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Biomedical subjects

F Gianoli

Publications and source records attributed to F Gianoli.

4 recordsLinked to original sources

Combined surgery for cataract and glaucoma: phacoemulsification and deep sclerectomy compared with phacoemulsification and trabeculectomy.

PURPOSE: To compare the outcome of phacoemulsification-intraocular lens (IOL) implantation combined with nonperforating deep sclerectomy (P-DS) with that of phacoemulsification-IOL implantation combined with trabeculectomy (P-T). SETTING: Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland. METHODS: This prospective study involved 60 eyes of 60 patients with cataract and various types of open-angle glaucoma. Thirty eyes had P-DS and 30, P-T. Follow-up was performed at regular intervals for up to 18 months. RESULTS: Mean follow-up was 12.5 months +/- 6.5 (SD) and 12.6 +/- 4.9 months for the P-DS and P-T groups, respectively. Mean preoperative intraocular pressure (IOP) was similar in both groups (24.8 +/- 5.9 mm Hg in the P-DS group and 24.6 +/- 7.2 mm Hg in the P-T group). There was no statistically significant difference in IOP decrease (14.2 +/- 4.0 mm Hg in the P-DS group and 15.2 +/- 2.8 mm Hg in the P-T group). Visual outcome was similar in both groups. The P-DS group experienced significantly less inflammation (40.0% versus 83.0%; P = .0012) and hyphema (6.7% versus 36.7%; P = .010) than the P-T group. CONCLUSION: Deep sclerectomy combined with cataract surgery resulted in an IOP reduction similar to that with phacotrabeculectomy with the same visual outcome, but the lower complication rate makes ambulatory care easier.

Adolescent↗

[Skew deviation].

BACKGROUND: Skew deviation is a vertical ocular misalignment of prenuclear origin. Although well described in the literature, it is still probably underdiagnosed. Natural history of skew deviation is not well described in the literature. PURPOSE: To describe the clinical presentations, etiologies and follow-up of skew deviation. METHODS: Retrospective study of 29 patients diagnosed with skew deviation between 1993 and 1996. RESULTS: The commonest cause was cerebrovascular accident (12/29) and the commonest localisation was mesencephalic (9/29). Other causes included surgery (7/29), tumor (4/29), trauma (3/29), degeneration (3/29), inflammatory (2/29), increased intracranial pressure (1/29). Other localisations included cerebellum (5/29), ponto-mesencephalic (3/29), and medulla (2/29). Vertical diplopia was always accompanied by other neuro-ophthalmologic abnormalities. 69.2% (18/26) patients were totally asymptomatic after 7.5 months. 30.8% (8/26) were still symptomatic (diplopia). One patient required surgery, three patients were relieved with prisms, one patient needed monocular occlusion. One patient died during follow-up and precise data were lacking in two symptomatic patients. CONCLUSION: Skew deviation is not so rare, 10% of the cases referred to us for diplopia in 3 years. The diagnosis of skew deviation should be entertained when vertical diplopia cannot be explained by pathology of extraocular muscles, peripheral or central cranial nerve III or IV palsies, myasthenia, or orbital pathology. Prognosis for recovery in patients with skew deviation is good. 70% will recover, after a median time of 7.5 months. Surgery should be postponed at least for 12 months.

Adolescent↗

[Cataract-glaucoma combined surgery: comparison between phacoemulsification combined with deep sclerectomy, or trabeculectomy].

PURPOSE: To study the success rate of combined phaco-intraocular lens (IOL)-deep sclerectomy (P-DS), a new perforating filtering surgery, versus phaco-IOL-trabeculectomy (P-T). METHODS: Of 38 patients, 39 eyes with cataract and different types of glaucoma, 19 eyes underwent P-DS, and 20 eyes underwent P-T. Patients were prospectively studied. RESULTS: The follow-up of both groups was 11 +/- 6 months. The intraocular pressure (IOP) decrease in both groups was similar (from a mean preoperative IOP of 26.5 +/- 6.8 mmHg, to a mean postoperative IOP of 14.8 +/- 1.3 mmHg in the P-DS group, vs 25.9 +/- 7.7 mmHg preoperative and 14.8 +/- 2.7 mmHg postoperative in the P-T group). The visual acuity outcome was similar in both groups. The complication rate was significantly lower in the P-DS group. CONCLUSIONS: Deep sclerectomy associated with cataract surgery offers the same IOP reduction and visual acuity outcome. However, the complication rate is significantly lower and allows easier ambulatory care.

Aged↗

Serum 25-hydroxyvitamin D: distribution and determinants in the Swiss population.

The serum 25-hydroxyvitamin D [25(OH)D] concentration was measured in a representative sample of the general adult population in Switzerland (n = 3276). The median concentration was 46 nmol/L and no significant difference was found between men and women. Between the ages of 25 and 74 y, 25(OH)D was not significantly correlated with age (r2 = 0.01). Six percent of the population was vitamin D deficient [ie, 25(OH)D less than or equal to 20 nmol/L] and between 34% and 95% had a relatively low concentration of vitamin D (ie, less than 38 or less than 95 nmol/L, respectively). Among the determinants of low 25(OH)D were indicators of little sunshine exposure, such as the winter season [odds ratio (OR) 2.4, 1.5-3.7 (95% confidence interval)] and less than 30 min of time spent outdoors daily by individuals greater than 65 y of age (OR 5.6, 1.5-21.2), as well as indicators of low nutritional intake of vitamin D, such as the absence of regular intake of butter or margarine (OR 2.0, 1.3-3.1) and the consumption of few dairy products (OR 1.7, 1.2-2.4).

25-Hydroxyvitamin D 2↗