[Pterygium surgery with sutureless, glueless conjunctival graft: Preliminary study at the Centre hospitalier universitaire de Cocody in Abidjan]. / Chirurgie du ptérygion par greffe conjonctivale sans suture ni colle biologique : étude préliminaire au centre hospitalier universitaire de Cocody à Abidjan.

PURPOSE: To optimize the pterygium management by delineating the role of sutureless, glueless conjunctival graft. MATERIALS AND METHODS: This was a prospective cohort study carried out at the Centre hospitalier universitaire de Cocody between October 1st, 2021 and March 31st, 2022. It analyzed a series of 36 cases of stage I, II and III pterygium by Cornand's classification, who underwent surgery by a sutureless conjunctival graft technique without biological glue. RESULTS: Demographically, 33.3% of our study population were between 30 and 40 years of age, with a mean of 47.86 years. The patients showed a female preponderance, 53%, with a male:female ratio of 0.89. At the clinical level, 75% of our population presented for ocular redness, 84% had a nasal pterygium, and 75% were stage 2. In terms of postoperative course and appearance, we observed 80.55% graft stability, 5.56% graft retraction, 2.78% graft displacement, and 11.11% graft loss. At the conclusion of follow-up, we noted an 8.33% recurrence rate. DISCUSSION: The use of intraoperative blood ensures patient safety and postoperative comfort. This technique demonstrates satisfactory results with primary, nasal pterygia. CONCLUSION: Conjunctival autograft without sutures or biological glue might be a very promising surgical alternative in the surgical treatment of pterygium.

[Ocular manifestations in patients with chronic renal insufficiency who are not dialysis: about 60 cases]. / Manifestations oculaires chez les patients insuffisants rénaux chroniques non dialyses : a propos de 60 cas.

OBJECTIVE: describe the ocular manifestations encounterd in chronic renal failure not on dialysis in order to ensure better management. METHODS: it is a descriptive analytical study, which took place from febrauary 2017 to june 2017. The study was carried out jointly in the Nephrology and Ophortamology departments of the Yopougon hospital and university center. It focused on patients with renal failure not on dialysis. A total of 60 patients were included with regard to the study inclusion criteria. RESULTS: patients personal history was dominated by high blood pressure arterial (88%) diabetes (27%). The decrease in visual acuity (BAV) and pruritus were symptoms at rates of 66.66% and 26% respectively. The review biomicroscopic anterior segment, has shown unilateral cataracts in 26.67% of cases. At the posterior pole, optic neuropathy was predominant (23,33%). The macular edemas were 10%. Arterial shrinkage (16.66%) was the most observed lesion of peripheral chorioretin. The hypertensive retinopathy (HR) and large papillary excavation (GEP) were the abnormalities most found on the back of the eye, each observing each in 43.75% of cases. We found no correlation between eye manifestations and IRC. CONCLUSION: There was no direct link between kidney failure and eye damage Observed. Several factors could explain the eye signs, including HTA and diabetes.

OBJECTIFS: décrire les manifestations oculaires rencontrées chez l'insuffisant rénal chronique non dialysé afin d'en assurer une meilleure prise en charge. MATÉRIEL ET MÉTHODES: il s'agit d'une étude descriptive et analytique, qui s'est déroulée du mois de février 2017 au mois de Juin 2017. L'étude a été menée conjointement dans les services de Néphrologie et d'Ophtalmologie du Centre Hospitalier et Universitaire (CHU) de Yopougon. Elle a porté sur les patients insuffisants rénaux non dialysés. Au total 60 patients ont été inclus eu égard aux critères d'inclusion de l'étude. RÉSULTATS: les antécédents personnels des patients étaient dominés par l'hypertension artérielle (88%) et le diabète (27%). Labaisse de l'acuité visuelle (BAV) et le prurit étaient lessymptômes plus exprimésà des taux respectifs de 66,66% et 26%. L'examen biomicroscopique du segment antérieur, a mis en évidence une cataracte unilatérale chez 26,67% des cas. Au pôle postérieur, les neuropathies optiques étaient prédominantes (23,33%). Les oedèmes maculaires étaient de 10%. Le rétrécissement artériel (16,66%) représentait la lésion la plus observée au niveau de la choriorétine périphérique. La rétinopathie hypertensive (RH) et la grande excavation papillaire (GEP) étaient les anomalies les plus retrouvées à l'examen du fond d'œil, s'observant chacune dans 43,75% des cas. Nous n'avons pas retrouvé de corrélation entre les manifestations oculaires et l'IRC. CONCLUSION: Il n'existait pas de lien direct entre l'insuffisance rénaleet les lésions oculaires observées. Plusieurs facteurs pourraient expliqués les signes oculaires, notamment l'HTA et le diabète.

[Comparison of Goldmann tonometry with air-puff tonometry. A study of 159 patients in Abidjan]. / Comparaison de la tonomérie de Goldmann à la tonométrie à air pulsé à propos de 159 patients à Abidjan.

PURPOSE: The goal of this study was to compare the intraocular pressure (IOP) values obtained with each of the tonometry methods as well as to study the effect of corneal pachymetry on the measurements obtained by each method. MATERIAL AND METHODS: We carried out a cross-sectional, descriptive, analytical, prospective study in the ophthalmology department of a multispecialty clinic in Abidjan (Ivory Coast) from April 2018 to August 2018. Patients aged 15 and over were included in the study. Over this period, IOP was measured by Goldman Applanation Tonometer (HaagStreit, AT 900, Switzerland) and air-puff Tonopachymeter (Nidek, NT 530 P, Japan), which also permitted measurement of central optical corneal pachymetry. The data analyzed focused on socio-demographic characteristics, ophthalmologic history, tonometry, and central corneal pachymetry. The comparison of the values obtained by both devices and the effect of central corneal thickness (CCT) on tonometry were analyzed using EpiDataAnalysis V2.2.2.183 software. RESULTS: We examined 318 eyes of 159 patients whose mean age was 40±12.57 years, range 16 to 82 years. The gender ratio was 1. A past ophthalmologic history was noted in 79.2% of patients. The mean IOP by Goldmann applanation tonometry was 12.75±3.17mmHg, and that by non-contact air-puff tonometry was 13.83±3.80mmHg. The mean central corneal thickness was 530.50±32.61µm. The difference between IOP measured by non-contact tonometry and that measured by contact tonometry was statistically significant, with P=0.00. There was no statistically significant relationship between central corneal pachymetry and contact tonometry (P=0.80). However, there was a statistically significant relationship between non-contact tonometry and central pachymetry (P=0.00). The values obtained with the air-puff tonometer are more affected by central corneal thickness. CONCLUSION: The values obtained by Goldmann applanation tonometry are not equivalent to those obtained by non-contact air-puff tonopachymetry.

[Ophthalmic Zoster In Children: About An Observation And Literature Review]. / Zona Ophtalmique Chez L'Enfant : A Propos D'Une Observation Et Revue De Litterature.

OBJECTIVE: the goal of this clinical case is to report a case of ophthalmic zoster in children and to insist on the relevance of early antiviral treatment so as to minimize corneal affection and preserve visual function. OBSERVATION: we report an eleven-years-old-girl case, with a history of varicella infection at 5 years old, who came for consultation for a painful eruption affecting the forehead, the upper eyelid, the nose, and the upper lips. The clinical examination showed many vesicles erythematous affecting the left hemi face. The diagnosis of ophthalmic zoster has been retained. The biological checkup was done namely blood count, and glycemia in empty stomach and a HIV serology. This checkup was normal. The treatment was a local antiseptic based and systemic with acyclovir and antalgic (tramadol) during 8 days. The evolution was favorable. Zoster is rare in children. The ophthalmic form is exceptional. The diagnosis is clinical and should mention some bladdery lesions grouped in bunch with a disposition which follows a metamere. It can be responsible of serious ocular complications which can compromise the visual function. CONCLUSION: the particularity of our observation is the presence of zoster in immunocompetent child and the ophthalmic localization remaining an exceptional form in children.

OBJECTIF: le but de ce cas clinique était de rapporter un cas de zona ophtalmique chez l'enfant et d'insister sur l'intérêt d'un traitement antiviral précoce afin de limiter l'atteinte cornéenne et de préserver la fonction visuelle. OBSERVATION: nous rapportons le cas d'une fillette de 11 ans, avec un antécédent de varicelle à l'âge de 5 ans qui a consulté pour une éruption douloureuse, prenant le front, la paupière supérieure, le nez et les lèvres supérieures. L'examen clinique a mis en évidence de multiples vésicules érythémateuses, intéressant l'hémiface gauche. Le diagnostic de zona ophtalmique a été retenu. Un bilan biologique a été effectué, notamment une numération formule sanguine, une glycémie à jeun et une sérologie VIH. Ledit bilan s'est révélé normal. Le traitement a été local à base d'antiseptique et systémique fait d'aciclovir et d'antalgique (tramadol) pendant 8 jours. L'évolution a été favorable. Le zona est rare chez l'enfant. La forme ophtalmique est exceptionnelle. Le diagnostic est clinique et doit être évoqué devant des lésions vésiculeuses groupées en bouquet et dont la disposition suit un métamère. Il peut être responsable de complications oculaires graves pouvant compromettre la fonction visuelle. CONCLUSION: la particularité de notre observation est la survenue de zona chez un enfant immunocompétent et la localisation ophtalmique qui reste une forme exceptionnelle chez l'enfant.

[Retinal detachment surgery: Evaluation of the anatomical success and functional outcomes in a consecutive series of patients operated between 2011 and 2014 at Nantes University Medical Center]. / Chirurgie des décollements de rétine : évaluation du succès anatomique et du devenir fonctionnel sur une série consécutive de patients opérés entre 2011 et 2014 au CHU de Nantes.

OBJECTIVE: Evaluate the anatomical and functional outcomes of retinal detachment (RD) surgery from January 2011 to November 2014. MATERIALS AND METHODS: We conducted a retrospective study of 182 eyes of 175 patients with a minimum follow-up of 6 months, operated for RD at Nantes University Medical Center. It consists of 56 simple RDs and 126 complex RDs treated in first intention by Scleral Buckling (SB), vitrectomy or combined surgery. The analysis is based on anatomic reattachment at the end of a follow-up of at least 6 months after the first surgery and the progression of the best corrected visual acuity (BCVA). RESULTS: One hundred and seventy-two vitrectomies, 15 SB and 5 combined surgeries (vitrectomy+SB) were performed. The overall anatomical success rate after a single operation was 131 eyes (72 %). It increased to 163 eyes (90 %) at the end of the follow-up. Depending on the type of RD, anatomic success at 6 months after surgery was achieved for 47 simple RDs (84 %) and 84 complex RDs (67 %). At the end of the follow-up, after one or more operations, these rates increased to 53 simple RDs (95 %) and 110 complex RDs (87 %). For all RDs with an anatomically successful result, we observed a visual improvement≥2 lines in 45 % of cases and a postoperative BCVA≥5/10 in 40 % of cases. CONCLUSION: This study confirms the evolution toward vitrectomy surgery for retinal detachment. It finds anatomical and functional results consistent with the literature, with a percentage of approximately 5 % of RDs still not reattached in spite of several operations.

[One step surgery for severe African endocrine exophtalmia: clinical case]. / Chirurgie en un temps d'une exophtalmie basedowienne africaine sévère: présentation d'un cas clinique.

INTRODUCTION: The association hyperthyroidism-exophtalmia is pathognomonic of the Graves disease. Classically, the treatment is based on a pluridisciplinary step-by-step approach with a precise chronology. In some African places, these optimal conditions are not present. When confronted to such particular situations, it can be proposed to treat surgically at the same time the endocrine disease and the ophthalmologic complications. OBSERVATION: The authors report the case of a 42-year-old women suffering of a great thyreotoxic goiter with severe bilateral exophtalmia, treated by thyroidectomy and orbital decompression in the same session with a good result after 18 months. DISCUSSION: This non-conventional approach can be useful in particular situations when the medical environment is not optimal. It permits the radical treatment of their disease and improves the prognosis of patients with poor capacities for survey.

[Decreased visual acuity in young patients; Javal's ophthalmometer is still contributing]. / Baisse de l'acuité visuelle du sujet jeune ; l'ophtalmomètre de Javal est toujours contributif.

PURPOSE: The purpose of this study was to recall the advantages of the Javal ophthalmometer in screening keratoconus. PATIENTS AND METHODS: In three young patients with progressive visual loss, optic neuropathy was strongly suspected by their ophthalmologist despite a strictly normal neuro-ophthalmology record. The patients underwent an ophthalmic clinical examination at the Bordeaux University Hospital, which guided the paraclinical examination with corneal videotopography (Orbscan II(®), Bausch and Lomb) and the biomechanical properties of the cornea with the ocular response analyzer (ORA(®), Reichert). RESULTS: Visual acuity improved in all patients on the pinhole visual acuity test. The videotopography concluded in keratoconus in all three patients. The biomechanical parameters were abnormal. The patients were equipped successfully with hard contact lenses. CONCLUSION: Despite the latest technologies including videotopography and ORA(®), examination of the cornea with the Javal ophthalmometer remains a landmark of the eye examination and can assist in screening some keratoconus conditions and avoiding diagnostic uncertainties as well as inappropriate and expensive paraclinical examinations.

[Comparison of Lasik with femtosecond laser versus Lasik with mechanical microkeratome: predictability of flap depth, corneal biomechanical effects and optical aberrations]. / Comparaison entre le Lasik au laser femtoseconde et le Lasik au microkératome mécanique: prédictibilité des découpes, biomécanique cornéenne et aberrations optiques.

OBJECTIVES: To compare the predictability of flap thickness, high-order optic aberrations (HOAs), and biomechanical properties of cornea between patients treated by Lasik with mechanical microkeratome versus patients treated by FemtoLasik. SETTING: Department of ophthalmology, Pellegrin University Hospital, Bordeaux, France. PATIENTS AND METHODS: We conducted a retrospective study on 53 myopic patients who underwent Lasik with either mechanical microkeratome (MK group) or femtosecond laser (FS group). Refraction, central corneal thickness, high-order optic aberrations (HOAs), corneal hysteresis (CH), and corneal resistance factor (CRF), were analysed pre- and postoperatively in both groups. The central corneal thickness was measured with OCT-Visante(®) (Carl-Zeiss, Meditec), biomechanical parameters with ORA(®) (Reichert), and optical aberrations with the Wave Scan(®) (AMO) aberrometer. RESULTS: We included 44 eyes of 22 patients in the MK group and 62 eyes of 31 patients in the FS group. Preoperatively, the mean best-corrected visual acuity was 0.95 in both groups. In the MK group, the flap was significantly thicker than expected (162/130 µm), but in the FS group, there was no significant difference (117/120 µm). The biomechanical properties of the cornea were lower in both groups independently of the flap cutting technique. The HOAs increased after Lasik and were not influenced by the flap cutting technique. CONCLUSION: Neither mechanical microkeratome, nor femtosecond laser for flap creation, increases HOAs and the biomechanical changes of the cornea, according to ORA(®), significantly after Lasik.

[Comparison of the depth predictability of intra corneal ring segment implantation by mechanical versus femtosecond laser-assisted techniques using optical coherence tomography (OCT Visante(®))]. / Comparaison en tomographie en cohérence optique (OCT Visante(®)) de la prédictibilité de la profondeur d'implantation des anneaux intracornéens après tunnélisation mécanique versus tunnélisation assistée au laser femtoseconde.

UNLABELLED: Comparison of the depth predictability of intracorneal ring segment implantation by mechanical versus femtosecond laser-assisted techniques using optical coherence tomography (OCT Visante(®)). PURPOSE: To compare the depth predictability of intracorneal ring segment implantation by mechanical versus femtosecond laser-assisted techniques using OCT Visante(®). METHODS: This observational prospective study included, after patients' consent, 76 keratoconic eyes, of which 31 eyes (group 1) were operated using the mechanical technique and 45 eyes (group 2) with the femtosecond laser-assisted technique. The target depth was two-thirds of the peripheral corneal thickness, ranging from 5 to 7 mm in diameter. Every patient underwent high-resolution anterior segment OCT (OCT Visante(®)) measurement preoperatively and for the implant depth, 1 month postoperatively. Then two different sites were used to determine the segment depth, at the segment site and tangentially, at a distance of 700 µm central to the segment's inner edge. RESULTS: Both measurement techniques demonstrated that targeted implantation depth of 66% of the corneal thickness was not observed in either group. The mean difference between the preoperative expected depth and final segment implantation was 76.64 ± 48.76 µm in the manual technique and 85.85 ± 33.02 µm in the femtosecond-assisted technique, with no statistically significant difference between the groups. Comparison between the measurement sites showed implantation depth to be shallower, 54.93±6.03%, at the tangential site compared to 55.14 ± 8.08% at the implant site in group 1 and 56.17 ± 5.82% versus 58.88 ± 6.06%, respectively, in group 2. CONCLUSION: Both mechanical and femtosecond laser-assisted techniques showed a more superficial Intacs(®) placement than predicted. No statistically significant difference was observed in implantation depth between the two groups.

[Congenital anophthalmias: a case of trisomy 13]. / Anophtalmies congénitales: à propos d'un cas de trisomie 13.

Congenital anophthalmia is the result of a lack of development or regression of the primary optic vesicle in utero. It can be isolated or associated with other malformations and can be unilateral or, rarely, bilateral. Different etiologies are usually found such as chromosomal aberrations, gene mutations, toxic agents, and infections. We report a case of bilateral congenital anophthalmia in a setting of a polymalformative syndrome with microcephalia and bilateral lip cleft. Karyotype studies confirmed trisomy 13 known as Patau's syndrome. Trisomy 13 is a rare lethal chromosomal aberration frequently responsible for uni- or bilateral microphthalmia and occasionally for anophthalmia.

[Fundus albipunctatus incidentally discovered in a black African man]. / Fundus albipunctatus de découverte fortuite chez un adulte mélanoderme africain.

Fundus albipunctatus is a recessive autosomal disease classified as one of the causes of congenital stationary night blindness. It is characterized by early hemeralopia beginning in infancy. We report the incidental discovery of the disease in a 23-year-old black African man with late hemeralopia onset. During the 4 years of follow-up, visual acuity, ERG, and visual field remained normal. We underline the possibility of late hemeralopia onset and discuss the possible progressive features of this disease. Progression may be conditioned by the mutation of the RDH5 gene, which codes for retinol dehydrogenase-5.

[Mixed retinal thrombosis in a patient carrying prothrombin gene mutation in a homozygote state]. / Thrombose mixte rétinienne chez un patient porteur d'une mutation du gène de la prothrombine, à l'état homozygote.

We reported a case of a thrombosis of the retinal and central artery and vein in a 44-year-old patient, with high-grade T-cell lymphoma. Cardiovascular family history and a medical history of cerebral ischemia caused by in situ fibrinolysis, led to perform thorough hematologic and genetic examinations. These disclosed a prothrombin gene G 20210 a variant in a homozygous state. In a heterozygous state, this mutation leads to an increase in plasma prothrombin rate of the order of 30%. Therefore, it is considered to be a major risk factor for venous thrombotic disease. Otherwise, acute leukemia or non-Hodgkin's lymphoma may induce thrombosis of retinal artery and vein by means of an optic nerve infiltration, as well as beta-thalassemia, ocular trauma and retrobulbar anesthesia. Retinal central artery and vein are seldom both involved; whereas occlusions of their branches are more frequent.