Capsule contraction after continuous curvilinear capsulorhexis: poly(methyl methacrylate) versus silicone intraocular lenses.

PURPOSE: To evaluate the progressive contraction of the anterior capsule opening after in-the-bag implantation of 2 types of intraocular lenses (IOLs). SETTING: Department of Ophthalmology, University of Brest, Brest, France. METHODS: In this prospective study, 32 single-piece poly(methyl methacrylate) (PMMA) (Pharmacia 812 C) and 30 3-piece silicone IOLs with PMMA haptics (Allergan SI-40NB) were implanted in the bag after standardized phacoemulsification performed by the same surgeon. All patients were older than 70 years, and none had zonular weakness. The surface of continuous curvilinear capsulorhexis (CCC) was measured 1, 30, and 150 days postoperatively using a 3 charge-coupled device camera and a digitized computer analysis system. RESULTS: A significant progressive constriction was observed at 150 days in 70% in the silicone group and 32% in the PMMA group. In addition, CCC contraction was greater in silicone group (P < .05). The mean surface decrease was 4.20 mm2 in the silicone group and 1.53 mm2 in the PMMA group. There was no correlation between sex, age, initial capsulorhexis area, final capsule shrinkage. In some eyes, especially in those with a single-piece PMMA IOL (41%), there was no constriction, but fine changes in the capsule opening were seen. CONCLUSION: Evolutive anterior capsulorhexis modifications were observed in all patients; however, the contraction rate was statistically higher in the silicone group. These results suggest that silicone IOL implantation should be avoided in eyes at risk for CCC constriction.

[Keratoconus, changes in corneal topography and allergy. Study of 3 groups of patients]. / Kératocône, modification de la topographie cornéenne et allergie. Etude de trois groupes de patients.

PURPOSE: To study the relation between keratoconus and atopy based on allergic prick tests, and the association of infraclinical keratoconus with atopy compared to "normal eyes". Simultaneously corneal topographic modifications have been researched to patients presenting an ocular atopy versus normal patients. MATERIAL AND METHOD: A videokeratoscope has been used for the selection of 22 keratoconic patients, 17 infraclinical keratoconic subjects and 22 patients with no ocular abnormality. Incidence of allergic phenomenon was assessed with two tests (Prick test, lacrymal total IgE dose). The videokeratoscopy was also performed in the research of corneal modifications in a group of 45 patients with an ocular atopy. RESULTS: The results of allergologic tests (positives Prick tests) showed a statistical significant difference between the keratoconus group (63.6%) and respectively the infraclinical keratoconus group (23.5%) and the normal eyes group (22.7%). No videotopographic picture of keratoconus and infraclinical keratoconus has been noted in patients with ocular atopy. CONCLUSION: Keratoconus is related to allergy. In this study, no association of allergy with infraclinical keratoconus was found. Further more, no videotopographic changes was observed in ocular allergic cases.

[Motivation of candidates for refractive surgery]. / Motivation des patients candidats à une chirurgie réfractive.

PURPOSE: To determine the profile and motivations of patients who are candidates for refractive surgery. MATERIAL: and METHODS: We studied 102 patients with low myopia (less than 6 diopters) in a single-center investigation. RESULTS: Among the total population studied, the motivation for refractive surgery was essentially comfort and appearance. Fewer men wore contact lenses than women and had worn them for a shorter period of time. Those involved in sports were more often in individual sports. Contact-lens wearers were most often students or in the paramedical professions. DISCUSSION: The population interested in refractive surgery was very young. The proportion of candidates who had never worn contact lenses was surprisingly high. CONCLUSION: This analysis suggests that patients too often consider refractive surgery as an easy option.