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G Van Effenterre

Publications and source records attributed to G Van Effenterre.

At least 19 recordsLinked to original sources
PubMed1998

[Anisometropia and presbyopia: prescription of progressive lenses, a new approach].

OBJECTIVE OF THE STUDY: To show that anisometropia does not absolutely preclude the prescription of progressive lenses. MATERIALS AND METHODS: Forty-one anisometropes and presbyopes were selected for a prolonged trial of visual correction using progressive lenses. The congenital or acquired type of their anisometropia and its particular form were also studied. Each patient was submitted to a protocol comprising of a series of ophthalmologic and orthoptic tests so as to evaluate the patient's subjective far and near refraction, with measurement of phorias and of horizontal and vertical ductions, visual acuity, and the quality of binocular vision while looking in different directions. A preliminary trial of correction in actual situation was done in order to check fusion in near vision. The entire range of tests was repeated two months after the patient was provided with the lenses. The tolerance for progressive lenses during the different activities of daily life was evaluated after the second and the sixth months. RESULTS: Seven patients presenting an associated strabismus were not provided with the lenses because the initial pre-lens trial revealed a total inability to read within the near-vision zone. Among the 34 patients provided with the lenses, 21 constantly wore their progressive lenses and said that they were satisfied, 6 wore their progressive lenses during daily activities but preferred to use their unifocal lenses for prolonged reading, and 7 abandoned their progressive lenses because they could not tolerate them. Association with a strabismus is not synonymous with an initial impossibility or with abandonment because of the 27 patients who constantly wore their progressive lenses 9 were strabismic. The best results were obtained in the age range of 45 to 52 years old, for visual acuity for > 20/40, and in cases of congenital anisometropia with intermittent or permanent unilateral neutralization. On the other hand, patients presenting an acquired anisometropia, particularly postoperative, proved to be poor candidates. CONCLUSION: Weak and strong anisometropia does not absolutely preclude the prescription of progressive lenses except for certain strabismic subjects with an abnormal lateral-oriented posture.

Activities of Daily Living↗
PubMed1994

[Prevention of retinal detachment in Wagner-Stickler disease. Comparative study of different methods. Apropos of 22 cases].

Prophylactic treatment in patients presenting Wagner-Stickler disease has not been yet well defined. We retrospectively studied twenty-two patients who had a retinal detachment on the first eye. Among the ten patients treated by peripheral confluent laser photocoagulation, five had a retinal detachment after a mean follow-up of fifteen months; with a 42% rate of spontaneous retinal detachment bilateralization, we can conclude that laser therapy has not been efficient. Four patients treated by focal or circular laser photocoagulation, cryotherapy or vitrectomy developed retinal detachment. Eight eyes treated by a preventive encircling scleral buckle did not develop retinal detachment, with a mean follow-up of twenty-one months. This follow-up is still too short, but greater than the mean bilateralization delay. Per and postoperative complications had no consequences.

Adolescent↗
PubMed1992

[Is vitrectomy cataractogenic? Study of changes of the crystalline lens after surgery of retinal detachment].

In order to assess the relationships between vitrectomy and postoperative crystalline lens changes we reviewed the records of 298 selected cases of operated retinal detachments in phakic eyes. We compared two groups: 155 eyes were operated with cryotherapy, vitrectomy and gas injection. 143 eyes received cryotherapy and retro-hyaloid fluid-gas exchange. Follow-up of at least 12 months and detailed description of the lens were available in 90 cases and 82 cases of the two groups respectively. Postoperative lens changes were as follows: nuclear sclerosis occurred in 63% of the vitrectomised eyes, mild in 14%, moderate in 16%, severe in 32%. In contrast, nuclear sclerosis occurred in only 4% of the non vitrectomised eyes, all these cases were noted as moderate. Posterior subcapsular opacities occurred in 4.5% of the vitrectomised eyes versus 2.4% of the non vitrectomised eyes. Nuclear sclerotic changes were correlated with vitrectomy and longer follow-up. Posterior subcapsular cataract was correlated with vitrectomy and larger intraocular gas bubble.

Adult↗
PubMed1992

[Posterior luxation of lens or implant: surgical treatment using a perfluorocarbon solution. Technique and results of 13 cases].

We used perfluorocarbon liquids in the management of 6 cases of posterior dislocation of the lens and 7 cases of (sub-) luxation of a posterior chamber intraocular lens (IOL). The perfluorocarbon liquid was injected into the vitreous cavity after complete vitrectomy, to bring back the lens or IOL to the posterior chamber where it can be easily removed. The main characteristics of perfluorocarbon liquids used in this indication are their high specific gravity and their good surface tension. Because of these two qualities, when injected in a vitrectomized eye, the perfluorocarbon liquid forms a bubble, filling the vitreous cavity from the posterior pole to the ora serrata with the dislocated lens or IOL floating on its surface. We found this technique to be helpful and quite atraumatic in this difficult surgical situation. Complications included regressive corneal edema in 6 cases and retinal dialysis with localized detachment in 3 cases.

Fluorocarbons↗
PubMed1991

[Suprasellar tumors in patients over 70 years of age. Value of limited frontotemporal craniotomy. Visual results. Apropos of 5 cases].

The authors report their experience of the surgical approach for suprasellar tumors (Jugum or tuberculum sellae meningiomas, 3 cases, and suprasellar craniopharyngiomas, 2 cases) in over than seventy years old patients (71-78 y). A limited craniectomy was performed at the fronto-temporal junction using three adjacent burr-holes. The duramater was cut with an Y-shaped incision. Cerebrospinal fluid was sucked out through a lateral subfrontal route, allowing an easy cerebral collapse in elderly patients, which can sometimes avoid even retraction. Such an supra-orbital craniectomy allowed a subfrontal approach, opening of the sylvian fissure and control of the inter optic, inter carotido-optic and latero-carotidian spaces as well as a good access to the inter pedoncular cistern. In 4 cases the craniectomy was performed after fronto-temporal skin incision, but a trans eyebrow skin incision was used in 1 case. All patients had uneventful postoperative course. Follow-up was from 3 to 5 years. A visual improvement occurred in all cases. Benefits of this surgical method are discussed and compared with use of a bone flap in patients over than 70 years.

Aged↗
PubMed1991

[Preventive treatment of retinal detachment of the contralateral eye. Results of 5 years follow-up of 109 eyes].

In 1987, we presented a study of 141 eyes treated prophylactically following retinal detachment in the fellow eye. A hundred and nine of these patients are reviewed with a minimum follow-up of five years. Only the evolution was studied, whether a peripheral retinal lesion was present or not at the time of prophylactic treatment. The examiner noted if new lesions had occurred, or if lesions present at the time of the first examination had developed: lattice degeneration or snail track developing into a retinal tear, hole or tear causing a retinal detachment, contained or not by laser treatment. Our study contained sixty two myopes. Fifty eyes had visible, dangerous lesions, and fifty nine a normal retina. Forty five circular barrages with four anterior radial rows returning to the ora serrata were performed, and sixty four barrages with tight anterior grids and a localised barrage of visible lesions. The results were judged on one criterion only: retinal detachment requiring emergency surgery. Only one retinal detachment occurred behind the barrage, caused by proliferative vitreoretinopathy due to multiple tears, and surgical results were good. Eight tears appeared in front of the barrage, five of these in healthy retina. Two very posterior tears behind the barrage were blocked with no problem by laser treatment. Four localised detachments occurred in front of the barrage, three of these without anterior grid treatment. The advantage of this is undeniable since out of sixty three cases treated in this way, only three tears were seen to be blocked by the laser shots, and one anterior localised detachment where the anterior grid was insufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[A case of tuberculoma of the orbit with sphenoidal origin].

We report the case of an orbital and sphenoidal tuberculosis observed in a young Indian man living in France. The orbital disease is presenting as an orbital mass with a radiologic bony lytic aspect, without systemic manifestation. A malignant process was suspected. The diagnosis was obtained by the culture for Mycobacterium tuberculosis of the biopsy specimen. Orbital involvement in tuberculosis is a rare manifestation in developed countries. Most cases reported in the literature were reported from Asia and Africa. Orbital tuberculosis may become established in one of two ways: primarily by heamatogenous spread to cause a periostitis or a tuberculoma of the orbital tissues, or secondarily by direct extension from neighbouring structures. It occurs in patients with or without associated pulmonary tuberculosis. Mycobacterium tuberculosis should be considered in the differential diagnosis of inflammatory orbital diseases. This diagnosis is based on clinical feature, positive tuberculin skin test and positive culture in resected tissues. The complete resolution of the disease with the specific antituberculous drugs emphasizes the point that tuberculosis must be evocated.

Adolescent↗
PubMed1987

[Prevention of bilateralization of idiopathic retinal detachment by treatment with argon laser].

The incidence of bilateral retinal detachment ranges from 12 to 15%. A retrospective study including of 141 patients with a systematical prophylactic treatment of the fellow eye is reported. After the prophylactic photocoagulation no bilateral retinal detachment occurred, no complication arose. The average follow-up was about 18 months. The authors describe the technique of the prophylactic argon laser treatment. This photocoagulation associates a focal treatment excluding suspicious lesions, and a 360 degree equatorial treatment, completed by several anterior radial rows and by a scattered but tight photocoagulation from the equator to the ora. The authors conclude that prophylactic and systematical treatment is safe and effective, avoiding the focal retinal detachments, anterior giant tears and probably many breaks. The follow-up is still too short to know the longterm percentage of bilateral detachments with such a treatment of the fellow eyes.

Adult↗
PubMed1986

Study of the first hundred phakic eyes treated by peripheral iridotomy using the N.D. Yag laser.

Performing a peripheral iridotomy with a ND Yag laser is a simple and efficient technique, with no side effects, no need for anaesthesia other than local and no surgical opening of the eye, with all the risks it entails. Out of 100 cases, 100% were a success from a technical point of view, and we observed no lesion of the lens which could have caused cataract. This out-patient technique, causing fewer complications than with Argon laser, can be used on any patient, whatever the age and the state of the angle, who has to be treated by peripheral iridotomy. The Neodymium Yag laser (ND: Yag) is a pulsed solid laser (1, 2, 3, 8, 29, 31). It cuts tissues (photodisruption) by means of a shock-wave produced by optical breakdown (plasma formation). Its effect is different from that of the Argon laser which burns tissues (photocoagulation). The present study, of 100 cases, deals with the use of ND: Yag in peripheral iridotomies.

Adult↗
PubMed1986

Digestive tract and renal small vessel hyalinosis, idiopathic nonarteriosclerotic intracerebral calcifications, retinal ischemic syndrome, and phenotypic abnormalities. A new familial syndrome.

A new familial syndrome that affected 3 of 7 siblings is described. All 3 patients were young women with a very peculiar phenotype, poikilodermia and hair greying, and idiopathic nonarteriosclerotic cerebral calcifications. Pathological studies demonstrated a marked and progressive hyalinosis involving capillaries and often arterioles and small veins of the digestive tract, kidneys, and calcified areas of the brain. Using electron microscopy, we found that the hyalin substance in the intestinal capillaries consisted of several concentric layers of basal membrane-like deposits within a finely granular fluffy material. Huge deposits of this material were present in the subepithelial and mesangial spaces of the kidneys. Endothelial cells and, in the kidneys, mesangial cells were markedly abnormal, and a true mesangiolysis pattern was present in 2 patients. The clinical and biologic expression of these vascular changes was variable. Diarrhea, rectal bleeding, malabsorption, and protein-losing enteropathy were the main and lethal clinical problems in the proband. Hypertension appeared in the early stage of a second pregnancy in 1 sister, and mild proteinuria was found in all 3 affected patients. Peripheral retinal ischemic syndrome and chorioretinal scars were found in the ocular fundi of both affected sisters of the proband. A subarachnoid hemorrhage, due to a right sylvian aneurism, also occurred in both sisters and was lethal in 1 sister. None of the known causes of distal vessel hyalinosis could be ascertained.

Adult↗
PubMed1986

Circular subtotal retinectomy and inferior semicircular retinotomy. Material and results in 38 cases.

Anatomical and functional results in 38 eyes with retinal detachment and major proliferative vitreoretinopathy (C3, D1, D2) treated by more or less wide retinotomy or circular retinectomy; 50% of the retinae have reattached, with an improvement of the visual function in 12 cases out of 21. The best procedure in these cases seems to be a retinotomy of at least 180 degrees on an eye filled with silicone oil to prevent secondary retractions. Circular retinectomy has been given up for retinotomy.

Adolescent↗