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Biomedical subjects

A Galand

Publications and source records attributed to A Galand.

At least 19 recordsLinked to original sources
PubMed2003

[Treatment of Graves macular edema with intravitreal injection of corticosteroids].

PURPOSE: To determine if intravitreal injection of triamcinolone is an effective option in treating severe macular oedema unresponsive to other treatments. METHODS: Fifteen eyes with severe macular oedema of long duration (9-30 months) were offered intravitreal injection of 4 mg triamcinolone. The visual acuity and anatomic responses were monitored with pre- and postoperative fluorescein angiography and optical coherence tomography (OCT). RESULTS: The minimal follow-up was 3 months (mean = 6 months). The central macular thickness evaluated by OCT decreased by 50%. This beneficial effect was correlated with a significant improvement in visual acuity. Ten of 15 patients (66%) improved their visual acuity by more than two Snellen lines. We could observe a significant increase in intraocular pressure (mean = 15%) due to corticosteroid medication. No injection-related complication occurred. One patient had to be retreated after 3 months due to recurrence of macular oedema. CONCLUSIONS: Intravitreal triamcinolone is a promising therapeutic option for severe macular oedema. Further study is warranted to evaluate the long-term efficacy and safety, as well as the need for retreatment.

Adult↗
PubMed2002

[Corneal ulcers associated with rheumatoid arthritis].

Keratoconjonctivitis sicca, scleritis and keratitis remain the major ocular manifestation, associated with rheumatoid arthritis. Corneal ulcers are a rare complication but can lead to perforation. Unstable epithelial barrier and immune disorders play a key role in the pathophysiology of such corneal melting. Moreover the association with systemic vasculitis reveals the need for an appropriate immunosuppressive treatment. New surgical approaches and early immunotherapy allow to maintain ocular integrity even if the visual prognosis is poor.

Arthritis, Rheumatoid↗
PubMed2001

Use of human fibrin glue and amniotic membrane transplant in corneal perforation.

PURPOSE: To repair corneal perforation using human fibrin glue (HFG) and amniotic membrane transplant (AMT). METHODS: Three patients in whom central corneal perforations, approximately 2 mm in diameter, occurred after ocular or systemic disease were successfully cured using HFG and AMT. The technique consists first of using a high-viscosity sodium hyaluronate viscoelastic material to restore anterior chamber depth followed by a debridement of the ulcer. The perforation site is filled with the HFG to corneal surface level. The so-formed plug is then secured with an AMT to avoid its extrusion. An extended-wear bandage contact lens and topical antibiotics were used in these patients for 3 weeks. RESULTS: Total reepithelialization was observed after an average of 15 postoperative days. The AMT dissolved within 8 weeks to uncover a whitish scar formed within the perforation sites. No complications were observed in any patients. After a follow-up period of 195-325 days, all corneas remained stable; there was no infection or ulcer recurrence, but some corneal scar thinning was observed in all three cases. CONCLUSION: The described surgical approach using HFG and AMT allowed a successful repair of corneal perforations with a diameter of 2 mm associated with significant loss of stroma. This method may be a good alternative to delay penetrating keratoplasty for treating corneal perforations, especially in acute cases in which graft rejection risk is high. eal

Aged↗
PubMed2001

[Current understanding of diabetic retinopathy].

The incidence of diabetes continues to increase and it is estimated that the world diabetic population will have doubled in 2010. Diabetic retinopathy, one of the most frequent and precocious diabetes' complications, is increasing too and it represents a major cause of blindness in industrialized Countries. The purpose of this article is to describe the relations existing between the risk factors and the physiopathology of diabetic retinopathy, which may be helpful in taking therapeutic and prevention decisions, for the management of diabetic patients.

Blindness↗
PubMed2000

Lens epithelial cell proliferation in human posterior capsule opacification specimens.

In previous in vitro studies on capsular bags it was shown that, after a sham extracapsular cataract extraction (ECCE) on human donor eyes, lens epithelial cells (LECs) show, in the short term, a dramatically elevated mitotic activity as compared to that in the intact lens. The long term in vivo proliferation of LECs in human lenses after ECCE and intraocular lens (IOL) implantation has not been studied until now. In the present study, the mitotic activity of LECs in human post-mortem eyes with posterior capsule opacification (PCO) was investigated. Human lenses with signs of PCO were dissected from donor eyes and incubated in MEM, supplemented with fetal calf serum, for 1 day (n = 10) or 7 days (n = 9). Six additional specimens were cultured for 7 days after removal of the IOL and lens fibres. After the incubation period, mitotic activity was estimated using the BrdU procedure and the Ki67 proliferating cell marker. The mean number of BrdU-positive nuclei in the intact PCO specimens was at a level of 7.5 (day 1) and 6.5 (day 7). Removal of the IOL and the lens fibres leads to a ten-fold increase in BrdU positive cells (mean = 84.5). No correlation with donor age was found. The Ki67 observations corroborate the BrdU results. The results demonstrate that after an initial rise in proliferative activity, as shown in the capsular bag model, the mitotic activity of LECs returns to a rate comparable to that in intact cultured non-cataractous lenses. As in control lenses, removal of lens fibres significantly elevated the proliferative activity of the remaining LECs. Suppression by newly formed differentiated lens fibres in the in vivo capsular bag may be responsible for this return to control levels of mitotic activity of LECs in the PCO specimens.

Aged↗
PubMed2000

[Cataract surgery in primary open angle glaucoma].

Cataract surgery has a moderate lowering effect on the intraocular pressure. When glaucoma seems controlled by medication, phacoemulsification gives a chance of improving the situation. Those eyes are most likely to get an intraocular pressure rise by retention of visco-elastic substance.

Anesthesia, Local↗
PubMed2000

[A proposed variation for glaucoma surgery].

When a trabeculectomy does not reduce the intraocular pressure, it is usually due to sealing of the scleral flap to the adjacent sclera, while the trabeculectomy itself remains open. A triangular excision in the scleral flap seems likely to keep the fistula in function. Deep sclerectomy does not lead to major hypotony, "the other complication" of trabeculectomy. However, the non perforating sclerectomy, under a sutured superficial scleral flap, could in the long term become inefficient. I propose a deep sclerectomy with controlled perforation under a notched superficial flap.

Glaucoma, Open-Angle↗
PubMed2000

[Cataract extraction after angle closure glaucoma].

The best therapeutic approach to angle closure with cataract is phacoemulsification and foldable implant. The surgery is performed as soon as the acute crisis is over. Both dispersive and cohesive visco-elastic substance are used in the narrow anterior chamber. Poor mydriasis is best managed by means of iris hooks.

Capsulorhexis↗
PubMed1998

[Drug-induced cataracts].

The fact that corticosteroids, phenothiazines and myotics induce cataract is well known. Moreover some informations about lens opacities have been reported less frequently after the use of cytostatics, deferoxamine, phenytoine, isotretinoine, oral contraceptives, allopurinol, synthetics antimalarial agents, diazepam, tetracyclines and sulfamides. Occasionally some others drugs have been suspected from experimental observations to produce cataract. Amongst all these drugs, corticosteroids are the most often incriminated.

Adrenal Cortex Hormones↗
PubMed1997

Microcephaly, muscular build, rhizomelia, and cataracts: description of a possible recessive syndrome and some comments on the use of electronic databases in syndromology.

We report on a 7-year-old boy born of consanguineous parents with severe microcephaly (-5 SD) but borderline intelligence, juvenile cataract, muscular build, rhizomelic shortness of limbs predominantly of femora, advanced bone age, and micropenis. This combination of signs appears unique and may represent an undescribed, possibly autosomal recessive MCA syndrome. The use of LDDB and POSSUM in the workup of such "new syndromes" is reviewed. Three search strategies are discussed: single rare sign browsing, best combinatory fit using an array of key words, and combined rare signs scan. Pitfalls in the use of such databases and the some problems raised by inconsistent/ incomplete encoding in those two popular, highly useful syndromology retrieval systems are discussed.

Cataract↗
PubMed1997

Separation of fibres from the capsule enhances mitotic activity of human lens epithelium.

Proliferation and migration of lens epithelial cells is at the origin of after-cataract, currently the main side effect of cataract surgery. Extracapsular cataract surgery necessitates opening of the anterior lens capsule and removal of the lens fibres before an intraocular lens can be placed in the cleaned capsular bag. The present study was aimed at testing the potential of the lens capsule and the fibres to affect the mitotic activity of the lens epithelial cells in human donor eyes. Pairs of human lenses used in this study were subjected to two different experimental conditions. In the first, only a small anterior capsulorhexis was made. In the other, fibres were separated from the epithelium by gentle hydrodissection, the nucleus was rotated and, either left in the capsular bag or removed by hydroexpression. The specimens were cultured for 48 hr in MEM with 2% serum. Mitotic activity was assessed by immunohistochemistry using the bromodeoxyuridine (BrdU) incorporation technique. Fellow lenses of the same donors were cultured intact as controls. Anterior capsulorhexis showed a small but significant (P < 0.02) increase in the number of BrdU positive nuclei in the equatorial region but not in the wound area. Lenses where fibres were separated from the epithelium showed a large increase in BrdU incorporation in the germinative region, as compared to the intact control lenses (P < 0.01). BrdU incorporation was highest when fibres were removed. Lens capsule integrity and the presence of contacts between fibres and epithelial cells may have a role in the control of the mitotic activity of the lens epithelium. The data recorded here could be useful for understanding lens cell biology and prevention of after-cataract.

Adolescent↗
PubMed1997

Complicated posterior capsulorhexis: aetiology, management, and outcome.

BACKGROUND: A 1 year retrospective analysis of 650 patients, who underwent a posterior capsulorhexis on their intact capsules, was performed to examine the incidence of complications, their aetiologies, and the outcome. METHODS: Data were analysed on 32 patients with complicated capsulorhexis for type of surgery, preoperative and postoperative factors, and relative risk factors for vitreous issue. RESULTS: There were six patients with vitreous loss. The posterior capsulorhexis was uncontrolled in 14 cases and difficult to perform in 12 cases. Implantation into the capsular bag was possible in all cases. Systemic vascular hazard and old age (over 80 years) were found to be statistically significant risk factors for vitreous loss (p = 0.002 and p = 0.03 respectively). The mean follow up was 13.5 months (range 4-25 months). One patient developed a retinal detachment and two had a transient clinical cystoid macular oedema. Visual acuity of > or = 20/40 was obtained in 93% of the patients. CONCLUSION: Loss of control of the posterior capsulorhexis has a low incidence but can lead to serious problems during surgery. A good knowledge of the technique is necessary to complete the procedure with a posterior capsulorhexis of the optimum size without vitreous loss.

Adult↗
PubMed1996

Posterior capsulorhexis in adult eyes with intact and clear capsules.

PURPOSE: To evaluate the feasibility and risks of primary posterior capsulorhexis. SETTING: Department of Ophthalmology, University Hospital of Liège, Belgium. METHODS: Retrospective analysis of 319 patients with cataracts who had phacoemulsification or manual extracapsular cataract extraction with a simultaneous circular posterior capsulorhexis between August 1993 and April 1994. The number of intraoperative complications and the number of postoperative complications that could be related to the posterior capsule opening were looked at. Fluorescein angiography was performed in a random sample of patients. RESULTS: Twelve intraoperative complications consisted of 5 irregular tears, 4 vitreous prolapses into the posterior capsulorhexis, and 3 vitreous prolapses into the anterior chamber; 11 occurred in eyes with positive posterior pressure. Postoperative complications consisted of 3 vitreous prolapses into the pupil and 1 retinal detachment. Two of the 3 late vitreous prolapses occurred in eyes in which the posterior capsulorhexis was larger than the intraocular lens (IOL) optic. The retinal detachment occurred in an eye with a 25.79 mm axial length. Fluorescein angiography of 49 cases revealed 3 with cystoid macular edema. CONCLUSIONS: Based on our results, we believe that primary posterior capsulorhexis can be a routine procedure during cataract surgery and IOL implantation in adults, except in cases of positive pressure. The diameter of the posterior capsulorhexis should be smaller than the diameter of the IOL optic.

Adult↗
PubMed1996

[Posterior capsulorhexis in adults].

PURPOSE: To evaluate the feasibility and the risks of posterior capsulorhexis. MATERIAL AND METHODS: Retrospective analysis of 504 cases operated by phacoemulsification or manual extracapsular cataract extraction with a circular posterior capsulectomy. These cataracts were due to age or of unknown etiology. We analysed the intraoperative and postoperative complications. Fluorescein angiography was performed in a sample of unselected cases. RESULTS: The intraoperative complications consisted in 5 uncontrolled tearing and 7 prolapses of vitreous (4 of the 7 only in the posterior capsulectomy). Eleven of these twelve incidents occurred in case of positive posterior pressure. In the postoperative period, 3 additional prolapses of the vitreous in the pupil were observed; two of these capsulorhexis had been made larger than the optic of the intraocular lens. Three eyes with 25.79; 34.69 and 26.3 mm axial length presented a retinal detachment. Among 49 cases submitted to fluorescein angiography, 3 showed cystoid macular edema. CONCLUSIONS: Posterior capsulorhexis would be feasible in the cataract-implant surgery in adults, except in case of positive pressure. The diameter of the capsulorhexis has to be smaller to the diameter of the intraocular lens optic.

Adult↗