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Biomedical subjects

P Demailly

Publications and source records attributed to P Demailly.

At least 19 recordsLinked to original sources
PubMed1992

X-PERT NCT advanced logic tonometer valuation.

The air pulsed automatic tonometer X-PERT NCT has been tested in hospitals on glaucomatous patients. This new technique avoids direct contact with the patient's eyes and therefore avoids any risk of contamination. The population studied consisted of 118 eyes of 60 patients whose intraocular pressure (I.O.P.) is measured by applanation with the Goldmann tonometer and then by the air pulsed tonometer. The average I.O.P. obtained by Goldmann tonometer is 17.5 +/- 5 mmHg while by X-PERT tonometer, the average I.O.P. is 17.4 +/- 1.5 mmHg. Statistical analysis of these data showed a very good correlation (r = 0.969) in the two methods of measurement.

Adolescent↗
PubMed1992

Daunorubicin versus 5-fluoro-uracil in surgical treatment of primary open angle glaucoma: a prospective study.

In a prospective randomized study, we compare the results at 20 months of 5 Fluoro-Uracil and Daunorubicin filtering surgery in two groups of 25 patients with primary open-angle glaucoma. For the first group of 14 eyes, 10 injections of 5FU are done and only one subconjunctival preoperative injection of Daunorubicin in the second group of 13 eyes. 5FU group consists of 13 patients: 9 males, 4 females. The mean age is 52.3 +/- 18.4 years. The mean follow-up is 6.9 +/- 7 months. Daunorubicin group consists of 12 patients: 9 males, 3 females. The mean age is 50.2 +/- 21.4 years. The mean follow-up is 7.3 +/- 7 months. By Kaplan-Meier method, the probability success rate is 79 per 100 with 5FU and 68 per 100 with Daunorubicin. After 5FU procedure, the most disturbing complication is related to the decrease in IOP during the first postoperative days: flat anterior chamber (9 eyes) (7 eyes after Daunorubicin), choroïdal detachment (6 eyes) (2 eyes after Daunorubicin), cataract (3 eyes in the two groups). After Daunorubicin, corneal complications are less frequent: corneal ulcer (2 eyes) (3 eyes after 5FU), corneal dystrophy (1 eye in the two groups). Transient chemosis and local palpebral oedema are constant after Daunorubicin. We compared the IOP reduction rate and visual function loss in the two groups.

Aged↗
PubMed1989

[Glaucoma: detection and therapeutic indications].

Glaucoma screening requires a good knowledge of the epidemiology and risk factors of this disease. So, we measure the intraocular pressure, analyse the visual field and examin the optic nerve head by ophtalmoscopy. Other investigations have been described, allowing early treatment. Some medications are active on aqueous humor production, others on outflow but side effects are often observed. Laser therapy is an alternative to surgery.

Glaucoma↗
PubMed1989

[Trabeculectomy and trabeculo-retraction in the treatment of chronic primary open-angle glaucoma. Long-term tonometric results].

The long term tonometric results of laser (Argon Laser Trabeculoplasty) and surgical (Trabeculectomy and combined-surgery) treatment in Primitive Chronic Open Angle Glaucoma are analysed on 184 eyes by a retrospective study. Three groups of patients are compared: group I: 81 trabeculoplasties followed 4 years, group II: 75 trabeculectomies followed 5 years, group III: 28 combined-surgery (intra-capsular cataract extraction without implantation combined with a trabeculectomy) followed 5 years. For the three groups, reduce of IOP is noted after 6 months but seems less important after 30 months. Instantaneous results curves show a success rate of 80 to 100% (of which 10 to 20% with additional medical treatment). But cumulative failures rates are higher: more than 50% at 4 years for group I and group II, and only 29% at 5 years for group III. These results are confirmed by actuarial curves: group I: probability success rate of 65% at 4 years group II: probability success rate of 49% at 5 years group III: probability success rate of 73% at 5 years. The comparison of group I and II by actuarial curves is not statistically significant (Logrank test: chi 2 = 0.05). We had discussed the advantage of a new prospective randomised study.

Actuarial Analysis↗
PubMed1989

[Personalities and chronic glaucoma].

This survey has investigated the occurence of psychopathological affections and their relationship with compliance in open angle glaucomatous patients. Three groups have been considered: 48 severe glaucomas, 37 early glaucomas and 48 control patients, under treatment for other ophthalmological affections. These groups have taken a psychiatric interview, compliance evaluating scale and psychological assessment (inducling: Vocabulaire Binois Pichot, Cattel's 16 Personality Factors and Autoanalyse, Thematic Aperception Test and the Rorschach Test analysed through Exner's Synthetic System). Anxiety personality and disoders are more frequent in the glaucomatous group than the control or early (P = 0.0156). Patients in the early group appeared to be most compliant. Personality structure play a role in the acceptance of the disease and in the degree of cooperation with treatment. Maximal compliance is observed at the beginning of the disease. Personality scales show that glaucomatous patients have difficulties in coping with aggressive pulsions and tend to react to affect loaded situations by a defensive or avoiding attitude.

Adult↗
PubMed1989

[Argon laser trabeculoretraction in chronic open-angle glaucoma with normal pressure. A prospective study on the tonometric and perimetric effect].

A prospective randomised study was undertaken on sixty eyes, thirty five patients, (27 women, 8 men) followed in the Saint-Joseph hospital of Paris, with low tension glaucoma (LTG). The thirty five patients were selected at random and had either an argon laser trabeculoplasty (ALT) or received only vascular medications (medial). The first group (ALT) included 29 eyes. The second group (medical) included 31 eyes. The two groups were comparable: mean age, men/women distribution, mean intraocular pressure, mean C/D ratio, mean total visual capability (TVC) with the friedmann analyser. The mean follow up for the two groups was seven years. Nevertheless for the ALT group the mean follow up after ALT was four years. We compared for the two groups: --the aspect of the mean intraocular pressure (IOP) curve with time, --the evolution gradient of visual capabilities with time. For the ALT group we compared: --the mean IOP and 24 hours diurnal curves before and after laser treatment and the evolution gradient of visual capabilities before and after laser treatment. The introduction of ALT in the treatment of LTG had neither tonometric effect nor effect on the slope of visual field damage. We concluded that ALT is not recommended in LTG, but not that the IOP should not be reduced in this form of glaucoma.

Aged↗
PubMed1989

[Treatment of chronic primary open-angle glaucoma. Long-term functional results].

The functional results of the treatment of primary open angle glaucoma (POAG) were analysed. A retrospective study was undertaken on 437 eyes from 282 patients (137 women, 145 men) followed in Saint Joseph's Hospital (Paris). The mean follow-up was 9.7 years (4-22 years). 265 eyes received only medical treatment, 83 eyes argon laser trabeculoplasty (ALT) and 89 eyes surgery (66 trabeculectomies - 23 cataract-glaucoma combined operations). At least twice a year, intraocular pressure (IOP), visual acuity (VA) and mean total visual capability (TVC) on the Friedmann analyser were recorded on a computer. The severity gradient (SG) was calculated from the evolution gradient of TVC versus IOP with time for each group (medical, ALT, surgery) before and after treatment. Medical SG was not significantly different from ALT SG or surgery SG (trabeculectomy or combined surgery). For each group, SG before treatment was not significantly different from SG after treatment. For tonometric failures after ALT or surgery, SG before treatment was not different from SG after treatment. Nevertheless, after trabeculectomy, in the cases of clear tonometric success (IOP less than or equal to 16 mmHg), SG was significantly improved (p less than 0.001). On the other hand, no positive influence was noted on visual field evolution in cases of a commonly admitted good tonometric control (IOP less than or equal to 21 mmHg). Visual acuity loss after trabeculectomy was greatest during the first year (6/20). The cataractogenic role of trabeculectomy was statistically confirmed. The incidence of cataract at 5 years was 46%. This cataractogenic effect occurred significantly more after 55 years. We discuss tonometric effect on TVC evolution.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Medium-term tonometric results of trabeculectomies performed after trabeculoretraction using an argon laser in chronic primary open-angle glaucoma].

Following unsuccessful Argon Laser Trabeculoplasty (ALT), 93 eyes were tracked for periods of 6 to 42 (mean: 24 months). The total failure rate of 20% is similar to the generally known failure rate of the trabeculectomies. However, failures are more frequent (37%) when trabeculectomy is performed between the second and third month after ALT. This may suggest not to operate on too soon after ALT or to perform filtering surgery with 5 Fluoro-uracil.

Adult↗
PubMed1988

[Comparative study of levobunolol and timolol in the treatment of chronic open-angle glaucoma and chronic ocular hypertension].

Forty patients with chronic open-angle glaucoma or ocular hypertension participated in this randomized double-masked clinical trial. The patients instilled either 0.5% Levobunolol or 0.5% Timolol into each eye twice daily for three months. Levobunolol produced an overall decrease in mean intraocular pressure of approximately 7 mmHg, while Timolol produced an overall decrease of approximately 5 mmHg but no significant difference has been proved. Intraocular pressure was inadequately controlled in five patients in each treatment group. Both drugs caused heart rate decreases that were judged to be of limited clinical significance. Levobunolol was found to be as safe and effective as Timolol for the treatment of patients with open-angle glaucoma as for those with chronic ocular hypertension.

Adrenergic beta-Antagonists↗
PubMed1988

[Surgical peripheral iridectomy and argon laser iridotomy in primary closed-angle glaucoma. Comparative statistical study].

The subject is to compare the middle term efficiency of surgical peripheral iridotomy and Argon laser iridotomy for primary closed angle glaucoma. We have considered reopened angles on 360 degrees after a crisis of closed angle; eyes with a positive "neosynephrine - pilocarpine" test; the second eye of a primary closed angle glaucoma and primary mixed glaucoma. Sixty affected eyes have been divided in two groups in a randomized study. Group A: Thirty eyes requiring a bilateral surgical peripheral iridectomy, Group B: Thirty eyes requiring a bilateral Argon laser iridotomy. The patients are regularly followed at intervals of: one week, three months, six months, one year and two years. Four parameters have been researched: 1. Intraocular pressure between 9 h-12 h a.m. Intraocular pressures lower or equal to 22 mmHg were considered to be successes. 2. Far visual acuity with correct lenses. 3. Opacity of the crystalline lenses: normal or sclerosed (0, +/-, +) cataract (++, ). 4. Post-operative complications. Some cases have required several periods of Argon laser photocoagulation (colorless iris, older patients) but we prefer a proper result immediately in order not to take any risks with pupillary blocking-up. The statistical analysis gives the following results: Same tonometric results according to the different technics even if the treatment has been prophylactic (positive provocation test; second eye) or curative (primary closed-angle glaucoma with solvable crisis; mixed glaucoma). No significant difference of visual acuity between the two groups after two years. Similarly, we have not found a significant difference between both techniques in each considered age group two years after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Metipranolol 0.1%: effect of a single dose on the nycthemeral pressure curve in an eye with chronic primary open-angle glaucoma].

A double blind randomised study was made to compare the efficiency in decreasing intra ocular pressure of Metipranolol 0.1% or 0.3% versus placebo in three groups of 15 patients with chronic open angle glaucoma with or without visual field defects. The results demonstrate that Metipranolol 0.1% significantly lowers the intra ocular pressure in comparison with placebo. But this lowering is less that the one with 0.3% and is markedly reduced after 9 hours. The action of Metipranolol 0.3% is more durable and is still observed at 24 hours with a drop of nearly 20% in comparison with the initial intra ocular pressure. In the three groups, no significant variation of pulse and arterial pressure could be noticed during this 24 hours study.

Adult↗
PubMed1987

[Mid-term results of a double-blind study comparing metipranolol to timolol in the treatment of primary open-angle glaucoma].

A study on 26 patients with chronic angle glaucoma was completed after 17 weeks. The IOP was satisfactorily stabilized on patients treated with Metipranolol drops. In the Timolol group, the IOP rose again after the 9th week and, at the completion of the study, the difference between the averages of the two groups is significant. No systemic effect was noted as well in the Metipranolol group as in the Timolol group.

Double-Blind Method↗
PubMed1987

[Use of 5-fluorouracil in the surgery of glaucoma].

63 eyes (46 patients) with different types of glaucoma have been operated by filtering surgery with subconjunctival 5 fluoro-uracil (5-FU) injections. The mean follow up is 7 months. Two groups of patients have been studied: In the 33 eyes with previous unsuccessful glaucoma surgery, the result was very good: 73% of complete success (IOP less than or = 20 mmHg without additional therapy) 18% of qualified success (IOP less than or = 20 mmHg with additional therapy) 8% of failure. The other group included 30 eyes without previous glaucoma surgery, but with a bad surgical prognosis. In all the cases, the result was good, only one eye required additional therapy. The corneal complications are the most frequent, but do not last long. The other complications depend upon the indications, there are many in the aphakic patients. The durable flat anterior chamber must also be quoted.

Conjunctiva↗
PubMed1986

[Quantitative perimetry and glaucoma].

The authors present the procedure used to quantify the perimetric data for some devices. The purpose is to follow accurately the evolution of perimetric defects in glaucoma: with the Friedmann analyser:global visual capabilities; with the Rodenstock Peritest:defect ratio; with the Autoperimeter 2000 (Dicon):Demailly index.

Female↗