PubMed Health⌕ Search

Biomedical subjects

J L Alió

Publications and source records attributed to J L Alió.

At least 19 recordsLinked to original sources
PubMed2006

Adal-1 bioadhesive for sutureless recession muscle surgery: a clinical trial.

AIMS: To evaluate the efficacy and biotolerance of the Adal-1 adhesive for muscle sealing in strabismus surgery. METHODS: 27 eyes were included in the study: 17 in the control group and 10 in the study group. Surgery was performed on the recession of the horizontal rectus muscles. In the control group the muscle was joined to the sclera by a Vicryl 7/0 suture. In the study group, the Adal-1 adhesive was used instead. The efficacy of the sealing of the muscle to the sclera and the biotolerance of the surrounding tissues were evaluated. RESULTS: The muscular recession in the control group was 8.17 (SD 2.38) with displacement of the sealing point of 0.02 (1.7) mm. In the group sealed with adhesive, the muscular recession was 9.09 (3.08) and the displacement was 0.15 (1.56) mm, with no significant differences between the techniques (p<0.05). The inflammation of the surrounding tissues in the immediate postoperative period was greater with the suture technique (p>0.05), but there were no differences in the other postoperative periods (Mann-Whitney U test). CONCLUSION: Adal-1 was an effective and safe alternative to sutures in muscle recession for strabismus surgery in this study.

Acrylates↗
PubMed2006

[Variation of central corneal thickness in diabetic patients as detected by ultrasonic pachymetry].

OBJECTIVE: To prove the existence of a correlation between central corneal thickness and diabetes. METHODS: Ultrasound pachymetry measurements were made in 1,000 patients. The sample was divided into two groups of patients: 953 of them were non-diabetic patients, and 47 were diabetic patients. RESULTS: The average central corneal thickness in diabetic patients was 571.96 +/- 26.81 microns with a range between 514 and 626. The average central corneal thickness found in non-diabetic patients was 544.89 +/- 35.36 microns with range of 448 to 649. The increase in central corneal thickness found in diabetic patients compared to non-diabetic patients was statistically significant (p<0.001, Student "t" test). CONCLUSIONS: We found that diabetic patients had an increased central corneal thickness when compared with non-diabetic patients.

Adolescent↗
PubMed2005

[Confocal microscopy of the cornea in photorefractive surgery].

OBJECTIVE: Corneal refractive surgery involves a range of techniques which have assumed a growing importance during the last few years. The advances of very different surgical methods and the early age of the majority of the patients subjected to surgery, limits our knowledge of the histopathologic changes in the operated corneas. For this reason, the development of any diagnostic tool which can permit us to improve our knowledge of the wound healing process would be of significant value. As we describe in our paper, confocal microscopy enables the assessment of the more important advantages for the study of corneal wound healing after refractive surgery: high magnification, harmless, and "in vivo", providing pathogenic information and lateral and axial definition not achievable with other exploration techniques. CONCLUSION: Confocal microscopy appears to be an essential tool for creating a global concept of quality in corneal refractive surgery.

Cicatrix↗
PubMed2005

[Chronic blepharitis and Demodex].

PURPOSE: Demodex is a mite commonly found in eyelash hair follicles and sebaceous glands of healthy people. Due to the fact this mite has also been reported in many chronic cases of blepharitis, we aimed to investigate the incidence of infestation with this mite in healthy people and in patients with chronic blepharitis, in addition to evaluating the response to the different treatments used for blepharitis. METHODS: 105 subjects without blepharitis were selected as a control group and 20 subjects diagnosed as having chronic blepharitis were selected as patients. Epilated eyelashes were observed under microscope in both groups of patients. Those with overpopulation of mites were treated with ether lid and eyelash scrubs and 2% mercury oxide ointment. RESULTS: The incidence of Demodex infestation in the control group was 0.08 mites per eyelash, whereas in the patients with chronic blepharitis the incidence was 0.69 mites per eyelash; this difference was statistically significant (p=0.006). All the mites found were Demodex folliculorum except in one patient where the mite was identified as Demodex brevis. After 3-8 weeks of specific treatment the number of mites per eyelash decreased dramatically (0.03, with p=0.001). Two patients were intolerant of the therapy. CONCLUSIONS: In this study the incidence of Demodex in patients with blepharitis was very high, when compared with normal subjects, showing a clear association between blepharitis and Demodex infestation. Treatment with mercury oxide ointment was satisfactory in controlling the infection, despite difficulty in its application and occasional toxicity.

Adult↗
PubMed2004

Five year follow up of biocolonisable microporous fluorocarbon haptic (BIOKOP) keratoprosthesis implantation in patients with high risk of corneal graft failure.

AIM: To study the anatomical and visual performance following implantation of a model of artificial cornea and to evaluate the postoperative long term complications. METHODS: 11 eyes of 11 patients with bilateral corneal blindness considered as potentially having high risk of failure of penetrating corneal keratoplasty were implanted with biocolonisable Kpro keratoprosthesis (BIOKOP I, FCI, Rantigny, France) in the period between January 1996 and May 1998. Only one eye was implanted in all patients and followed up for a period of 60 months. The visual outcome, anatomical and functional stability, complications, and the general performance of the keratoprosthesis were evaluated. RESULTS: The keratoprosthesis (BIOKOP I) only 36.3% remained in position to date. In the patients' last visit five eyes (45.4%) were blind and one (9.0%) showed a slight improvement in the best corrected visual acuity (BCVA) in comparison to preoperative tests. Six eyes (54.5%) showed improved BCVA before having postoperative complications. Four eyes underwent replacement of a BIOKOP I Kpro with a BIOKOP II as a result of extrusion. The keratoprostheses remained anatomically in situ for a mean of 25.5 months and their functional performance period was limited to a mean of 22 months. CONCLUSION: Corneal keratoprosthesis (BIOKOP I, II) does not provide a stable anatomical relation with the surrounding ocular structures. Its ability to restore vision is limited to a short postoperative period in eyes implanted with severe ocular surface disease.

Adolescent↗
PubMed2003

Ring electrode for radio-frequency heating of the cornea: modelling and in vitro experiments.

Radio-frequency thermokeratoplasty (RF-TKP) is a technique used to reshape the cornea curvature by means of thermal lesions using radio-frequency currents. This curvature change allows refractive disorders such as hyperopia to be corrected. A new electrode with ring geometry is proposed for RF-TKP. It was designed to create a single thermal lesion with a full-circle shape. Finite element models were developed, and the temperature distributions in the cornea were analysed for different ring electrode characteristics. The computer results indicated that the maximum temperature in the cornea was located in the vicinity of the ring electrode outer perimeter, and that the lesions had a semi-torus shape. The results also indicated that the electrode thickness, electrode radius and electrode thermal conductivity had a significant influence on the temperature distributions. In addition, in vitro experiments were performed on rabbit eyes. At 5 W power, the lesions were fully circular. Some lesions showed non-uniform characteristics along their circular path. Lesion depth depended on heating duration (60% of corneal thickness for 20 s, and 30% for 10 s). The results suggest that the critical shrinkage temperature (55-63 degrees C) was reached at the central stroma and along the entire circular path in all the cases.

Animals↗
PubMed2003

Follicular conjunctivitis caused by Chlamydia trachomatis in an infant Saharan population: molecular and clinical diagnosis.

AIMS: To ascertain the prevalence of acute trachoma as a supposed endemic disease among infants in the Saharan refugee camps of Tindouf (Algeria) and to evaluate the efficacy of treatment with a single dose of azithromycin. METHODS: 527 children aged between 3 and 17 were evaluated in the camp schools in October 2001. All the children were clinically and microbiologically examined, including slit lamp checks of anterior segment and two conjunctival swabs, one for the detection of membrane lipopolysaccharide by quick immunoassay test Clearview Chlamydia MF and the other for the detection of specific DNA by chlamydia plasmid specific polymerase chain reaction (PCR) assay. After examination, a single dose of azithromycin was administered to each child. One month later samples from positive children and 12 random negative children by the first PCR were taken to perform a new PCR assay. RESULTS: Chlamydia trachomatis was suspected in 2.47% of the children, papillary hypertrophy being the most frequently seen clinical sign. Scarring changes secondary to trachoma were detected in 11.7% of the children. Only four cases (0.8%) were positive to the immunoassay test and 12 cases (2.27%) were positive by PCR. After treatment a second PCR was performed on positive children and they were negative of chlamydia DNA amplification. However, one child who was negative and received the treatment was positive in the second PCR assay. CONCLUSION: Acute trachoma prevalence is much lower than expected among infants in this Saharan population. The possible reasons could be the recent improvements in hygiene and health care. Cicatricial trachoma is more frequent. The Clearview immunoassay test has very low sensitivity in the detection of this disease. A single dose of azithromycin is sufficient to treat chlamydial conjunctivitis. However, a programme of improvement in hygiene and health care is necessary to prevent re-infection.

Acute Disease↗
PubMed2003

Visual performance after congenital nystagmus surgery using extended hang back recession of the four horizontal rectus muscles.

PURPOSE: To evaluate the results of surgical correction of congenital nystagmus based on the use of extensive recessions of the four horizontal rectus muscles. The outcome of this procedure in terms of visual performance of the patients has been analyzed in follow-ups of at least 1 year. METHODS: Surgery was performed on 42 patients. An extended retroequatorial recession of the four horizontal rectus muscles was performed between 13 and 15 mm from the muscle insertion with hang back sutures in every case. Preoperatively, all cases showed either a horizontal pendular (4 cases) or jerk nystagmus (38 cases). RESULTS: After surgery, all cases showed full preservation of ductions in all gaze positions. Torticollis decreased in all cases. Binocular best-corrected vision improved in 19 (45.2%) patients and in the remaining 23 (54.8%) it remained unchanged. Consecutive exotropia was observed postoperatively in 7 patients. A second surgical procedure was performed in 9 cases (21.4%) and a botulinum injection in 3 cases (7%). All cases of diplopia resolved. Patient satisfaction was high in 38 cases (96%). CONCLUSIONS: Extended recession of horizontal rectus muscles using hang back sutures offers a good option for the surgical correction of sensorial and neuromuscular nystagmus, providing improvement in binocular best-corrected vision in 45% of the patients (21.4% more than 0.2 logMar units), a high satisfaction rate, and few associated complications. In patients with low vision this can be considered a success that may improve quality of life.

Adolescent↗
PubMed2001

Laser in situ keratomileusis for treatment of residual myopia after photorefractive keratectomy.

PURPOSE: To evaluate the results of laser in situ keratomileusis after photorefractive keratectomy. METHODS: Eighty eyes of 80 patients with residual myopia after photorefractive keratectomy were reoperated with laser in situ keratomileusis. The study was retrospective. Laser in situ keratomileusis was performed using the automated corneal shaper microkeratome and Chiron Technolas 217-C d1 excimer laser. Data measured after laser in situ keratomileusis included uncorrected visual acuity, best-corrected visual acuity, refraction, haze, pachymetry, and keratometry. The follow-up was at least 12 +/- 1.6 months (range, 12 to 15 months). RESULTS: After laser in situ keratomileusis the mean spherical equivalent was -0.24 diopters +/- 0.78. (range, -3 to +1.5) at 12 months, and the mean uncorrected visual acuity was 0.76 diopters +/- 0.24 (range, 0.1 to 1). Sixty-five eyes (81.3%) had various degrees of haze after laser in situ keratomileusis. One eye (1.2%) lost 2 lines of best-corrected visual acuity. CONCLUSIONS: Laser in situ keratomileusis enhancement may be a good alternative to correct residual myopia and astigmatism after primary photorefractive keratectomy. Corneal haze is a common problem in these eyes, and the treatment after laser in situ keratomileusis enhancement should be the same as the treatment after primary photorefractive keratectomy.

Adolescent↗
PubMed2001

Correction of irregular astigmatism with excimer laser assisted by sodium hyaluronate.

PURPOSE: To demonstrate the usefulness of excimer laser surgery assisted by sodium hyaluronate for the correction of irregular astigmatism after previous corneal refractive surgery. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Fifty eyes with surgically induced irregular astigmatism. All the patients had been subjected previously to one or more of the following: laser in situ keratomileusis (LASIK), incisional keratotomy, photorefractive keratotomy, phototherapeutic keratotomy, laser thermokeratoplasty, and corneal trauma. Irregular astigmatism developed thereafter. METHODS: Stability of the corneal topography pattern before surgical decision was observed for at least 6 months with the C-SCAN corneal topography with Ray Tracing (Technomed GmbH, Germany) and the Eye-Sys 2000 Corneal Analysis System (Eye Sys Co., Houston, TX). The lowest pachymetry value was 310 microm in the thinnest portion of the cornea. Ablation was performed with the Technolas 217 C-LASIK excimer laser (Bausch and Lomb Chiron Technolas GmbH, Dornach, Germany), in phototherapeutic keratectomy mode, assisted by a mask of 0.25% sodium hyaluronate. We performed our ablation either on the surface or under a flap, whether elevated or newly cut. MAIN OUTCOME MEASURES: Uncorrected and best-corrected visual acuity, manifest and cycloplegic refraction, superficial corneal surface quality, image distortion, and predicted corneal visual acuity. RESULTS: At 3 months of follow-up, the irregular corneal surface was significantly improved in all cases (n = 50). The superficial corneal surface quality improved from 70.5% +/- 9.16% to 75.6% +/- 10.38 (P < 0.0001). Six eyes lost 1 line of best-corrected visual acuity, three eyes lost 2 lines, and five eyes lost 3 or more lines. The real corneal ablation depth obtained was equal to 63% of that programmed because of the influence of masking substance. Mean uncorrected visual acuity improved from 20/80 +/- 20/125 to 20/63 +/- 20/100 (P = 0.01). Predicted corneal visual acuity improved from a mean of 20/32 +/- 20/80 to 20/25 +/- 20/63 (P = 0.004). Image distortion improved from a mean of 13.95 +/- 3.64 to 12.16 +/- 3.92 (P < 0.0001). We obtained a hyperopic shift in 56% and myopic shift in 40% of eyes. After 6 months of follow-up the irregular corneal surface continued to improve in all cases (n = 32). The superficial corneal surface quality improved from 69.38% +/- 9.48% to 73.13% +/- 8.87 (P = 0.002). Two eyes lost 2 lines of best-corrected visual acuity, and 3 eyes lost 1 line. Ray tracing was significantly improved in all cases at the end of follow-up regarding superficial corneal surface quality (P = 0.002) and the image distortion (P = 0.05). Improvement of predicted corneal visual acuity was not significant (P = 0.11). The procedure proved to be safe, with a safety index of 1.1. Differences between the surface and stromal treatments and between pattern and nonpattern irregular astigmatism were not statistically significant. CONCLUSION: It is possible to produce a more regular corneal surface and to improve best-corrected visual acuity in patients with irregular astigmatism using plano-scan excimer laser assisted by viscous masking solution of 0.25% sodium hyaluronate.

Astigmatism↗
PubMed2001

Laser in situ keratomileusis for undercorrection and overcorrection after radial keratotomy.

PURPOSE: To evaluate laser in situ keratomileusis (LASIK) in the management of overcorrection and undercorrection after radial keratotomy (RK). SETTING: Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: This prospective study comprised 20 eyes of 13 patients. The eyes were divided into 2 groups: 11 eyes that were overcorrected after RK and 9 eyes that were undercorrected after RK. Both groups were treated with LASIK after a mean interval of 22 months +/- 8.4 (SD) (range 12 to 45 months). The follow-up was 6 months. RESULTS: Six months after LASIK, there was a significant decrease in the spherical equivalent in both groups. Ninety-one percent of eyes in the overcorrected group and 89% in the undercorrected group were within +/-1.0 diopter of the intended correction. There was a significant improvement in the uncorrected visual acuity in both groups. In the overcorrected group, 91% showed no change or improvement in their best corrected visual acuity; in the undercorrected group, 89% showed no change or improvement. CONCLUSIONS: Laser in situ keratomileusis was relatively safe in treating both overcorrection and undercorrection after RK. With proper intraoperative precautions, LASIK can effectively treat the residual refractive defects after RK.

Adult↗
PubMed2001

Haze after laser in situ keratomileusis in eyes with previous photorefractive keratectomy.

In cases with previous photorefractive keratectomy (PRK), there is a risk of developing severe haze after laser in situ keratomileusis (LASIK). We report 3 patients (4 eyes) who developed severe haze after LASIK treatment for residual myopia following PRK. Both PRK and LASIK procedures were performed using the VISX 20/20 excimer laser. We report the grade of haze, amount of regression, and visual acuity after the patients were treated with topical steroids. In 2 eyes, the uncorrected visual acuity was 1.0 after 1 year with grade I haze. In the other 2 eyes, there was a residual refractive error, and the best spectacle-corrected visual acuity was 0.7 with grade II haze.

Administration, Topical↗
PubMed2001

Choroidal neovascularization in myopic eyes after laser-assisted in situ keratomileusis.

PURPOSE: To analyze the appearance and characteristics of choroidal neovascularization (CNV) in patients with high myopia corrected by laser-assisted in situ keratomileusis (LASIK). PATIENTS AND METHODS: The authors studied CNV in 2955 consecutive eyes (1632 patients) that underwent LASIK for the correction of myopia (from -6 to -27.5 diopters). Follow-up was 34.2+/-11.3 months. RESULTS: Choroidal neovascularization occurred in three eyes (0.10%) and in one eye previous CNV was reactivated (three women, one man). The time interval between refractive surgery and CNV was 13+/-9.5 months (range, 4-26 months). Mean best-corrected visual acuity (BCVA) after LASIK and before CNV development was 20/57 (range, 20/100-20/29). After the appearance of CNV, mean BCVA was 20/606 (range, 20/2000-20/80). Differences between BCVA before and after CNV were statistically significant (P = 0.04, paired Student's t-test). The CNV was treated in two cases by argon laser photocoagulation and in two cases by surgical excision of CNV by vitrectomy. The final mean BCVA was 20/277 (range, 20/800-20/50). Differences between BCVA after LASIK and after CNV treatment were statistically significant (P = 0.04, paired Student's t-test). CONCLUSIONS: Laser-assisted in situ keratomileusis as a correcting procedure for myopia was followed by low appearance of CNV. The appearance and treatment of CNV was followed by a significant decrease of BCVA.

Adult↗
PubMed2001

Detection and identification of fungal pathogens by PCR and by ITS2 and 5.8S ribosomal DNA typing in ocular infections.

The goal of this study was to determine whether sequence analysis of internal transcribed spacer/5.8S ribosomal DNA (rDNA) can be used to detect fungal pathogens in patients with ocular infections (endophthalmitis and keratitis). Internal transcribed spacer 1 (ITS1) and ITS2 and 5.8S rDNA were amplified by PCR and seminested PCR to detect fungal DNA. Fifty strains of 12 fungal species (yeasts and molds) were used to test the selected primers and conditions of the PCR. PCR and seminested PCR of this region were carried out to evaluate the sensitivity and specificity of the method. It proved possible to amplify the ITS2/5.8S region of all the fungal strains by this PCR method. All negative controls (human and bacterial DNA) were PCR negative. The sensitivity of the seminested PCR amplification reaction by DNA dilutions was 1 organism per PCR, and the sensitivity by cell dilutions was fewer than 10 organisms per PCR. Intraocular sampling or corneal scraping was undertaken for all patients with suspected infectious endophthalmitis or keratitis (nonherpetic), respectively, between November 1999 and February 2001. PCRs were subsequently performed with 11 ocular samples. The amplified DNA was sequenced, and aligned against sequences in GenBank at the National Institutes of Health. The results were PCR positive for fungal primers for three corneal scrapings, one aqueous sample, and one vitreous sample; one of them was negative by culture. Molecular fungal identification was successful in all cases. Bacterial detection by PCR was positive for three aqueous samples and one vitreous sample; one of these was negative by culture. Amplification of ITS2/5.8S rDNA and molecular typing shows potential as a rapid technique for identifying fungi in ocular samples.

DNA, Fungal↗
PubMed2001

[Circular flap rhexis: a refinement technique for LASIK re-treatment].

PURPOSE: To describe a new approach to re-treatment after Laser in situ keratomileusis (LASIK) by means of lifting the corneal flap in order to decrease the epithelial damage and its related complications, such as epithelial ingrowth and flap melting, which are more frequent after LASIK re-treatment than after primary LASIK. MATERIAL AND METHODS: The new technique, called circular flap rhexis, is based on a careful flap edge identification, linear epithelial tear for minimizing epithelial irregularities and defects, and a delicate flap replacement to promote a strong adhesion between the flap edge and the stromal bed. The LASIK re-treatment with this flap rhexis technique was performed in 43 eyes at 3 or 6 months after the primary LASIK. After a 12 month follow-up, the epithelial ingrowth and flap melting rates were recorded. RESULTS: Epithelial growth was found in 9.3% of the cases (4 out of 43 eyes) and flap melting in 2.3% of the cases (1 out of 43) at 12 months after LASIK re-treatment by circular flap rhexis. These disorders were always peripheral and did not affect visual acuity or corneal astigmatism. CONCLUSION: LASIK re-treatment using circular flap rhexis is an effective technique to decrease the epithelium related complications after LASIK re-treatment.

Epithelium, Corneal↗
PubMed2000

Laser in situ keratomileusis flap margin: wound healing and complications imaged by in vivo confocal microscopy.

PURPOSE: To examine the healing response of laser in situ keratomileusis flap margin in vivo. METHODS: Forty-three eyes of 43 patients who had undergone myopic (n = 39) or hyperopic (n = 4) laser in situ keratomileusis were examined once after surgery. The flap margin was imaged by in vivo confocal microscopy at various depths, and the wound healing response, flap alignment, and complications were evaluated. Ten eyes were examined on day 3 postoperatively, 13 eyes at 1 to 2 weeks, 10 eyes at 1 to 2 months, five eyes at 3 months, and five eyes at 6 months or later. RESULTS: At 3 days after laser in situ keratomileusis, the surface epithelium and basal epithelium appeared normal. Keratocyte activation was strongest at 1 to 2 weeks and 1 to 2 months, and an increased amount of haze was observed correspondingly. Intrastromal epithelial cells forming a plug could occasionally be perceived in the wound gape. Wound constriction was completed in most cases by 3 to 6 months or later. Good alignment was observed in 12 of 43 flaps (27.9%) and moderate and poor alignment in 17 of 43 flaps (39.5%) and 13 of 43 flaps (30.2%), respectively. Poor alignment was not associated with lamellar epithelial ingrowth. Epithelial ingrowth was associated with dense haze at the interface. Diffuse lamellar keratitis was imaged in two corneas after hyperopic laser in situ keratomileusis. CONCLUSIONS: The laser in situ keratomileusis incision wound at the flap margin appears to heal after the sequence observed in incisional wounds in nonhuman primates. Complications, such as lamellar epithelial in growth and diffuse lamellar keratitis, were often observed, particularly after hyperopic laser in situ keratomileusis.

Adult↗