[Penetrating keratoplasty in corneal perforations]. / La Kératoplastie transfixiante dans les perforations de la cornée.

Complications and results are described following 34 transfixing keratoplasties conducted on 27 perforated eyes of diverse origins: herpes (11 cases), traumas (7 cases), chronic ulcerations (7 cases), abscess (2 cases). Seven patients required a secondary keratoplasty, 6 of these being herpes cases. Postoperative treatment by corticosteroids, and the use of a soft contact lens to protect the donor-epithelium are discussed. Resulting vision was more than 5/10 in 5 patients (19%) and more than 1/10 in 7 patients (26%).

[Outcome of the unaffected eye in retinal detachment. Study of 1148 patients]. / Le devenir de l'oeil adelphe dans le décollement de rétine. Etude sur 1148 patients.

We have found a global bilateral retinal detachments (R.D.) rate of 15,52% over a population of 1148 patients. 60% of these bilateral R.D. have been seen by us for the first time at the moment of the detachment of the second eye. The actual percentage of R.D. on a second eye that was free of any R.D. at the first examination is 3,5% only, and it climbs to 4,45% if we consider only the second eyes harboring dangerous peripheral retinal lesions. This result compares favourably to the 10% to 20% second eye R.D. rate in the absence of preventive treatment; it has been obtained through a systematic prophylaxy of all retinal breaks and almost all lattice, snowflake, and schisis by cryoapplication or xenon photocoagulation or mostly argon laser photocoagulation. In the absence of any peripheral retinal lesion systematic equatorial argon laser circular photocoagulations can be useful.

[Retinal detachments treated by argon laser photocoagulation]. / Décollements de rétine traités par photocoagulation au laser à argon.

Twenty-nine rhegmatogenous retinal detachments were treated in 29 patients by argon laser photocoagulation ("damming" technique) between 10-1-77 and 06-30-81. Mean follow up time has been 19.1 months, and retinal detachments have remained perfectly contained in 28 patients without any subsequent macular problem. Eleven cases were asymptomatic retinal detachments, 4 of these occurring after previous argon laser prophylaxis, 16 cases being localized postoperative recurrences or failures after single or repeated surgery. These argon laser "dams" must only be conducted in the absence of major vitreous traction and with strict post-laser control; their indications are therefore limited but they can be useful procedures.

[Severe keratomycosis. Diagnosis and treatment]. / Kératomycoses sévères. Diagnostic et traitement.

We reported three consecutive cases of severe fungal keratitis initially undiagnosed by corneal scrapping. Corneal biopsy showed fungal elements of Paecilomyces lilacinus, Fusarium solani, Scedosporium apiospermum. Most cases of fungal keratitis could be treated successfully if adequate antifungal therapy were started early. Early and accurate diagnosis is of major importance. The results of our cases confirm the superiority of corneal biopsy over corneal scrapping. Corneal biopsy is a procedure of choice in suspected cases of keratomycosis in which corneal scrapings fail.

Drug-induced cicatricial pemphigoid affecting the conjunctiva. Light and electron microscopic features.

Cicatricial pemphigoid (CP) is a chronic inflammatory disease which can affect the conjunctiva. It is a slowly progressive disorder of unknown but presumed autoimmune etiology. Pseudopemphigoid, or CP associated with ocular drug administration, has also been described. These cases, which appear clinically indistinguishable from unilateral idiopathic CP affecting the conjunctiva, have been related to the use of echothiophate iodide, pilocarpine, idoxuridine, and epinephrine. We report the histopathologic and ultrastructural characteristics of 22 biopsies from ten patients with iatrogenic CP following the use of various ocular drugs. All patients presented with clinically obvious, active CP affecting the conjunctiva. Light microscopy and electron microscopy revealed findings identical to those previously reported for idiopathic CP of the conjunctiva: squamous metaplasia, increased numbers of desmosomes, basal lamina modifications suggestive of damage and attempted repair, subepithelial inflammatory cell infiltration, and diminished intravascular space within the stroma. These patients responded to immunosuppressive therapy. The authors wonder if it is possible that these patients were destined to develop CP, but that with topical ocular drug use, a more rapid emergence of the chronic cicatrizing feature of CP developed.