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Biomedical subjects

J L Menezo

Publications and source records attributed to J L Menezo.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Branch retinal vein occlusion associated with the 20210 G-to-A prothrombin variant.

PURPOSE: To describe a case of branch retinal vein occlusion (BRVO) in a patient who tested positive for the 20210 A allele of the prothrombin (PT) gene. METHODS: A 48-year-old man had visual loss in the right eye secondary to BRVO confirmed by ophthalmoscopy and fluorescein angiography. His medical history was not remarkable for common risk factors for retinal occlusive diseases. RESULTS: Laboratory tests for hypercoagulability were positive for PT 20210 A variant. The patient's family tested negative for the PT variant. CONCLUSIONS: Laboratory tests for coagulopathy, including the PT 20210 A variant, should be added to the examination of patients with central or BRVO, especially if most common risk factors for thrombosis have been excluded.

Blindness↗
PubMedDate not supplied

Multilayer amniotic membrane transplantation in severe ocular graft versus host disease.

PURPOSE: To clarify the usefulness of multilayer amniotic membrane transplantation in an unusual case of calcareous corneal degeneration in a patient with graft-versus-host disease. METHODS: A 20-year-old Caucasian woman had bilateral calcareous corneal degeneration of one year of evolution, secondary to graft-versus-host disease. Treatment for both eyes with topical steroids and antibiotic ointment was not successful. Right eye had a spontaneous corneal perforation, and a three-layer circle amniotic membrane graft was applied to the whole cornea. RESULTS: During a follow-up period of 20 months we observed stability of the corneal epithelium and stroma. The amniotic membrane-covered area showed rapid epithelization, reduced inflammation and suppressed fibrosis formation. CONCLUSIONS: Multilayer amniotic membrane transplantation may be considered an alterantive for reconstructing the ocular surface in a patient with severe dry eyes and calcareous corneal degeneration, even with little perforation.

Adult↗
PubMedDate not supplied

Macular phototrauma after cataract extraction and multifocal lens implantation: case report.

PURPOSE: To report a patient who developed photic injury after cataract surgery and multifocal MF4 lens implantation METHODS: A 41-year-old caucasian woman without antecedents of interest was subjected to left catarct surgery involving phacoemulsification with capsular sac implantation of a new type of multifocal lens. A coaxial light microscope was used for surgery. The operation was filmed and anterior pole photographs were obtained. RESULTS: Two days after the operation, the patient noted a paracentral scotoma and hand movement visual acuity in the left eye. Indirect ophthalmoscopy revealed an oval, hyperpigmented macular lesion compatible with phototoxic maculopathy. CONCLUSIONS: Phototoxic injury to the macula may occur after cataract extraction. Implantation of an intraocular lens is an important factor in the producion of maculopathy, on account of its light-focusing effect on the retina. This effect was probably increased in our patient by the use of a new autofocus multifocal lens.

Adult↗
PubMedDate not supplied

Effect of prophylactic brimonidine on bleeding complications after cataract surgery.

PURPOSE: To evaluate the effect of prophylactic brimonidine on bleeding complications after cataract surgery. METHODS: The authors performed a prospective, double-masked, two-surgeon study of 137 patients (137 eyes) who underwent phacoemulsification and intraocular lens implantation with or without prophylactic brimonidine before cataract surgery. The authors also compared the effect of brimonidine among patients with systemic diseases such as diabetes mellitus (types I and II), hypertension, and anticoagulant or antiplatelet treatment. RESULTS: Subconjunctival hemorrhage was observed in 73.70% of the patients not treated with brimonidine before surgery and in only 23.75% of the patients who were given prophylactic brimonidine (p<0.001, chi2). The grade of hemorrhage was also statistically significant (p<0.001, Mann-Whitney). No statistically significant difference with regard to the presence of hemorrhage in diabetic patients or in the anticoagulant or antiplatelet treatment group was observed. However, a statistically significant difference (p<0.027, chi2) was found between hypertensive patients treated and not treated with prophylactic brimonidine before cataract surgery. CONCLUSIONS: This study suggests that brimonidine administered before cataract surgery may significantly reduce subconjunctival hemorrhage in the general population. It has been shown to be beneficial in hypertensive patients. A strong statistical trend, but not significance has been found in diabetic patients or in patients treated with antiplatelet or anticoagulant drugs, but further studies are needed to reach conclusive results.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Diffuse unilateral subacute neuroretinitis in Europe.

BACKGROUND: Diffuse unilateral subacute neuroretinitis is thought to be caused by a solitary helminth migrating within the subretinal space. Laser photocoagulation of the located worm is the preferred mode of therapy. METHODS: We describe the clinical and electrophysiological features of a case of a 15-year-old Caucasian male with a longstanding diffuse unilateral subacute neuroretinitis (DUSN), in whom two worms were seen in the fundus examination. Focal photocoagulation of the worms was applied as treatment. RESULTS: No signs of inflammation could be seen after treatment. Three months later, the patient was doing well. Follow-up examination 4 years later revealed an unchanged fundus appearance in the affected eye, with no evidence of progression of the syndrome. CONCLUSIONS: If a worm is identified in DUSN, focal laser treatment of the located area is the treatment of choice, regardless of whether fundus changes suggest late stages of the disease. However, the eye of the patient should be thoroughly examined to rule out the presence of more than one worm that might cause the failure of therapy.

Acute Disease↗
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Posterior chamber silicone intraocular lens for the correction of myopia: an experimental study in rabbits.

PURPOSE: To establish whether ocular lesions arise after implantation of posterior chamber silicone intraocular lenses (IOL) for the correction of high myopia. METHODS: Twenty-three posterior chamber silicone IOL were implanted in 23 eyes of the same number of pigmented rabbits. After different follow-up time (from one week to one year) the eyes were enucleated and processed for histopathological study after determining the protein concentration in the aqueous humor. The IOL were removed for staining and examination, and adhered cells were counted. Ten eyes analogous to those operated upon were used as controls. RESULTS: Intense inflammation was observed in the early postoperative period in all cases. Protein concentration in the aqueous humor was initially high and decreased over time, though without reaching normal values at one year. Mono- and multinucleated cells were seen adhering to the IOL, though they decreased in number over time and were practically absent after one year. Friction between the posterior surface of the iris and the IOL had no clinical repercussions. The only pigment accumulations were in the iris and in the peritrabecular zone. There were no significant differences in the accumulation of granules in relation to IOL diameter or power. Excluding three cataracts morphologically similar to traumatic cataracts, five lens opacifications were observed: two were anterior subcapsular cataracts, and the other three were only precapsular deposits. The IOL had no synechiae to the ocular tissues. CONCLUSIONS: Opacification of the lens is the main concern with implanted posterior chamber silicone IOL. Larger series of eyes must be analysed to establish the true incidence and reversibility of these opacities.

Animals↗
PubMedDate not supplied

Digital system measurement of decentration of Worst-Fechner iris claw myopia intraocular lens.

BACKGROUND: Topography measures the centration in refractive and corneal refractive surgery, but until recently there was no effective method to measure decentration in intraocular lens (IOL) implantation. PATIENTS AND METHODS: We measured the decentration of 22 phakic eyes, in 14 high myopic patients, based upon photographs of the anterior segment using a digital analysis system (IMAGEnet Topcon Corporation 1988, Tokyo, Japan). These eyes had undergone IOL implantation for the correction of myopia with Worst-Fechner iris claw lenses. Decentration was measured with respect to the centers of both the cornea and pupil. RESULTS: Mean decentration of the IOL center from the cornea center was 0.51 +/- 0.25 mm (range, 0 to 0.8374 mm). When measured with respect to the center of the pupil, the average decentration was 0.47 +/- 0.29 mm (range, 0.182 to 0.9341 mm). A positive correlation between the decentration measurements of the two methods was found (p < .01 indicated statistical significance). CONCLUSIONS: This digital imaging system (IMAGEnet) accurately measured decentration of IOLs in myopic eyes.

Adult↗
PubMedDate not supplied

Comparison of intersecting trapezoidal keratotomy and arcuate transverse keratotomy in the correction of high astigmatism.

BACKGROUND: High astigmatism can be corrected using trapezoidal or arcuate transverse keratotomies. Videokeratography enables qualitative evaluation of the corneal topography. METHODS: Fifty-five eyes of 41 patients presenting with high astigmatism after penetrating keratoplasty or naturally occurring astigmatism (mean, 6.29 diopters [D]; range, 3.00 to 16.00 D) underwent correction using either intersecting trapezoidal or arcuate transverse keratotomies. Corneal topographic maps were analyzed and classified into keratographic patterns. Mean follow up was 3 years (range, 1 to 6 years). RESULTS: The mean net decrease in refractive astigmatism was 3.60 D (52.7% reduction). The flattening/steepening ratio was on average higher for intersecting trapezoidal keratotomy (7.26 for astigmatism after penetrating keratoplasty and 8.31 for naturally occurring astigmatism) than for arcuate transverse keratotomy (.98 in astigmatism after penetrating keratoplasty and 1.76 in naturally occurring astigmatism). Accordingly, intersecting trapezoidal keratotomy tended to produce a hyperopic shift in the spherical equivalent refraction (mean hyperopic shift, 2.65 and .56 D, respectively). The mean vector-corrected change of refractive astigmatism after intersecting trapezoidal keratotomy was 88.8% in naturally occurring (n = 21 eyes) and 70.3% in penetrating keratoplasty astigmatism (n = 13). Arcuate transverse incisions corrected on average 79.9% of naturally occurring (n = 13) and 60.8% of penetrating keratoplasty astigmatism (n = 8). Videokeratography showed the asymmetric bowtie pattern as the most frequent pattern for both procedures. Intersecting trapezoidal keratotomy was characterized by relatively higher incidences of polygonal and irregular patterns. Arcuate transverse incisions caused less wound healing defects and glare than intersecting trapezoidal keratotomy. CONCLUSIONS: Both intersecting trapezoidal keratotomy and arcuate transverse incisions effectively reduced high naturally occurring astigmatism and astigmatism after penetrating keratoplasty. However, greater corneal surface irregularity and more complications were seen following intersecting trapezoidal keratotomy. Trapezoidal keratotomy should not be used unless a large decrease of myopia is needed, and then a nonintersecting technique is preferable.

Adult↗
PubMedDate not supplied

Iris claw phakic intraocular lens for high myopia.

BACKGROUND: The implantation of a Worst-Fechner iris claw intraocular lens (IOL) is one of the surgical procedures used for the correction of high myopia. This technique reduces myopia with stable refractive results; however, its potential long-term risks have not been evaluated. We report results in 94 eyes with a minimum follow-up of 3 years. METHODS: We studied 94 eyes of 62 patients with myopia > or = -7.00 diopters (D) who underwent Worst-Fechner IOL implantation. Lens decentration, permeability of the blood-aqueous barrier by iris angiography, and changes in corneal endothelial density were analyzed. RESULTS: Mean follow-up time was 48.9 months (range 36 to 72 mo). Three years after surgery, 58 eyes (61%) had an uncorrected visual acuity > or = 20/40, and 77 eyes (82%) gained two or more lines of spectacle-corrected visual acuity with respect to the preoperative value; 75 eyes (79%) were within +/- 1.00 D of emmetropia and 46 eyes (48%) were within +/- 0.50 D of emmetropia. The mean endothelial cell loss was 17.9% at 5 years after surgery, while the percentage of hexagonality and the coefficient of cell variation tended toward preoperative levels. No vision threatening complications were seen. CONCLUSIONS: The implantation of a Worst-Fechner iris claw phakic IOL reduced high myopia with a stable refractive outcome. Endothelial cell damage was within acceptable limits. The absence of major complications makes this procedure an acceptable method for correcting high myopia.

Adult↗
PubMedDate not supplied

Posterior chamber phakic intraocular lenses to correct high myopia: a comparative study between Staar and Adatomed models.

PURPOSE: To determine the feasibility of using posterior chamber phakic intraocular lenses (PIOLs) to treat high myopia, comparing two different models, Staar and Adatomed. METHODS: Twenty-four eyes from 12 patients were studied prospectively. A phakic Staar IOL was implanted in one eye of each patient, and the other eye received a phakic Adatomed IOL. Patients with uveitis or ocular trauma prior to ocular surgery, diabetic retinopathy, or capsular pseudoexfoliation were excluded. The mean preoperative spherical equivalent refraction was -16.00 +/- 5.05 D for the Staar group and -15.39 +/- 2.83 D for the Adatomed group. Average follow-up was 32.4 months (range, 19 to 46 mo) for the Adatomed group and 18.3 months (range, 11 to 21 mo) for the Staar group and included evaluation of intraocular pressure, intraocular lens pigment deposits, lens decentration, anterior subcapsular cataract, and visual acuity. RESULTS: Spectacle-corrected and uncorrected visual acuity improved in all eyes in both groups. No statistically significant differences in visual acuity gain were observed with the two materials (Student t-test, P = .08 for the Staar group and P = .6 for the Adatomed group), although the gain in visual acuity was somewhat greater with the Staar PIOLs. The difference in mean intraocular pressure before surgery and at last follow-up was 1.5 mmHg for the Staar group and 2.3 mmHg for the Adatomed group (P = .36). The incidence of lens pigment deposits was the same in both groups (41.66%), with deposits in 5 of the 12 eyes in both groups. The incidence of lens decentration was higher in the Adatomed group (5/12; 41.66%) than in the Staar group (2/12; 16.7%). Anterior subcapsular cataract was higher in the Adatomed group (4/12; 33.3%) than in the Staar group (3/12; 25%). CONCLUSIONS: There was a higher incidence of lens decentration and anterior subcapsular cataract in the Adatomed group than in the Staar group.

Adult↗
PubMedDate not supplied

Implantation of iris devices in congenital and traumatic aniridias: surgery solutions and complications.

PURPOSE: To show surgical solutions in patients with traumatic and congenital aniridia, to evaluate the clinical improvement of these patients when iris prosthesis are implanted, and to examine safety and complications of these implants in a long-term follow-up. METHODS: Eight patients were included in this retrospective noncomparative case series. Nine eyes had an artificial iris implantation for traumatic or congenital aniridia. Three eyes received a black diaphragm intraocular lens (IOL) in capsular bag after phacoemulsification. An aniridia prosthesis, sulcus sutured, in front of a previous IOL was implanted in two eyes. A black diaphragm IOL, sulcus sutured, in two eyes; two iris diaphragm rings, in front of the previous IOL, in one eye; and a sector iris prosthesis in front of an IOL in the last eye were implanted. Mean follow-up was 22.5 months (range 16 to 44 months). RESULTS: All patients had improved visual acuity (VA) and visual comfort after surgery. The glare disability was subjectively better in all cases. Two patients developed new ocular hypertension after surgery; one of them was controlled by medical treatment and the other needed cyclodiode. Two of the patients with glaucoma preoperatively also needed cyclodiode procedure and one of them an Ahmed valve. CONCLUSIONS: Several kinds of artificial iris implants are available. In all our patients with aniridia, iris artificial prostheses improved VA and diminished visual discomfort. Glaucoma is the most important complication after artificial iris implant. It is possible to implant the iris prosthesis in the capsular bag, but this requires a large capsulorrhexis and presents a surgical challenge.

Adult↗