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Biomedical subjects

A Péchereau

Publications and source records attributed to A Péchereau.

At least 19 recordsLinked to original sources
PubMed2006

[Amniotic membrane transplantation and limbic-conjunctival autograft for recurrent pterygium, either invasive or with optic axis involvement].

OBJECTIVE: To evaluate amniotic membrane transplantation with limbic-conjunctival autograft during recurrent pterygium surgery in cases with a risk of stromal defect or with optic axis involvement, in order to limit the corneal defect in pterygium and preserve vision with moderate astigmatism. MATERIALS AND METHODS: Retrospective study of 50 cases. Three clinical aspects were encountered: A, recurrent pterygium after simple surgery (a corrected stromal defect)--six cases; B, primary pterygium at risk of stromal defect - five cases; C, primary pterygium with optic axis involvement--four cases. Each patient underwent ablative surgery followed by ocular surface rebuilding with limbic-conjunctival autograft combined with amniotic membrane graft on the corneal defect. Visual acuity and astigmatism were measured and compared before and after surgery. RESULTS: The mean follow-up was 13 months. At the end of the follow-up, the recurrence rate was 27% (four cases: two in A, two in B, and none in C). Mean visual acuity was improved from 0.7 to 0.8 postoperatively (p=0.041). Astigmatism changed slightly from 1.47 to 1.98 dioptres (p=0.155). DISCUSSION: For recurrent pterygium, with stromal defect or optic axis involvement, amniotic membrane transplantation and limbic-conjunctival autograft seems not to influence the recurrence rate. However, by limiting initial keratectomy, this surgical procedure only slightly modifies visual acuity and astigmatism in the cases where the two parameters are slightly affected. Failure can be easily managed with further surgery such as lamellar keratoplasty. CONCLUSION: Amniotic membrane transplantation and limbic-conjunctival autograft for recurrent pterygium or with optic axis involvement can be useful to integrate in the therapeutic arsenal of pterygium surgery.

Adult↗
PubMed2000

[Surgery for idiopathic and secondary epiretinal membranes: functional results and complications].

PURPOSE: To evaluate visual outcome after epiretinal membrane surgery. MATERIAL: and method: Retrospective study of 50 consecutive epiretinal membranes (ERM) (23 idiopathic and 27 secondary) with 12 to 42-month follow-up (mean 24 months). Functional evaluations were performed before and after surgery according to the idiopathic or secondary nature of the epiretinal membranes. RESULTS: For idiopathic ERM, vision improved by more than two lines in 43% of the eyes (33% after ERM surgery alone and 55% after ERM followed by cataract surgery) with final visual acuity of 4/10 for 66% of the patients (58% and 82% respectively); there was visual degradation for the two ERM on highly myopic eyes. For the secondary ERM, vision improved by more than 2 lines for 41% of the eyes and final visual acuity of 4/10 for 33% of the patients; visual degradation for almost all ERM secondary to uveitis was associated with preoperative cystoid macular edema. CONCLUSION: After surgery for idiopathic or secondary ERM, visual acuity is good with the exception of the idiopathic ERM on highly myopic eyes and of the uveitic ERM with preoperative cystoid macular edema. Progression of cataract often perturbs visual outcome analysis.

Adolescent↗
PubMed1999

[Non-immunologic factors of failure of penetrating keratoplasties. Prospective study of 119 corneal grafts at the Nantes Hospital Center in 1995].

PURPOSE: A single-center prospective study was carried out in Nantes to evaluate corneal graft outcome, while immunosuppressive treatment was used topically or systemically, during the first year. METHODS: A cohort of 119 patients underwent penetrating keratoplasty between 1-1-95 and 31-XII-95. Systematic standardized exams were performed at 15 days, 1 month, 4 months, 6 months and 1 year. Grafts were obtained from organo-cultured corneas at +31 degrees C. Intraveinous methyl prednisolone was given at the time of the surgery in most cases (82%). Corticosteroid eye drops are used in all cases and systemic Cyclosporin A was given for high-risk rejection keratoplasties (29.5%). RESULTS: The clear graft rate at 1 year is 97% for keratoconus, 87.8% for bullous dystrophies and 80.7% for regrafts. The leading causes of graft failure are: graft rejection (25%), endothelial consequences of a non controlled elevated intra ocular pressure (25%) and ocular surface disorders (16%). Prevalence and management of elevated IOP (from 8% to 20%) and ocular surface disorders (from 18% to 43%) are reported over one year. CONCLUSION: This study points out the great frequency of elevated-IOP-related disorders and ocular surface diseases in corneal graft outcome. They must be tracked down and uncompromisingly treated before and after transplantation.

Adolescent↗
PubMed1998

A novel method for controlling the quantity of mitomycin-C applied during filtering surgery for glaucoma.

The use of a sponge impregnated with mitomycin-C is an increasingly common practice in glaucoma surgery. The appropriate antibiotic concentration and exposure time have been considered in the literature, but not the exact amount to be used or the size of the sponge. The purpose of this study was to estimate the quantity of mitomycin-C contained in sponges prepared by different surgeons as compared to that in applicators of the type used in Schirmer's test graduation (5 x 5 mm). Four surgeons each cut and prepared 10 sponges for intraoperative use according to their usual method. The same procedure was performed with 10 Schirmer's test graduations. Each sponge and each graduation was immersed in a solution of mitomycin-C 0.2 mg/ml, and the quantity of antibiotic (microg) in each was calculated as the difference between wet and dry weight. The mean quantity (+/- SEM) of mitomycin-C contained in cut sponges was 9.6 +/- 4.4 microg (range 1.9-17.3), and the differences between surgeons were statistically significant (p<0.0001). The mean quantity of antibiotic in Schirmer's test graduation was 1.7 +/- 0.3 microg (range 1.1-2.5), and the differences between surgeons were not statistically significant (p=0.79). The quantities of mitomycin-C contained in sponges prepared for glaucoma surgery differed for a given surgeon and between surgeons. Thus, variations in the doses applied to the sclera could account for certain complications due to mitomycin-C. The use of a Schirmer's test graduation improves predictability for the quantity of mitomycin-C applied to the sclera.

Antibiotics, Antineoplastic↗
PubMed1989

[Epidemiology of myopia, astigmatism, anisometropia].

Elements of epidemiology concerning myopia, astigmatism and anisometropia are still uncertain. Meanwhile, a certain number of means concerning the evolution presence and the importance of these ametropias can be proposed.

Adolescent↗
PubMed1989

[Bifocal glasses--progressive glasses. Anticholinesterases].

The use of this therapeutic group follows precise rules: far and near rectitude, normal binocular vision. Application conditions are very strict. The limits of this therapeutic is the possible duration of its application, which should be limited.

Cholinesterase Inhibitors↗
PubMed1989

[Semeiology of accommodative strabismus].

Only the evolution under the total optical correction permits to define whether a strabismus is partially or totally accommodative. This answer can take very variable forms.

Accommodation, Ocular↗
PubMed1981

Kinetic electro-oculography: aims - disadvantages and limitations.

A recording technique is essential in the study of ocular movements. At present, numerous mechanical, optical and electrical methods are under review. Kinetic electro-oculography is at the moment the only available technique which fulfills most clinical requirements. However, it is a delicate method, subject to numerous hazards; the sources of errors are manifold. With electro-oculography, we can only expect a qualitative and comparative assessment of horizontal movements. Displacements along the oblique axes cannot be studied.

Electrooculography↗
PubMed1981

The muscle elongation test in functional squints. History - basis and clinical features.

Work carried out by Cüppers has proved that squint deviations are related to the innervational and viscoelastic impairments of th ocular muscles, whose association and degree vary according to each case. The passive duction test is always positive in retraction syndromes, but it is not precise enough to detect most of the viscoelastic impairments of functional squints. The authors have noted important and frequent anomalies of muscle stretching; they describe the operative features of a muscle elongation test in various types of strabismic deviations.

Elasticity↗
PubMed1981

The muscle elongation test in functional esotropias. Statistical survey of 211 cases.

Study of the muscle elongation test in 211 patients with convergent squints who never have been operated on previously reveals that about 35% of cases display abnormal muscle stretching; 48 cases retain a lasting anesthetic angle in spite of a normal elongation test. Particularly significant correlations exist between a positive muscle elongation test and the degree of clinical oculogyric spasm, electro-oculographic motor impairments, squint deviation degrees, and age at strabismus onset. All these correlations prove that viscoelastic anomalies of the ocular muscles are secondary to supranuclear innervational impairments. In addition, both together have an asymmetrical degree on each eye in more than half the cases. The authors conclude that, in order to choose the correct surgical procedure, the results of the anesthetic and muscle elongation tests must be taken into account.

Child↗
PubMed1981

Surgical results in functional squints. Analysis and pathogenetic meaning.

(1) In functional squints, it is necessary to assess, in each case, the exact and particular role played by innervational and viscoelastic impairments by carrying out a thorough clinical examination, an electro-oculographic recording and the anesthetic and muscle elongation tests. Such as appraisal is still only approximate, however. (2) Various surgical methods permit the suppression of the deviation but all the procedures are purely empirical, and their results have no pathogenetic significance. Moreover, all the surgical actions cause some muscle and health scarring. For all these reasons, a high rate of success of one-step surgery is not possible. (3) An accurate appraisal of motor balance and, in particular, of the sensory state is very difficult. It can only be achieved by successive controls over a long period of time. Early surgery has many substantial drawbacks. The adjustable-suture technique is very tempting, but the lack of cooperation of most young children renders it use difficult.

Age Factors↗