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Biomedical subjects

A Retout

Publications and source records attributed to A Retout.

At least 19 recordsLinked to original sources
PubMed2005

[Infantile esotropia: comparison of surgery results when the intervention takes place before or after 30 months of age].

OBJECTIVE: Present and compare surgery results of children with congenital or infantile esotropia, who had surgery before or after 30 months of age, in the Rouen Department of Ophthalmology between 1996 and 2000. PATIENTS AND METHODS: A retrospective study included 37 patients, 23 females and 14 males, 19 in the first group who had surgery before 30 months at an average age of 24 months (15-30) and 18 in the second group who had surgery after 30 months at an average age of 56 months (38-81). Hypermetropia was found up to 2 diopters for 14 of 19 patients in the first group and 13 of 18 in the second. We noted the surgical procedure. We compared pre- and postoperative amblyopia as well as pre- and postoperative objective deviations at near and distance ranges. The exclusion criteria were follow-up for less than 3 months, esotropia emergence after 12 months of age, children aged more than 7 years at the first surgery, and children with central nervous system disorders. Finally, esthetic aspect, postoperative distance and near sensory results were evaluated. Success was defined by orthotropic position, esotropia less than 15 prism diopters, or consecutive exotropia less than 10 prism diopters. RESULTS: The mean follow-up after surgery was 30 months (3-56) for the first group and 28 months (3-67) for the second. Motor results were similar between the two groups: we found 10 out of 19 successes (esotropia (E(T)) less than 15 diopters (D) or exotropia (X(T)) less than 10 D) in the first group, and 15 out of 18 successes in the second group. There were 3 out of 19 failures (E(T) more than 20 D or X(T) more than 15 D) in the first group and 3 out of 18 in the second. Hypermetropia and preoperative deviation were not significantly different for good or bad motor results (p<0.05). A second-step surgery was performed for two children in the first group and three in the second group, and one of the three children of the second group had a third step. Sensory results were very similar with 6 of 19 cases achieving binocular union in the first group and 7 of 18 in the second one. Finally, one patient from each group presented amblyopia after surgery. CONCLUSION: In our study, as in the literature, infantile esotropia surgery can result in excellent motor alignment, while sensory results are not as good. It appears in our study that there is no significant advantage in performing surgery before 30 months for infantile esotropia. The follow-up of our patients may have been insufficient, and our definition of the semi-early surgery (before 30 months) was already too late in comparison with other studies (less than 24 months).

Age Factors↗
PubMed2005

[Comparison of two surgical techniques for the treatment of superior oblique palsy].

AIM: To compare two surgical techniques for the treatment of superior oblique palsy. PATIENTS AND METHODS: Retrospective study involving 32 patients operated on at the Rouen Teaching Hospital for superior oblique palsy. Group 1 patients were treated by surgical reinforcement of the superior oblique muscle and group 2 patients were treated by surgical loosening (or weakening) of the antagonist muscles. One-year follow-up explored head tilt, diplopia, vertical deviation and cyclotorsion. RESULTS: Functional results (presence of diplopia or stiff neck) were positive in both groups but better in group 1. Only 12.5% of patients required a second operation. Cyclotorsion amounted to less than 2% in group 1 and was still greater than 8% in group 2; on the other hand, vertical deviation had improved more in group 2, where it decreased to 2.1 diopters versus 3.1 in group 1. DISCUSSION: and conclusion: Only reinforcing the superior oblique adequately corrects cyclotorsion, which is the main cause of asthenopia and diplopia, despite an often insufficient height correction that is otherwise clinically well tolerated. We suggest reinforcing the superior oblique as a first intent rather than weakening hyperactive muscles, and in case of excessive postoperative height, we would carry out additional treatment of one of the hyperactive muscles later.

Adolescent↗
PubMed2000

[Limbal autograft transplantation, eight consecutive cases].

BACKGROUND: Limbal autograft transplantation is the procedure of choice in the management of ocular surface disorders secondary to stem cells deficiency. The aim of our study was to investigate the indications, results and limits of this infrequent surgery. METHODS: Limbal autograft transplantation was performed in 8 patients and the mean follow-up period was 11 months. Limbal stem cell deficiency was due to chemical burns in 4 patients, history of prior surgery extending to the limbus in 2 patients, chronic limbitis with dystichiasis in one patient and persistent corneal epithelial defect after keratoplasty in one case. RESULTS: In 6 out of 8 cases, the stability of the ocular surface normalized and comfort significantly improved. Four of these patients had increased visual acuity after surgery. Two patients who presented with severe alkali burn did not respond well to limbal autotransplantation. CONCLUSION: Limbal autograft transplantation is a reliable and effective procedure in limbal stem cells deficiencies. New associate procedures such as amniotic membrane transplantation will however be necessary to improve the prognosis of very severe corneal surface disorders.

Adolescent↗
PubMed2000

[Phacoemulsification following radial keratotomy. Topographic and refractive analysis concerning an 18-month period (apropos of a case)].

We followed a 45-year-old man who underwent clear cornea phacoemulsification cataract extraction 3 years after radial keratotomy during an 18 month period. We report early and late refractive analysis and corneal topography during the followup period. The patient experienced an hyperopic shift which was different from the aim of 5 diopters due to an early corneal flattening of 3 diopters and an underestimation of the IOL power of 2 diopters using SRKII calculation formula. Corneal flattening regressed after 3 weeks. We recommend that these patients should be informed of an eventual early hyperopic shift and late refractive error, that Binkhorst II or Hoffer-Q intraocular lens calculation formulas be used and keratometry measurements be obtained from computerized videokeratography.

Corneal Topography↗
PubMed1999

[Peribulbar anesthesia for peroperative and postoperative pain control in eye enucleation or evisceration: 31 cases].

OBJECTIVES: The aim of this prospective study was to assess peroperative and postoperative analgesia in eye enucleation or evisceration performed under peribulbar anesthesia. PATIENTS AND METHODS: We report 31 patients undergoing an eye enucleation (17 cases) or evisceration (14 cases). The surgical procedure was performed under local anesthesia alone in 22 patients. General anesthesia was associated with local anesthesia in 9 patients. Peribulbar block was achieved with the first insertion of the needle parallel to the inferior orbital floor and the second at level of supraorbital notch. A mixed anesthetic solution of equal quantity of lidocaine 2% with epinephrine (0.25 mg/20 ml) and bupivacaine 0.50% with epinephrine (0.10 mg/20 ml) was injected (total quantity 16.8 +/- 4.3 ml). RESULTS: To assess the peroperative pain we considered the patients with local anesthesia only (22 patients). One of these 22 patients needed one injection (0.50 mg/kg) of propofol for cutting the optic nerve. Surgery was ended without any other drug but that case was considered as a failure. Peroperative analgesia was obtained in 21 of 22 patients (95.4%). To assess analgesia in the postoperative period we included 31 patients. Analgesia was complete from the accomplishment of the peribulbar block to the 4th hour in all patients (efficacy 100%). From the 4th to the 24th hour, pain remained absent in 11 (enucleation 10 cases and evisceration 1 case) of the 31 patients and no drug was used. In 20 patients (enucleation 7 cases and evisceration 13 cases), pain appeared between the 4th and the 10th hour and patients were relieved by paracetamol alone in 14 cases (enucleation 6 cases and evisceration 8 cases) or by its association with nalbuphine in 5 cases (enucleation 1 case and evisceration 4 cases). In one patient (evisceration) the association of the drugs was uneffective. CONCLUSION: Peribulbar anesthesia is safe and generates major postoperative analgesia so we suggest to offer that technique to patients undergoing evisceration or enucleation.

Acetaminophen↗
PubMed1994

[Popliteal pterygium syndrome. A exceptional case].

We report the case of a patient with a popliteal pterygium syndrome, a rare malformation associating, in its complete form, cleft lip and cleft palate, cleft lower lip, intergingival synechia, defects of the genito-urinary tract and popliteal pterygium. Based on this observation and a review of the literature, the phenotypic and genotypic aspects of this malformation were discussed together with adapted therapeutic management and genetic counselling.

Abnormalities, Multiple↗
PubMed1991

[Retinal toxicity caused by intravitreous injection of an aminoglycoside. Apropos of a case].

The authors present a case of severe retinal ischemia associated with Dibekacin intraocular injection. This aminoglycoside was used, at an inadvertent dose, for the treatment of a postoperative endophthalmitis. The prominent finding at ocular ophthalmoscopy was oedematous retina with hemorrhages in the macular area. Fluorescein angiography revealed severe retinal vascular non perfusion. The eye subsequently developed neovascular glaucoma. Precautions are necessary to prevent such a catastrophic event; the injectable solution must be prepared on the surgical field, the injection should be performed slowly in the anterior vitreous without exceeding 0.2 mg when Gentamicin is used.

Aged↗
PubMed1989

[Corneal abscess caused by Pasteurella following cat scratch injury].

Authors report a Pasteurella Multocida corneal abscess after a scratch from a cat. The evolution was torpid and needed a transfixiant keratoplasty. They recall bacterial tanks, infestation ways, clinical manifestations and bacteriological identification. They note the low occurrence of ophthalmological manifestations and the sensibility of Pasteurella to various antibiotics, especially Beta lactams, phenicol and cyclins.

Abscess↗
PubMed1989

[Biomicroscopy of the fundus oculi using a 90 diopter lens].

An improved method of indirect biomicroscopic examination of the ocular fundus has been made possible with the use of a + 90 D lens since 1985. Its special optical characteristics make it a very useful instrument. During this study of 220 retinal detachments we compared this instrument with other methods for examining the ocular fundus (Goldmann fundus contact lens, panfundoscope, binocular indirect ophthalmoscope with a 20 D lens). Other uses for the lens are described. This non-contact examining technique provides excellent visualisation, a wide field of vision, and good patient tolerance. The 90 D lens is particularly useful in vitreo-retinal management of retinal detachment both during and immediately after surgery.

Humans↗
PubMed1989

[Endophthalmitis caused by Aspergillus (anatomo-clinical study of a case)].

The authors report a case of endogenous aspergillosis endophthalmitis. Ocular involvement was very important and not controlled by several vitrectomy and intra-vitreous Amphotericin B. Pathological examination revealed abscesses in the vitreous, choroid and retina. Diagnosis and treatment are discussed.

Aspergillosis↗