[Retrocorneal pigmentary dispersion in patients with anterior chamber pseudophakia and endothelial loss]. / Dispersion pigmentaire rétro-cornéenne chez les pseudophaques de chambre antérieure et déperdition endothéliale.

The causes of late postoperative corneal endothelial decompensation in pseudophakic anterior chamber eyes with well placed intraocular lenses are not clear. The authors measured the degree of retrocorneal pigment dispersion and endothelial cell loss during six months, in a series of 27 anterior chamber pseudophakic eyes, operated more than one year ago, using a Konan wide-field specular microscope. A significant correlation was found between retrocorneal pigment dispersion and endothelial cell loss. A possible mechanism of this correlation is discussed: the retrocorneal pigment dispersion could be associated with rupture of the blood aqueous barrier. This rupture might be responsible for chronic low grade endothelitis. In current practice, retrocorneal pigment dispersion in anterior chamber pseudophakic eyes is an indication for half-yearly follow-up with specular microscopy, which may lead to an explantation of the anterior chamber lens.

[Myopia and cataract]. / Myopie et cataracte.

Myopia and cataracts are frequently associated: a cataract may lead to index myopia; high myopia is complicated by the frequent and early development of cataracts. In this case, given the retinal fragility, there are problems in operating techniques and indication. Extra-capsular extraction with in-the-bag implantation is the safest technique. A lens implant of well-calculated strength can best correct a preexistent myopia. The refractive goal varies according to the patient's age and activity. Intra and postoperative complications are rarer than expected with such abnormal eyes. A useful visual acuity can be obtained in 90% of the cases.

[Retinal detachment in pseudophakic patients. Apropos of 39 cases]. / Décollement de rétine du pseudophake--A propos de 39 cas.

Pseudophakic Retinal Detachment (PRD) is of major concern, because since 1981, the number of patients receiving implants per year has been higher than that not implanted in the United States. Recently, the number of PRD has exceeded that of Aphakic Retinal Detachment (A.R.D.). This has been observed over the last two years in our unit. We report on 39 cases treated in the unit of Pr METGE between April 1986 and April 1988; P.R.D. characteristics, surgical procedures and anatomic results are presented. We have distinguished 4 types of P.R.D. Differences in prognosis may be imputed to the larger number of undetected tears and the more advanced vitreo-retinal proliferation in PRD as compared with A.R.D. Surgical procedures in PRD are identical with those of A.R.D., and implant may be maintained. Reinterventions, vitrectomy, and internal tamponnement are more frequently needed. The best prognosis observed in our patients occurred for PRD following ECCE + posterior chamber lens without peroperatory complications.

Establishment and characterization of human ocular melanoma cell lines.

Five continuous cell lines have been established from 29 ocular melanomas and maintained for periods ranging from 3 to 9 years in medium identical to that in which 3 concomitantly studied lines of cutaneous melanoma cells were cultured as controls. The long-term problems to be overcome in establishing uveal cell lines are related to cell-doubling times which ranged from 72 to 432 hr, and plating efficiency, which ranged from 0.5%-6.5%. Tumors and cell lines were found to contain melanosomes. The morphology of uveal cells during the early subcultures exhibited multiple changes. Two different established cell lines were obtained from one ciliary-body tumor. Biochemical studies revealed markers of melanogenesis and neuroendocrine compounds. Cytogenetic studies revealed chromosomal abnormalities that differed between uveal and conjunctival melanomas.

[Keratoplasty à chaud: preliminary study]. / Kératoplasties à chaud: étude préliminaire.

The purpose of this paper is to review causes and follow up of 16 patients who have had a keratoplasty "à chaud" for corneal ulceration, perforation, or reviving chronically abscess, with a 9 years follow-up for a first group, and 8 months for the second. In 58%, the graft remained clear, and in 16%, the acuity was 4 to 6/10 degrees. Keratoplasty "à chaud" seems to be the most efficient method for treatment of inflammation, the most radical to restore the integrity of the eye, and can give oftentimes an accurate optical result.

[Ocular implantation and exfoliative syndrome]. / Implantation oculaire et syndrome exfoliatif.

Operative difficulties and post operative complications after posterior chamber lens implantation are described in 27 eyes with exfoliation syndrome, 8 simple exfoliation syndromes and 19 capsular glaucoma. 14 eyes were operated on by extracapsular extraction and posterior chamber lens implantation in the capsular bag; 13 eyes had extracapsular cataract implantation combined with trabeculectomy. Operative difficulties were due to bad mydriasis and zonular laxity. There was no zonular dialysis. Post-operative visual acuity was between 20/40 and 20/20 in 70% of the cases. There was nos lens luxation. Intercapsular implantation is possible without great risk. The risk of zonular rupture occurs principally during extracapsular extraction. Implants 4 to 12 times Lighter than a cataract human lens do not seem to be dangerous when there is no peroperative zonular rupture.

[Galand disk implant and pupillary block]. / Implant disque de Galand et bloc pupillaire.

We have implanted 530 Galand's disc lens in the last 15 months. Stability and self-centering of implant were good when peroperative vitreous pressure was normal and in any case when wound was closed. Pupillary blocks, specific complications of this lens were rare (less than 1%); they can be prevented occurred by simple and adequate protocols.

[The value of inferior trabeculectomy in combined cataract-glaucoma surgery. Apropos of 54 cases]. / Intérêt d'une filtrante inférieure dans les interventions combinées cataracte-glaucome. A propos de 54 cas.

In 54 consecutive cases of glaucoma triple procedure, a trabeculectomy was systematically performed at six o'clock. By separating the order and the locations of the incisions as well as their placement in limbo-corneal sites, haemorrhages are minimized. A watertight, controlled running suture avoids post-operative flat anterior chamber, and permits rapid tonometric normalisation. The results of these first cases are: a mean post-operative ocular pressure (O.P.): 15.1 mmHg, mean drop of O.P.: 36%; tonometric normalisation and visual-functional improvement above 90%.

[Implantation in severe myopia cataract]. / Implantation pour cataracte chez le grand myope.

Based upon biometric and statistical analysis of 163 eyes (26 mm or longer), it appears that high myopia cataract occur all the earlier as the eye is long; on average, these were operated on ten years earlier than cataracts in the general population. Extra-capsular extraction and intercapsular implantation were generally used. Pre and post-operative complications are remarkably rare for such abnormal eyes. After a mean period of 22 months, detachment of the retina was observed in 1.84% of patients and secondary capsulotomy performed in 8%. Because they prevent secondary capsular opacification and anterior vitreous propagation, it appears that such barrier-type implants should be systematically placed. Current large-diameter implants allow for vitreoretinal observation. Based upon this patient population, a formula for implant power calculation specific to high myopia has been elaborated. The desired degree of refraction varies with age and patient activity.

[Value of qualitative keratometry for the correction of postoperative astigmatism]. / Valeur de la kératométrie qualitative pour la correction de l'astigmatisme post-opératoire.

The use of a per operative qualitative Keratometer is of interest in prevention of astigmatism in cataract extraction. Our study, which included two groups of forty patients each, demonstrated that the Karickhoff Keratometer can markedly decrease the degree of immediate post-operative astigmatism = gain of 2.38 delta in comparison with the control group and astigmatism less than or equal to 2 in 35% of the cases.

[Endophthalmia of pseudophakic patients]. / Endophtalmies du pseudophake.

After the era of antibiotics, a real improvement has been stated in the percentage of endophthalmis following cataract surgery which has fallen from 1% between 1950 and 1977, to 0.2-0.3% now. Since 10 lenses have been implanted, the incidence of acute bacterial endophthalmitis due to pathogenic organisms has not increased. But we now encounter many cases of "cold endophthalmitis", with a lowered symptomatology, a delayed onset, and which are due to organisms of low virulence. Their prognosis can be improved by early vitrectomy combined to intraocular antibiotics in the more severe cases, and by using antibiotics of high intraocular penetration in the milder cases. We report fifteen cases of pseudophakic endophthalmitis. The clinical course was acute in one case, sub acute in eleven cases, and chronic in three cases. In the latter fourteen cases a vitrectomy was performed in 60% of the cases. Aqueous and vitreous taps have found cocci gram + in five cases. Visual results are superior to 1/20 in 2/3 of the cases.