a good reliability. The mean concentration after intracameral injection was 6,300 micrograms/ml and was higher than after peribulbar injection. This concentration was near than theorical intracameral rate, suggesting that there was no diffusion in the posterior segment. There was no significant difference in the 2 groups in endothelial cells loss.
Intracameral injection of lidocaine is an effective technique to anesthetize intracameral structures without diffusion in posterior segment prior to phakoemulsification.
Journal Français d Ophtalmologie 03/1999; 22(1):21-4. · 0.51 Impact Factor
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ABSTRACT: Effectiveness of radial keratotomy for undercorrections following photorefractive keratectomy.
Twenty myopic eyes from minus 4.75 to minus 8.25 were treated by Excimer laser photorefractive keratectomy and regressed to a mean myopic refraction of minus 2.20 +/- 0.81 after a follow-up of 10 to 22 months (mean: 16.25). Radial keratotomy was performed using Hoffmann Fyodorov Thornton nomogram. Blade depth was set according to pachymetry performed before surgery under microscopic examination, paracentrally on the meridian of each incision.
Postoperative results were evaluated after 6 to 20 months follow-up. After radial keratotomy mean refractive error was minus 0.30 +/- 0.43 and minus 0.32 +/- 0.25 at 3-6 and 6-12 months respectively. Visual acuity, without correction, was prior to radial keratotomy: 2.18 +/- 0.99; 8.125 +/- 0.6 at 3-6 months and 8.43 +/- 1.57 at 6-12 months after radial keratotomy.
Radial keratotomy appears to be a safe, simple and predictible technique to treat undercorrections following Excimer laser photokeratectomy.
Journal Français d Ophtalmologie 02/1996; 19(2):120-6. · 0.51 Impact Factor
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ABSTRACT: Corneal disease is the second most common cause of blindness in tropical countries after cataract. It mainly strikes children who are exposed to numerous infectious agents against which they are unprotected due to the absence of basic health care. In high risk groups, the incidence of childhood corneal-related blindness is more than 20 times higher than in developed countries. There are many causes of corneal-related blindness. Endemic trachoma persists in some areas and inflammatory forms can lead to blindness. Eradication requires instillation of antibiotics in the eye, improvement of sanitary conditions, and campaigns against promiscuity. Xerophthalmia can induce blindness by perforation of the cornea in children with vitamin A deficiency. Measles, herpes simplex keratitis, and corneal ulcer that progresses to bacterial or fungal infections, or to amebic keratitis are also major causes of corneal-related blindness. The incidence of onchocerciasis is decreasing thanks to treatment with ivermectin and programs to control simulium. Neonatal gonococcal ophthalmia and leprosy-associated ocular disease can also lead to blindness. This overview of the various causes illustrates the close correlation between the level of life and living conditions and the occurrence of corneal-related blindness in tropical areas.
Médecine tropicale: revue du Corps de santé colonial 02/1995; 55(4 Pt 2):445-9.
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ABSTRACT: The authors report ocular complications in intracarotid chemotherapy with Nitrosyl-urea on 39 patients with intracerebral malignant tumor (anaplastic astrocytoma). Internal carotid infusion catheter was in infra-ophthalmic position. They also report 13 ocular complications (33% of cases) as arterial retinal occlusions essentially, ipsilateral to catheter site. Their study and literature revue emphasize five ocular toxicity factors; intracarotid catheter position, type of drug, its quantity, its solubility and solvent, the rate of infusion.
Journal Français d Ophtalmologie 02/1993; 16(5):304-10. · 0.51 Impact Factor
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ABSTRACT: Devant une pression intra-oculaire élevée, il faut en premier lieu confirmer cette hypertonie et préciser ses caractéristiques, par une courbe diurne de la PIO ou au moins par plusieurs mesures. L’épaisseur cornéenne centrale doit être mesurée, une cornée mince étant un facteur de risque d’évolution vers la neuropathie glaucomateuse. Dans un 2e temps, il faut préciser si l’hypertonie oculaire est isolée, par une documentation initiale complète de bonne qualité de la tête du nerf optique et des fibres nerveuses rétiniennes (HRT, GDx, OCT) et une analyse du champs visuel (périmétrie automatisée standard, périmétrie bleu-jaune, FDT) complétées par la recherche de facteurs de risque associés. De ce bilan dépend la conduite thérapeutique, sachant que si dans la majorité des cas, surveillance et information sont suffisantes mais nécessaires, un traitement doit cependant être initié dans les HTO à haut risque d’évolution.In cases of high intraocular pressure, the patient's hypertension must first be confirmed and its characteristics delineated with a diurnal IOP curve or at least several different measures. Central corneal thickness should be measured, since a thin cornea is a risk factor of progression toward glaucomatous neuropathy. Later, the optic nerve head and retinal nerve fibers should be tested (HRT, GDx, and OCT), to determine whether the ocular hypertension is associated with other findings, and visual field analysis should be carried out (standard automated perimetry, blue-yellow perimetry, FDT), completed by a search for associated risk factors. Therapeutic decisions will be based on this workup, keeping in mind that in the majority of cases, monitoring and information are sufficient but necessary; treatment should, however, be initiated in cases of ocular hypertension with a high risk of progression.
Journal francais d'ophtalmologie 28:13-16. · 0.51 Impact Factor
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ABSTRACT: To evaluate a new magnetic resonance imaging protocol for dynamic study of the lacrimal outflow system and to use this protocol to search for problems in patients with an assumed permeable outflow system who develop epiphora.
A prospective study of nine patients, including 2 asymptomatic controls was conducted. The magnetic resonance protocol included, gadolinium instillation into the conjunctival cul-de-sac, 3D gradient-echo T1-weighted acquisition, 2 mm thick images passing through the nasolacrimal duct, dynamic acquisition after gadolinium instillation for timing dye progression through the outflow system.
Similar results were obtained for the two control subjects with lacrimal transit time of a median 100 seconds. Three distinct events were individualized gadolinium arrival in the lacrimal sac (t1), at the extremity of the bony portion of the lacrimal duct (té), and the extremity of the mucosal portion of the duct (t3). Patients with an assumed permeable outflow system who had epiphora show results intermediary between passed dye and total blockage of the dye within the lacrimal sac.
The study of the lacrimal outflow system using this new magnetic resonance imaging protocol contributes to the physiological study of tear evacuation and could be useful for quantitative assessment of lacrimal stenosis, particularly interesting for therapeutic guidance.
Journal Français d Ophtalmologie 22(6):628-34. · 0.51 Impact Factor
