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Biomedical subjects

M Gonvers

Publications and source records attributed to M Gonvers.

At least 19 recordsLinked to original sources
PubMed1996

[Phacoemulsification and clear cornea incision: review of 100 initial cases].

AIM: Evaluation of complications during the learning period of phacoemulsifications with clear-corneal incision. PATIENTS AND METHODS: Retrospective study of the 100 first cases with a follow-up of 3 to 24 months. RESULTS: During operation, 5 (5%) cases (one 180 degrees dialysis, 4 broken posterior capsules) presented with a significant complication needing anterior vitrectomy. Eight corneal tunnels were sutured at the end of surgery and 3 others a few days later. No case showed signs of intraocular infection. Cystoid macular edema developed in 4 patients who all recovered good visual acuity. Excessive fibrosis of anterior capsule with capsulorhexis contraction was encountered in 2 cases harbouring plate haptic silicone lenses and needed YAG-laser treatment. None of the eyes with complications had visual acuity inferior to 0.6, except for 2 eyes which had preoperative macular diseases. CONCLUSION: This study demonstrates that phacoemulsification with clear cornea incision is a safe procedure, provided that the complications related to the learning period are set apart. None of the complications encountered in our 100 first cases severely prejudiced the functional results.

Adult↗
PubMed1996

[Laser treatment of macular holes].

OBJECTIVE: To study a new technic of laser treatment of macular holes. METHODS: 21 eyes with stage II-IV macular hole were treated with Argon-green laser. Pigment epithelium in the area of the hole was whitened with spots of 100-200 microns, 100-300 mW. We expected this treatment to create a cellular proliferation that could close and contract the hole. Follow-up after treatment ranged from 3 to 24 months (mean: 9.3 months). RESULTS: Within one month after treatment, the macular hole was closed in 7 eyes (33%) and partially closed in 5 eyes (24%). The visual acuity increased from 1 to 5 lignes (ETDRS chart) in 9 eyes (43%), it remained the same in 9 eyes (43%) and decreased from 1 to 2 lignes in 3 eyes (14%). CONCLUSION: Laser treatment of macular holes seems to be effective and could be proposed as an alternative to the patients who cannot be operated on by vitrectomy and gas tamponade.

Adult↗
PubMed1995

A new device for noncontact wide-angle viewing of the fundus during vitrectomy.

Noncontact wide-angle viewing of the fundus during vitrectomy has heretofore relied on an image inverter and a 90-diopter lens fixed with a tube under the microscope. A new device in which the 90-diopter lens is not connected to the microscope but, rather, is connected to an independent support system is described. This device offers many advantages: (1) focusing on the various parts of the eye during vitreous surgery need not be done manually but is achieved by the up or down movement of the microscope, (2) translation of the microscope is easier during tilting of the eye, (3) a lateral slit-lamp can be easily added for illumination of the fundus, and (4) there is no risk that the 90-diopter lens will touch the cornea.

Equipment Design↗
PubMed1995

[Silicone one piece intraocular implant and anterior capsule fibrosis].

BACKGROUND: Foldable plate haptic silicone intraocular lenses (IOLs) were surmised to produce greater anterior capsule fibrosis than poly(methyl metacrylate) (PMMA) intraocular lenses. MATERIAL AND METHODS: A retrospective study of 34 eyes was carried out 12 to 15 months after phacoemulsification. All surgical procedures were performed by the same surgeon (M.G.) using two different techniques: 17 eyes were operated on through a temporal clear-cornea incison and implanted with a foldable plate haptic silicone IOL (STAAR AA4203); 17 eyes were operated on through a superior sclerocorneal incision and received a PMMA IOL (Kabi Pharmacia 809P). Secondary opacification of the anterior capsule was compared between the two groups. RESULTS: Seventy percent of eyes (12/17) with plate haptic silicone IOL had moderate or important anterior capsule fibrosis or shrinkage. Only 18% of eyes (3/17) with PMMA IOL presented with this complication. However, posterior capsule opacification was almost similar in both groups. CONCLUSION: Foldable plate haptic silicone IOLs seem to produce a more important anterior capsule fibrosis or shrinkage than PMMA IOL one year after phacoemulsification and saccular implantation. Although etiology is unknown, either huge contact between IOL and anterior capsule, or lack of contact between anterior and posterior capsules are hypotheses advanced. Posterior capsule opacification is similar in the two groups.

Fibrosis↗
PubMed1995

[Retinal detachment and laser drainage].

OBJECTIVE: To compare laser and 30G needle perforation of the choroid for drainage of subretinal fluid. METHOD: Hundred and six cases of retinal detachment were operated on by episcleral buckle, retinopexy and external drainage of subretinal fluid. After radial sclerotomy, the choroid was perforated in 53 cases with Argon laser (group I) and in 53 other cases with 30G needle (group II). Complications were compared between both groups. RESULTS: Group I (laser drainage): In one of 53 eyes (1.8%), a retinal perforation occurred. In this eye, the retinal detachment was shallow. In an other eye (1.8%), retinal perforation occurred secondary to incarceration of the retina at the drainage site. Two eyes (3.6%) had limited hemorrhage at the drainage site. Group II (30G needle drainage): Three of 53 eyes (3.6%) had direct retinal perforation, and three (3.6%) had perforation secondary to retinal incarceration at the drainage site. Seven eyes (13.2%) had subretinal hemorrhage. CONCLUSION: Laser is safer than 30G needle for perforation of the choroid and drainage of subretinal fluid, and is associated with a lower incidence of retinal perforations and subretinal hemorrhages.

Adolescent↗
PubMed1995

Retinotomies of 180 degrees or more.

PURPOSE: To investigate the anatomic and functional results of large retinotomies. METHODS: The charts of 33 consecutive patients who underwent peripheral retinotomy of 180 degrees or more and silicone oil injection during vitrectomy for retinal detachment with proliferative vitreoretinopathy were reviewed. Silicone oil was removed from 26 eyes (79%), but 2 hypotonic eyes (6%) required reinjection of silicone. RESULTS: After a minimum follow-up of 6 months, the retina was completely attached in 28 eyes (85%). Twenty-eight eyes (85%) achieved a final visual acuity of 5/200 or better, and seventeen eyes (51%) achieved visual acuity of 20/200 or better. Intraocular pressure did not change significantly from the initial to the final examination. At the last follow-up, hypotony (intraocular pressure < or = 5 mmHg) was seen in 1 of the 28 eyes with reattached retina (3.6%). A new macular epiretinal membrane, related to the duration of silicone oil tamponade, developed and was peeled off in 12 eyes (36%) in an additional procedure. No association could be found between the anatomic or functional results and the extent of the retinotomy. Presented herein is the largest series of retinotomies of 180 degrees or more followed up after silicone oil removal. CONCLUSION: Large retinotomy (> or = 180 degrees) in selected cases of vitreoretinal surgery seems to be an effective procedure.

Adolescent↗
PubMed1994

New approach to managing vitreous loss and dislocated lens fragments during phacoemulsification.

I performed a one-port pars plana vitrectomy during phacoemulsification to manage vitreous loss with and without posterior dislocation of lens fragments in nine consecutive cases. I used a 1 mm vitrectomy instrument with an infusion sleeve for the vitrectomy; the coaxial light of the microscope and an infusion contact lens held on the cornea provided intraocular illumination. Eight of the nine cases achieved a visual acuity equal to or better than 20/25 after a mean follow-up of 5.7 months. One patient's visual acuity was 20/70 because of severe background diabetic retinopathy.

Cataract Extraction↗
PubMed1994

[Phacoemulsification with incision of the clear cornea].

METHODS: I reviewed the records of my first 33 phacoemulsifications with a clear cornea incision. The first 3 cases in the series had their temporal corneal incision sutured because of insufficiency in the self-sealing mechanism. RESULTS: Change of refraction induced by surgery was especially studied in 23 cases whose mean follow-up had been 3.5 months. This proved to be very moderate and stable from the first post-operative day up to the last control which took place 5-6 months later. CONCLUSION: The only drawback of the technique, was the occurrence in several cases of anterior capsule fibrosis which seemed related to the nature (silicone) and shape (plate haptics) of the foldable IOL.

Cataract Extraction↗
PubMed1993

Sophisticated vitreoretinal surgery in patients with a healthy fellow eye. An 11-year retrospective study.

Forty-four patients who had undergone successful vitreoretinal surgery were included in a retrospective study intended to evaluate the real benefit of surgery in each case. All patients presented with a retinal detachment complicated by proliferative vitreoretinopathy in one eye, the fellow eye being healthy. The number of operations undergone by each patient and the total operating time per patient were carefully recorded. Objective parameters such as visual acuity, visual field and stereoscopic function were monitored. Visual comfort and subjective complaints were graded by means of a questionnaire given to the patients. Any severe event occurring in the fellow eye during the follow-up period was also registered. Sophisticated vitreoretinal surgery in patients with a good fellow eye is useful to the patient if binocular function can be restored at least partially. Correction of unilateral aphakia by a contact lens should not be considered an acceptable solution.

Depth Perception↗
PubMed1992

[Pars plana vitrectomy in uveitis].

A vitrectomy was performed in 30 eyes suffering from different forms of uveitis. An improvement of visual acuity was obtained in 29 cases and was explained by removal of vitreous haze and/or of the cataract, but not by the improvement of the inflammatory process.

Adolescent↗
PubMed1992

[Ocular toxocara canis in a 30-year-old adult].

Pars plana vitrectomy was performed in a 30-year-old patient who presented a posterior traction detachment due to an inflammatory granuloma. The granuloma removed in toto during surgery revealed characteristic features of toxocariasis lesion (first case described in the literature). An ELISA test performed on a vitreous sample was strongly positive. Retinotomy around the granuloma was necessary to re-attach the retina and silicone oil was used as a tamponade for 4 months. VA improved from HM to 15/200 after silicone removal.

Adult↗
PubMed1991

Choroidal metastasis and rhegmatogenous retinal detachment.

The association of a rhegmatogenous retinal detachment (RRD) with a uveal metastasis is an exceptional occurrence. In this article, the authors report the first successfully treated case (to their knowledge) of a patient with one eye in whom both the RRD and the metastasis is treated successfully. The RRD was operated on using a buckling procedure with cryopexy of the retinal break and drainage of the subretinal fluid. The metastasis, originating from an invasive canalicular carcinoma of the breast, was irradiated several days after surgery with a linear accelerator. The primary tumor was treated with systemic hormonotherapy. One and a half years after surgery, the patient is still alive. Visual acuity in the eye is 20/30, the retina is flat and no signs of tumor recurrence have been observed.

Aged↗
PubMed1990

Temporary silicone oil tamponade in the treatment of complicated diabetic retinal detachments.

A retrospective study is reported on 132 eyes with retinal detachment, resulting from advanced proliferative diabetic retinopathy, treated using vitrectomy techniques and silicone oil tamponade. Epiretinal surgery was performed using a bimanual technique. Silicone oil was removed in 64 eyes (49%) which regained an improved final vision of 5/200 or better. In 17 eyes (13%), vision was improved but silicone oil could not be removed. It is expected that the function of several of these eyes will eventually deteriorate because of progressive silicone-induced glaucoma. The remaining 51 eyes (38%) were surgical and functional failures.

Diabetic Retinopathy↗
PubMed1990

[Surgical treatment of epiretinal macular fibrosis: the Lausanne experience].

Between 1981 and 1988, vitreous surgery was performed on 28 nondiabetic patients with epiretinal macular fibroplasia. The fibroplasia was idiopathic in 9 eyes, occurred after successful surgery for retinal detachment in 10, and was associated with other ocular disorders in 9. The patients were followed up for between 5 and 72 months. While visual acuity improved in 26 cases, metamorphopsia increased in all. The results were poorer in cases where symptoms had already existed for more than 6 months or where not only the retina, but also the macula was detached. Complications were confined to 3 cases in which peripheral tears occurred intraoperatively; there were 2 postoperative retinal detachments. While increased lens opacification was observed in 7 patients, a recurrence was seen only in one.

Adult↗
PubMed1987

New instrumentation and technique for epiretinal surgery.

A multifunctional probe for vitreous surgery, which combines fiberoptic endoillumination, microforceps, bipolar diathermy, and infusion/aspiration, has allowed the development of an original technique for the peeling of very adherent preretinal membranes.

Equipment Design↗
PubMed1986

The effect of liquid silicone on the rabbit retina. Histologic and ultrastructural study.

Silicone oil was injected into 23 rabbit eyes, which had undergone vitrectomy and which were then examined in the electron microscope six weeks later. Retinal lesions were observed in the outer plexiform layer. They consisted mainly of a subtotal disappearance of the processes of horizontal and bipolar cells and of the synaptic terminals of the photoreceptors. The lesions were seen only in areas of the retina that had been in permanent contact with the oil bubble. They did not depend on the purity of the silicone oil injected.

Animals↗
PubMed1985

Temporary silicone oil tamponade in the management of retinal detachment with proliferative vitreoretinopathy.

Silicone oil was used as a temporary (four to six weeks) tamponade in conjunction with vitreous surgery in the management of 146 eyes with retinal detachment complicated by proliferative vitreoretinopathy. A success rate of 62% (90 of 146 cases) was achieved six months after the silicone was removed. Clinical complications directly related to silicone oil were rare and did not progress or develop after the removal of silicone except for opacification of the lens in phakic eyes. This occurred frequently (43 of 55 eyes) and progressed many months after the withdrawal of silicone.

Eye Diseases↗