Biomedical subjects
Publications and source records attributed to J L Menezo.
A comparative study of two groups of patients with cataracts and high myopia was made. The percentage of patients with a visual acuity equal to or better than 20/40 (P less than .01) and normocorrections +/- 1 diopter (P less than .01) was significantly greater in the group with extracapsular cataract extraction and intraocular lens implantation.
We have performed Retinal Fluorescein Angiograms in three groups of patients who had been previously administered, respectively: intravenous sodium fluorescein, hard gelatin-coated fluorescein oral capsules, and enteric-coated fluorescein capsules. In all groups, we carried out a curve of the dye plasma levels. We concluded that the enteric-coated fluorescein capsules provide effective dye plasma levels for the performance of the angiogram between 40 and 60 minutes later, thus obtaining great sharpness and quality retinal images, much better than those attained with the hard gelatin-coated fluorescein capsules.
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Tuberculous endophthalmitis is a rare condition not described to date in association with intravenous drug abuse. Characteristics such as the lack of proven tuberculous disease in other organs and intense progression towards panophthalmitis make this case all the more interesting. The histopathological diagnosis is based on the identification of acid-alcohol resistant bacilli, and typical granuloma lesions with focal caseosis in stained sections.
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Six patients were affected by extensive central corneal scars and disruption of the anterior segment. Reconstruction of the anterior segment, synechialysis, membranectomy, and vitrectomy were performed as first-step procedures. Rotational autografts combined with either anterior or posterior chamber intraocular lens implantation were then performed. The results in this series of severely traumatized eyes were satisfactory with a follow-up of three years.
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Formation of thick and occasionally dense retropseudophakos membranes and rapid fibrosis of the posterior capsule is a complication that adversely affects the outcome of intraocular lens implantation. We have observed this condition in 17 patients, most of whom presented with traumatic and congenital cataracts. It appears to occur more frequently in young individuals and children. Simple capsulotomy, by the limbal approach or with the YAG laser, does not reliably eliminate the membranes. We have used vitrectomy and scissors dissection through the pars plana to achieve good anatomical results. Postoperative visual acuity has been satisfactory, except in amblyopic eyes related to congenital cataracts.
Complications in a group of 91 children with congenital and traumatic cataracts in whom intraocular lenses (IOL) have been implanted have been studied. The influence of viscoelastic substances (Healon) in the prevention and treatment of some of these complications, and as a causal factor in others, is presented. Ten different styles of lenses were implanted allowing a comparison of the relationship between the type of lens fixation and the complications observed.
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We performed an angiographic study of the iris and retina of 121 implanted eyes and 94 aphakic eyes 15 days, three months, six months, and 12 months postoperatively to determine the incidence of cystoid macular edema (CME) and iris leakage and the relationship between them. The angiographic study shows that iris leakage is a common feature of cataract surgery in the immediate postoperative period. Apparently the type of extraction (extracapsular or intracapsular) does not influence the appearance of these iris angiographic findings. However, the percentage of observed CME after three months is less (P less than 0.05) in patients with an intraocular lens (IOL) who have had extracapsular cataract extraction (ECCE) than in patients who have had intracapsular cataract extraction (ICCE) and the presence of CME is closely related to the angiographically observed iris leakage.
One hundred and seventy one eyes with intraocular lenses were studied to compare the predictive accuracy of the Fyodorov and Van der Heijde theoretical formulae of the Sanders-Retzlaff-Kraff (SRK) regression formula. The SRK regression formula was the most accurate. Our personal calculations of the A constants of this formula are given for several types of implants and manufacturers.
Report of an intraocular foreign body that was well-tolerated for over two years.
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Results of vitrectomy in 16 cases are reported. In one group of 7 patients the operation immediately preceded the extraction of a non-metallic or metallic capsulated foreign body by means of foreign body forceps, or a magnetized metal thread using the one- or two-way "pars plana" approach. In the second group of 9 cases a "pars plana" vitrectomy was carried out to treat sequelae from a double perforation caused by lead shot. The Douvas roto-extractor was used in all eyes. Results obtained in the first group (combined foreign body extraction and vitrectomy) were satisfactory in all but one case, which ended with-phtisis bulbi. Visual acuities were of 0,2 or more. In the second group (reparative vitrectomy) an acceptable V.A. was obtained except in two cases. Results were less satisfactory than in the first group.
Visual rehabilitation by conventional aphakic spectacles and contact lenses has posed a serious problem in the pediatric population. While the use of intraocular lenses has not achieved widespread acceptance as a form of aphakic correction, we have obtained encouraging results in some of our patients. In this report, we discuss two categories: those patients with congenital cataracts, and those patients with traumatic cataracts.
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