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Biomedical subjects

L Lasram

Publications and source records attributed to L Lasram.

16 recordsLinked to original sources

[Ambulatory cataract surgery].

UNLABELLED: The purpose of this study is to show the result of outpatient cataract surgery and its differences or advantages with inpatient cataract surgery. PATIENTS AND METHODS: The retrospective study concern 722 consecutives patients collected from June 1995 till May 1997; 388 underwent outpatient cataract surgery and 384 underwent inpatient cataract surgery. RESULTS: There were non significant difference between the two groups in type of cataract surgery. Immediate postoperative complications and final visual acuity did not show any significant difference in both groups. CONCLUSION: This analysis shows the great advantages of this simple surgical procedure such an increase in cataract operation leading to a decrease of patients in waiting list.

Adolescent↗

[Ocular signs of primary hyperoxaluria type I].

PURPOSE: To report the results of ophthalmological examination of 14 patients with primary oxalosis of type I, and to appreciate the diagnostic value of these signs. MATERIAL AND METHODS: Fourteen patients, 7 girls and 7 boys with an average age of 8-35 years (3 months - 15 years). Ten patients had renal failure, 2 died without dialysis and eight were treated with dialysis; 5 out of 8 had hemodialysis and the duration of this treatment varied between 3 months and 3.5 years, 3 out of 8 had peritoneal dialysis. RESULTS: Visual acuity was 10/10 in 11 cases and we noted a vision of 5/10 in one eye in one case. Ocular fundus examination was normal in 7 cases. In 5 cases, it showed numerous minute white round flecks at the posterior pole and near the retinal vessels which probably correspond to deposition of calcium oxalate crystals. In one case we found a diffuse retinal pigment atrophy and in another case a sectorial papillar atrophy without loss of vision. CONCLUSION: This flecked retinopathy can occur before hemodialysis or after a few months or years of hemodialysis. There is no correlation between duration of dialysis and ocular lesions.

Adolescent↗

[Primary hyperoxaluria: Tunisian experience apropos of 24 pediatric cases].

We report on 24 children (10 girls) presenting with primary hyperoxaluria. The mean age at diagnosis was 6.3 years (range: 3 months-14.8 years). The mean interval between initial symptom and diagnosis was 1.3 year. The average follow-up period was 22 months (range: 1-60 months). At the time of diagnosis the renal function was normal in 6 children, moderately altered in 1 and severely in 17. During the follow-up the renal function remained stable in 6 patients, improved in 2, deteriorated in 4. The 12 patients with end-stage renal disease at diagnosis remained unchanged. Urolithiasis were present in all patients older than 2 years, and in 1 among the 5 infants. Medullary nephrocalcinosis was observed in 3 patients in whom the renal function was preserved. Diffuse nephrocalcinosis was present in all patients with end-stage renal failure. Improvement of renal function was secondary to stone removal in 2 patients. Extracorporeal shock wave lithotripsy performed in 7 patients was efficient only in 3. In 10 patients oxalate bone disease was correlated with both renal function and dialysis duration, whereas retinal involvement noted in 6 patients was not.

Adolescent↗

[Type 1 neurofibromatosis in Tunisia: 66 cases].

A multidisciplinary transversal descriptive study was conducted from June to October 1992 to determine the clinical manifestations and laboratory findings observed in 66 patients with type 1 neurofibromatosis. Diagnostic criteria were those of the National Institute of Health as recommended for subjects over 20 years of age. All patients over the age of 25 had café au lait spots, neurofibromas, lentigines and nodules. Occurrence of lesions of the central nervous system was significantly earlier than peripheral nervous manifestations. The optic glioma was the most frequent lesion of the central nervous system. Complications were observed during the first twenty years of the disease. Based on these findings, we propose a clinical and laboratory work-up designed as a function of age.

Adolescent↗

[Contribution of an ophthalmologic test to the diagnosis of familial nephropathies. Apropos of 10 cases].

The authors reported ten cases of familial nephropathy (two cystinosis, three Senior and Loken syndrome, one Alport's syndrome and four Oxalosis) associated to ocular manifestations. Aetiologic diagnosis was known from ocular symptoms in five cases (all cases of cystinosis and Senior and Loken syndrome). The authors undertook this study to analyse the value of ocular manifestations in determining the right aetiologic diagnosis in familial nephropathies. The results of this study showed that ocular manifestations are helpful for aetiologic diagnosis in the first diseases. Indeed, corneal injury is synonym of cystinosis and retinitis pigmentosa is usually associated with Senior and Loken syndrome. In Alport's syndrome, ocular manifestations: antcrior lenticonus cataractous and perimacular white points only have orientation value in the diagnosis of this disease. Oxalosis ocular manifestations which consist of retinal oxalate deposits appear late and are concomitant to familial renal insufficiency. They cannot help in the diagnostic search.

Adolescent↗

[Treatment of late leaking of filtering bullae].

Leaking filtering blebs must be repaired immediately to avoid major complications such as hypotony and endophtalmitis. We report four cases of leaking filtering blebs occurring between one to six years after trabeculectomy. Revealing signs were hypotony in two cases and athalamia in two cases. Patching was done in one case and conjunctival reinforcement by rotation of conjunctival flap in 2 cases and free conjunctival graft in one case. Leaking disappeared in all the cases. Normal intraocular pressure (10-12 mmHg) was obtained in all cases except one which was achieved by rotation of conjunctival flap and complicated by retraction of conjunctiva. Conjunctival reinforcement without exicion of the bleb is an easy technique and respect the filtration site. Major complication in our patients is retraction of conjunctival flap which can be avoided by: exicion of Tenon, good fixation to the cornea, and free conjunctival graft.

Aged↗

[Gelatinous dystrophy of the cornea. Apropos of 5 cases].

Gelatinous drop-like corneal dystrophy is a rare disease, described for the first time by Nakaizumi (Japan) in 1914. We report 5 cases of this primary corneal amyloidosis. Three of our patients are brothers, the two other cases are isolated cases. Photophobia and progressive loss of vision are the first presenting signs. Corneal lesions are typically bilateral white nodular deposits beneath the epithelium. Patients underwent repeated keratoplasties with a mean interval of 5 years because of the recurrence of the disease on the corneal graft. Diagnosis of corneal amyloidosis was confirmed in all cases by histology. We compared our results with the data reported in the literature.

Adult↗

[Goldenhar syndrome. Surgical emergency apropos of a case].

We report a case of Goldenhar syndrome in a six week old infant. This patient had bilateral peribulbar choristoma, bilateral pre-auricular appendix and left superior palpebral coloboma with severe exposure keratitis. This condition necessitated an emergency surgical eyelid repair. The authors discuss the different clinical manifestations of this syndrome and therapeutic modalities, particularly the surgical treatment of choristoma and palpebral coloboma.

Coloboma↗

[Behçet's disease disclosed by ocular conjunctival aphthous ulcer. Apropos of a case].

Aphthosis in Behçet's disease is usually located in the oro-genital areas, but other locations have been described. The authors report the case of a 45 year old woman who presented with an ocular conjunctival aphthous ulcer. This was the initial presentation of Behçet's disease. This case report illustrates that aphthosis in Behçet's disease can have unusual sites such as the ocular conjunctiva. Furthermore, in this case, the conjunctival aphthosis was presenting sign of this systemic disease.

Behcet Syndrome↗

[Macular edema and chronic renal insufficiency].

The authors report two cases of macular oedema in two patients suffering from chronic renal failure. One of the patients, a women aged 36, with a renal transplant, presented with intra-retinal macular oedema, caused by a marked impairment of renal function. In the second case, the macular oedema, associated with papilloedema occurred in a patient aged 56, the day after renal dialysis and spontaneously regressed. The mechanism of macular oedema, seems to be related to modifications of the osmotic pressure and is probably associated with renal dialysis as shown in the second case.

Adult↗