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.
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.
From a KOS herpes simplex virus strain prepared in VERO cells we have been able to obtain after several exposures to increasing concentrations of trifluorothymidine, four resistant mutants. Among these strains, 31 T mutant was a TK-altered strain of low pathogenicity, sensible to acyclovir and did not induce recurrences. These properties might allow the use of such a strain as a living attenuated antiherpetic vaccine.
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 report two personal cases of intra ocular cysticercosis typical by their sub retinal and intra vitreous localization. After a short review of epidemiology and biological diagnostic we propose a treatment which associates a medical part with Praziquantel, killing the larva and a surgical part with pars plana vitrectomy allowing the control of the inflammation, contemporary of the larva's death and the intra-vitreous cysticercosis extraction.
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.
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.
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.
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.
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.
We have studied the biocompatibility of the hydroxypropylmethylcellulose in ten rabbits' eyes after lensectomy and posterior vitrectomy. In seven eyes the inflammatory reaction was severe. The reason why the hydroxypropylmethylcellulose is biocompatible in the anterior segment and not in the vitreous body seems to be explained by its quantity and its concentration in the eye at the end of the surgical procedure.
An analytic study of electroretinogramms (ERG) from 280 patients under antimalarial therapy has been made. The pratician has stopped treatment in 4.8% of the ERG. Among the investigated parameters, the only statistic difference is the cumulative doses.
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.
The eye plays a double role: on the one side it is the optic camera, on the other side independent of the optic path ways it is the light receptor which stimulates the retino-hypothalamique pathway of the endocrine-visceral system. To determine this influence, we compared the metabolisme (water balance, blood sugar and blood cell count) as well as the hormones (ACTH, Cortisol) of fifty patients with bilateral almost total cataract, before (practically blind) and after cataract surgery (regain of light). There was a significant difference between the metabolic and hormonal values before and after cataract extraction, reaching physiologically normal levels due to the stimulating influence of light after the operation.
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).
Transretinal PO2 profiles were recorded during normoxia and hyperoxia in normal and ischemic retinal territories in anesthetized miniature pigs using double barrelled recess type microelectrodes. In normoxia and hyperoxia the PO2 in the normal territory decreased from the inner retina and the choroid towards the mid-retina, indicating that the choroid cannot supply O2 to the whole normal retina. Preretinal and transretinal PO2 measurements in ischemic territories following a laser occlusion of a retinal branch vein demonstrated that in normoxia the direction of PO2 gradients prevents O2 diffusing from the choroid to reach the inner retina. This explains why the ischemic territories are hypoxic. In the contrary, during hyperoxia the intraretinal PO2 gradient indicates an O2 flux from the choroid to the inner retina resulting to marked preretinal PO2 increase at the affected territories. We proposed the hypothesis that in the ischemic retinas the hyperoxia does not induce a rise of the O2 consumption of the outer retina. Hence hyperoxia could be a useful tool to restore the oxygenation of the inner hypoxic retinal layers.
The authors study two hundred observations of children with esotropia operated by recession of internal muscles associated or not with one or two loops. The indications are precise, then the secondary exotropia is studied. The technic doesn't seem to give more frequent exotropia than other surgical procedures if the initial protocol is right.
The authors suggest the production by the cultured RPE cell of one or more angiogenic substances. This activity is highly increased when RPE are cultured in poor conditions, either due to a poor medium or after having been challenged by a high number of rod outer segments. The mitotic factor appears heat-labile and trypsine sensitive, but not dialysable which suggest their biochemical nature to be a protein.
A previous study showed the good tolerance of the human type IV collagen lenses implanted by epikeratoplasty in 8 monkeys. It also showed type IV collagen is a good material for the reepithelialization. But we have been interested in the stability of the epithelial healing. The ultrastructural study found anchoring structures. However these were inconstant. So the authors try to understand better the mechanisms of this synthesis of the anchoring structures and describe the future ways of this experimental study.
The aim of this study is to examine the variation of HLA expression on organ-cultured human corneas. Using an indirect immunofluorescence technique and monoclonal antibodies anti-HLA-A, B, C and anti-HLA-DR histocompatibility antigens were detected. In fresh corneas class I antigens were detected on epithelium and stroma but not on endothelium. Class II antigens were not detected on any corneal layer but were present on Langerhans cells within epithelium and stroma. The expression of HLA-A, B, C antigens within the corneal epithelium and the corneal stroma was not altered by 28 days of organ culture. HLA-DR antigens were present on Langerhans cells on corneas that had been in organ culture up to 14 days (present 6/9). After 14-28 days in culture Langerhans cells were not found on most corneas (present 3/12). Corneal preservation in organ culture at 31 degrees C affects expression of HLA antigens particularly of HLA-DR antigens. Combination of HLA matching donor-recipient with an 10-15 days organ cultured corneal button in high-risk patients seems to be of interest.
