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Biomedical subjects

F Malet

Publications and source records attributed to F Malet.

At least 19 recordsLinked to original sources
PubMed2006

[Bilateral infectious keratitis in a patient wearing cosmetic soft contact lenses].

We report a case of an immunocompetent 20-year-old woman, wearing planocosmetic contact lenses to change the color of her eyes, with no contact lens hygiene regimen. She developed a bilateral infectious keratitis. Acanthamoeba and Fusarium solani were isolated in both eyes. Bilateral penetrating keratoplasty was needed because of bilateral corneal perforation. Three months later, bilateral simultaneous phacoemulsification was performed because of a dense cataract and a severe decrease in her vision. Six months after surgery, her best corrected visual acuity was 0.7 in the right eye, and 0.6 in the left eye. Cosmetic contact lenses expose the wearers to the same potential ocular complications as other contact lenses. Wearers must be informed of such complications, which may be sight-threatening. Based on this case, we strongly recommend that all cosmetic contact lens wearers be examined and followed as if they were standard contact lens wearers.

Adult↗
PubMed2006

[Practical measures. Contact lenses after glaucoma surgery].

New soft therapeutic contact lenses after glaucoma surgery provide good results, both in terms of tolerance and efficacy (60% pressure increase in a personal series of ten patients with the Trabeculens contact lens). Indicated for moderate immediate postoperative leakage, their use remains transitory and they should be removed as soon as intraocular pressure is (rapidly) corrected. After glaucoma surgery, wearing contact lenses can be discussed if there are no contraindications and 6-12 months after the intervention in a compliant patient. Evaluation of the risk-benefit ratio is important. Gas-permeable, small-diatmeter hard contact lenses, bi- or trifocal spherical or posterior toric - the most stable - should be favored. Soft contact lenses can also be used, but because of their presence on the conjunctiva, notably in the filtration zone, they are less frequently recommended. Contact lens wear should in all cases be strictly limited to the daytime.

Contact Lenses, Hydrophilic↗
PubMed2001

INTACS inserts for treating keratoconus: one-year results.

OBJECTIVE: To evaluate the use of INTACS micro-thin prescription inserts (Kera Vision, Inc., Fremont, CA) for the treatment of keratoconus. DESIGN: Prospective, nonrandomized (self-controlled) comparative trial. PARTICIPANTS/INTERVENTION: Ten patients from our prospective clinical study who had completed 12 months of follow-up were evaluated. All patients had keratoconus with clear central corneas and were contact lens intolerant. After reviewing corneal pachymetry and topography of individual patients, INTACS inserts of 0.45-mm thickness were placed in the inferior cornea to lift the cone and INTACS of 0.25-mm thickness were inserted superiorly to counterbalance and flatten the overall anterior corneal surface. MAIN OUTCOME MEASURES: Differences between preoperative and postoperative uncorrected visual acuity, best spectacle-corrected visual acuity, manifest refraction, and keratometry values were statistically assessed. Changes in corneal ectasia were evaluated by reviewing corneotopographic maps. RESULTS: No intraoperative complications occurred in this series of patients. Spherical equivalent error and refractive astigmatism were reduced with INTACS inserts treatment. Postoperative month 12 uncorrected visual acuity (logarithm of the minimum angle of resolution [logMAR] mean, 0.35, standard deviation [SD], 0.16 [approximately 20/50, approximately 2 lines]) was significantly better than preoperative (logMAR mean, 1.05; SD, 0.33 [approximately 20/200, approximately 3 lines]; P <or=0.05). Average best spectacle-corrected visual acuity at postoperative month 12 was improved by approximately two lines compared with baseline (logMAR mean, 0.22; SD, 0.12 [approximately 20/32, approximately 1 line]; logMAR mean, 0.38; SD, 0.13 [approximately 20/50, approximately 1 line], respectively). Topographic corneal shape (size and height of the cone) was improved for all subjects after insert placement. CONCLUSIONS: INTACS micro-thin prescription inserts seem to provide a viable method for treating clear corneal keratoconus for patients who are contact lens intolerant. The corneal steepening and astigmatism associated with keratoconus were reduced, and visual acuity was improved with treatment in almost all eyes.

Adult↗
PubMed2001

Ocular surface changes induced by contact lens wear.

PURPOSE: To evaluate subclinical inflammation and mucus production of the conjunctiva in asymptomatic contact lens (CL) wearers, and to obtain an estimation of the chronologic variations in each group. METHODS: Eighteen eyes fitted with rigid CL (RCL) and 28 eyes with soft CL (SCL) worn daily were compared with 10 eyes from five healthy non-CL wearers. Impression cytology (IC) specimens were collected after clinical examination and were analyzed by flow cytometry using antibodies directed to HLA DR and intercellular adhesion molecule type 1 (ICAM-1) (CD 54), as inflammatory markers, and to the peptidic core of the conjunctival mucin (M1/MUC5AC) for mucus and goblet cell detection. The percentage of positive cells was calculated, and levels of fluorescence expression were quantified and compared between each group. RESULTS: A significant increase of HLA DR and ICAM-1 was observed in the SCL group in comparison with the control group. The two inflammatory markers were highly positively correlated with each other. Mucin detection with M1/MUC5AC did not find a significant difference between each group in terms of percentage of positive cells, but analyses of mean levels of fluorescence showed a significant decrease in the two CL groups. Evolution in time was different for each group, with a regular low level of inflammation in the RCL group in the first 10 years in comparison with the SCL group. In the SCL group, inflammation seemed to be higher before 2 years and after 10 years of wear. Mucin expression was variable in time, but without significant difference at any time. CONCLUSION: This study confirms difference in expression of subclinical conjunctival inflammation in asymptomatic CL wearers, with lower levels for RCL than SCL wearers with daily or extended wear. The mucin system is also modified by this low but chronic aggression of the ocular surface, with a tendency to decrease with time in the RCL and SCL groups.

Adult↗
PubMed2001

[An observational, retrospective two-year cost study in primary open-angle glaucoma and ocular hypertension in newly diagnosed patients].

PURPOSE: To investigate the different treatment strategies in France and the direct costs for patients with newly diagnosed primary open-angle glaucoma or ocular hypertension who have started treatment with beta-blockers, and to estimate the total direct cost for two years of treat. MATERIAL: and methods: We analyzed 225 medical charts retrospective in eleven academically and office-based centers in France over the first two years after diagnosis. Standard costs for each resource in current medical practice were determined from the French Social Security perspective. RESULTS: The vast majority of patients (90%) had a diagnosis of primary, open-angle glaucoma or ocular hypertension in both eyes. In 60% of the patients we found a moderate or severe defect in their visual field or optic nerve. Intraocular pressure before treatment was 23.9+4.7mmHg and 17.5+4.2mmHg after two years of treatment. Over the first two years, 25% of visits led to a change in therapy (medical or surgical), involving 64% of the patients. Two-thirds of the changes occurred during the first year of treatment and in around 80% of cases for low intraocular pressure at check-up. Laser surgery or surgical intervention was performed in 25% of the patients. Total direct costs for two years were 5698F.F. The intraocular pressure before treatment was positively correlated (p<0.01) with treatment costs, while the initial intraocular pressure-lowering effects of treatment were negatively correlated with two-year costs. CONCLUSION: After two years of treatment, the mean intraocular pressure decreased from 24 to 17.5mmHg. The higher the basal intraocular pressures is, the more intensive the treatment and the higher the costs. The more efficient the treatment to decrease baseline intraocular pressure is, the earlier the costs will be reduced.

Aged↗
PubMed2000

Correcting keratoconus with intracorneal rings.

PURPOSE: To evaluate the potential of intrastromal corneal ring technology (Intacs, KeraVision) to correct keratoconus without central corneal scarring. SETTING: Department of Ophthalmology, Brest University Hospital, Brest, France. METHODS: In this prospective, noncomparative, interventional case series, Intacs segments were implanted in 10 keratoconic eyes with clear central corneas and contact lens intolerance after corneal pachymetry was checked. Segment thicknesses varied based on corneal topography analysis. RESULTS: No intraoperative complications occurred. The mean follow-up was 10.6 months. Postoperative results revealed a reduction in astigmatism and spherical correction and an increase in topographical regularity and increased uncorrected visual acuity. CONCLUSION: Intacs technology can reduce the corneal steepening and astigmatism associated with keratoconus.

Adult↗
PubMed1996

Myopic photorefractive keratectomy in eyes with atypical inferior corneal steepening.

PURPOSE: To evaluate the visual and refractive results of photorefractive keratectomy (PRK) in eyes with atypical inferior corneal steepening (AICS). SETTING: Department of Ophthalmology, Hôpital Morvan, University of Breast, France. METHODS: Using videokeratopography, we screened 310 eyes that had PRK from November 1992 through November 1993 and found that 35 eyes exhibited topographic patterns consistent with AICS with no clinical findings. The results at 6 months and 1 year were compared with those of 185 eyes with normal topography treated concurrently. RESULTS: There were no statistically significant differences between the two groups in mean spherical equivalent, mean uncorrected visual acuity, and mean best spectacle-corrected visual acuity 6 months and 1 year after PRK. CONCLUSION: After 1 year, PRK in eyes with AICS appeared to give results similar to those in eyes with normal topography. Further follow-up is needed.

Adult↗
PubMed1995

Bacterial keratitis therapy in guinea pigs with lomefloxacin by initially high-followed by low-dosage regimen.

Lomefloxacin is known to have an excellent corneal penetration. The therapeutic effect of two specific treatment regimens with lomefloxacin 0.3% eye drops was studied in a Pseudomonas aeruginosa-induced keratitis model in guinea pigs. An initial loading dose of 1 drop every 5 min for 5 times was used in all groups. Its purpose was to obtain high bactericidal corneal levels in the two actively treated groups. The follow-up treatment for 7 days was by a twice daily regimen in one group and 3 times daily in the other treated group. There were two control groups - one with no treatment and the other with vehicle treatment (initial loading dose followed by twice daily regimen). Clinical signs of cornea, conjunctiva and eye adnexae improved significantly within 2 days in both lomefloxacin regimens, whereas clinical signs deteriorated with vehicle treatment. Fifty percent of the animals treated with lomefloxacin showed no colonies in the swab culture after 2 days of therapy, while all vehicle-treated animals were positive even at day 6, with 5 out of 9 animals continuing to be positive at day 8. Pseudomonas in the range of 100-2,300 colonies was isolated from the grounded and cultured cornea at the end of the study in 4 out of 9 vehicle-treated animals but in none of the lomefloxacin-treated guinea pigs. The biggest difference in the degree of secondary inflammation between lomefloxacin and vehicle-treated groups was observed in the cornea which was the target tissue of infection. An unexpected observation was the lower degree of corneal inflammation in the twice daily treated animals when compared to the 3 times daily treatment group. This finding may be due to the somewhat lower initial degree of corneal inflammation in this group and suggests that the course of corneal recovery is predominately dependent on the initial degree of infection with both dosage regimens of lomefloxacin capable of eradicating corneal organisms.

Animals↗
PubMed1993

[Preventive treatment of herpetic keratitis with acyclovir tablets].

Although several drugs are available to treat superficial herpes simplex keratitis, viral latency and recurrences represent clinical challenges that have been inadequately addressed by current topical antiviral agents. One hundred and ninety patients with previous herpes simplex keratitis were entered in an open study to evaluate the efficacy of the prophylactic therapy of recurrence with Acyclovir (200 mg) four times daily for 1 month to 24 months. Forty patients were treated because of frequently recurring herpetic keratitis; 36 were treated during a short period because of known risk factors; 23 were treated after ocular surgery which needed topical corticosteroid therapy in the postoperative period and 91 patients were treated after penetrating keratoplasty for herpetic keratitis. The results of this study indicate that oral Acyclovir significantly lowered the incidence of recurrences of herpetic keratitis in selected patients.

Acyclovir↗
PubMed1993

[Superficial amebic keratitis].

Acanthamoeba keratitis is now a well-known entity. However most studies report deep keratitis. We present 4 cases of superficial amebic keratitis in contact lens wearers. Clinical aspects were linear, polymorphous alterations of the corneal epithelium. All patients healed with a combination of debridement of the epithelial lesions and Brolene eye drops. Our cases demonstrate that early diagnosis with early treatment allow healing of superficial amebic keratitis.

Acanthamoeba Keratitis↗
PubMed1992

[Photorefractive keratectomy following undercorrected myopic epikeratoplasties].

Five eyes had a delayed refractive regression following myopic epikeratoplasty; the undercorrection ranged between -8.00 and -10.00 diopters. Four of the 5 eyes had a loss of best spectacle visual acuity of two Snellen lines or more. Excimer laser photorefractive keratectomy was performed to achieve a full refractive correction. A dense subepithelial haze was observed in the 5 eyes. The 3 months postoperative refraction ranged between -1.00 D and +2.50 D but the spectacle corrected visual acuity reached only 0.1 to 0.2. Because of the poor visual acuity results, the five epikeratoplasty lenticles were removed, resulting in restoration of best preoperative spectacle visual acuity in 4 of the 5 eyes. Excimer laser photorefractive keratectomy was not a helpful means of correcting residual high myopia after myopic epikeratoplasty. The poor results may be explained by the preexisting stromal abnormalities.

Adult↗
PubMed1991

Use of collagen shields in the treatment of herpetic keratitis.

Eighteen patients with typical Herpes simplex virus dendritic keratitis confirmed by viral isolation were treated with corneal collagen shields presoaked with trifluorothymidine for 15 minutes and trifluorothymidine eye drops 5 times daily. The average healing time was 2.9 days (range 1-7 days). No allergic reactions were observed. Toxic punctate keratitis occurred in 3 eyes. The results of this open study suggest that the effect of collagen corneal shields in conjunction with trifluorothymidine shortens the average epithelial healing time compared with other studies that have used antiviral drugs alone.

Adult↗
PubMed1991

Acyclovir in herpetic anterior uveitis.

The optimal management of herpes simplex stromal keratitis and uveitis is controversial. Thirty-two patients with presumptive herpetic anterior uveitis without active corneal inflammation received 3% acyclovir ophthalmic ointment five times daily and acyclovir 200mg orally five times a day. Eight of 18 patients (44.4%) who had received corticosteroids deteriorated over the first five days of therapy; one of 14 patients (7.1%) without previous corticosteroid use worsened during this time (P less than .05). The mean healing time was similar in these two groups. These results suggest that antiviral therapy may be first-line treatment in patients with herpetic keratouveitis who have not received corticosteroids.

Acyclovir↗
PubMed1991

[Epikeratoplasty using lyophilized lenticles for the correction if aphakia in adults].

Fifty adult aphakic patients were treated surgically by epikeratoplasty. Forty-one eyes had posttraumatic aphakia including 26 eyes with corneal scars. Results are presented with a mean follow-up of 31 months. 64% of eyes achieved an uncorrected visual acuity of 0.2 or better. Best visual acuity was 0.2 or better in 92% of eyes (this percentage is similar to the preoperative figure) and 0.5 or better in 62%. 78% of eyes had a refraction within 3 diopters of emmetropia. 10% of eyes lost 2 or more lines of best visual acuity. Mean keratometric results and spheric equivalent of the refraction show stability of the procedure during a 2 year follow up period. These results confirm, that in selected patients, epikeratoplasty is a valid surgical alternative for adult aphakia.

Aphakia↗
PubMed1989

2-(2-hydroxy-4-methylphenyl)aminothiazole hydrochloride as a dual inhibitor of cyclooxygenase/lipoxygenase and a free radical scavenger. 2nd communication: anti-inflammatory activity.

The paper describes the topical anti-inflammatory activity of 2-(2-hydroxy-4-methylphenyl)aminothiazole hydrochloride (CBS-113 A), a dual inhibitor of cyclooxygenase/lipoxygenase and a potent free radical scavenger. When applied in eye drops (0.01 to 0.1% according to the model used), the drug inhibited inflammation in experimental conjunctivitis and uveitis induced by various procedures (e.g. paracentesis, endotoxin, S-antigen, albumin, Fe2+). The compound also inhibited leukocyte infiltration and histamine release when administered locally in pleural cavity with carrageenan. CBS-113 A could decrease plasma leakage induced by arachidonic acid or platelet activating factor in skin and airway, respectively. However, it was devoid of any activity when administered by systemic route. The compound appears as a potentially useful anti-inflammatory drug, in particular in ophthalmology and as an alternative to glucocorticoids, since it does not present the side effects of these steroids (e.g. worsening of herpetic keratitis).

Animals↗
PubMed1989

[Experimental herpes simplex keratitis in rabbits. Evaluation of pro-infectious effects of topical non-steroidal anti-inflammatory agents].

We tested 3 non steroidal anti-inflammatory drugs in experimental herpes keratitis in order to determine possible pro-infectious consequences. The drugs were Indomethacine, Flurbiprofen and a new non steroidal anti-inflammatory, CBS 113 A, mixed inhibitor of cycloxygenase and lipoxygenase. We studied simultaneously the evolution of the keratitis and viral excretion. We considered that an anti-inflammatory agent had a pro-infectious effect if the keratitis was more serious and/or viral excretion longer in comparison with placebo. We have shown, for the 3 drugs, in comparison with dexamethasone activity, absence of a pro-infectious effect. We compared our results on Flurpiprofen with an other study which gave this anti-inflammatory drug pro-infectious capacities; the concentration used was higher. CBS 113 A, inhibiting the metabolism of arachidonic acid via lipoxygenase and cycloxygenase and thus preventing the formation of metabolitis involved in inflammation (prostaglandins, leukotrienes,...), should have a spectrum of activity wider than that of NSAID. Subject to further studies, these 3 nonsteroidal anti-inflammatory could be used in herpetic kerato-uveitis.

Administration, Topical↗