[Rhegmatogenous retinal detachment: Topography of breaks and agreement with lincoff's rules]. / Décollement de rétine rhegmatogène : topographie des déhiscences et conformité aux lois de Lincoff.

PURPOSE: To study the topography of retinal breaks and their agreement with Lincoff's rules. MATERIALS AND METHODS: We performed a retrospective descriptive study of patients with recent rhegmatogenous retinal detachments followed on the ophthalmology service of Abass Ndao Hospital from January 2006 through December 2016. Patients with no prior retinal treatment were included. RESULTS: Over 11 years, we reviewed 97 patients with 107 eyes with retinal detachments. The mean age of our patients was 51.7 years, range 23-79 years. There were 69 male patients, for a male:female ratio of 2.46. Refraction revealed that 38.1% of patients were myopes. Fourteen percent (14%) of patients had experienced trauma to the eye with the detachment. The right eye was involved in 54.6% of patients. The onset was insidious in 54.6% of cases and sudden in 23.7% of cases. All patients had decreased visual acuity, associated with a scotoma in 26.8% of cases. Visual acuity was decreased to light perception through 7/10. In 64.9% of cases, Lincoff's rules were observed. DISCUSSION: Lincoff's rules are still relevant for localization of the breaks in retinal detachments. CONCLUSION: Diagnosis of a retinal detachment is an essential step, since it determines the treatment. Lincoff's rules still have a role in finding the retinal break in retinal detachments.

[Role of CT in diagnosis and monitoring of retinoblastoma in Senegal]. / Apport de la TDM dans le diagnostic et le suivi du retinoblastome au Sénégal.

INTRODUCTION: Retinoblastoma is a malignant tumor of neuroepithelial origin, developed from young retinal cells, occurring in infants and young children. The goal of the study was to assess the role of CT in the diagnosis of retinoblastoma at the Aristide le Dantec Hospital in Dakar. PATIENTS AND METHODS: This is an 11-year retrospective study of 160 patient records in the ophthalmology department and pediatric oncology unit of the same hospital. RESULTS: One hundred and sixty (160) patients were recruited. The male:female ratio was 1.05. The mean age was 32.19 months. Leukocoria was the most common clinical sign, occurring in 105 cases (65.62 %). The retinoblastoma was intraocular in 97 cases (60.62 %). We saw 122 (76.25 %) unilateral and 3 (1.87 %) trilateral presentations. CT was performed in 150 children with 110 cases (73.33 %) of calcifications ; 62 cases (41.33 %) of optic nerve invasion ; 24 cases (16 %) of extraocular muscle invasion and 18 cases (12 %) endocranial extension. Associated tumors were found on CT: 2 cases of suprasellar mass and 1 case of pineoblastoma. In patients whose specimens were analyzed, histology showed 48.15 % optic nerve invasion, consistent with the CT findings. DISCUSSION: CT has an important role in the diagnosis of retinoblastoma, despite its recent contraindication in bilateral and unilateral multinodular forms. CONCLUSION: CT is a good alternative to MRI in the diagnosis of retinoblastoma in developing countries with limited technological resources.

[Ametropia among senegalese children in a hospital setting]. / Amétropie de l'enfant sénégalais en milieu hospitalier.

INTRODUCTION: Ametropia is common in children and cause strabismus and amblyopia. The goal was to establish its prevalence in a hospital setting among Senegalese children. PATIENTS AND METHODS: This was a retrospective study of patients under 15 years of age with clear ocular media. The marital status, circumstances of discovery, and results of cycloplegic refraction were recorded. RESULTS: Of 1506 children, 175 demonstrated ametropia. The mean age was 8 years, and the male : female ratio was 0.68. Family history of ametropia was present in 8.5 %. Decreased VA was present in 39.66 %, headache 10.06 %, and strabismus 4.47 %. Automated refraction in 109 patients and skiascopy in one patient showed 58.18 % cases of myopia, 18.18 % of hyperopia and 36.57 % of astigmatism. DISCUSSION: The most common ametropia was myopia. Patients were referred for symptomatic ametropia. CONCLUSION: Screening for ametropia might occur earlier if it is associated with pediatric monitoring in our regions.

[Giant retinal tears: Senegalese experience]. / Aspect thérapeutique des déchirures géantes de la rétine : expérience sénégalaise.

PURPOSE: To appreciate the epidemiological characteristics and to show the therapeutic aspects of the giant retinal tears. PATIENTS AND METHODS: We conducted a retrospective study from January 2014 to June 2017 on subjects with giant retinal tears. Patients with media opacities limiting examination were excluded. RESULTS: We identified 17 cases of giant retinal tears. The frequency of detachments related to a giant retinal tear was 17% compared to all retinal tears. The mean age was 50.75 years with a sex ratio (M/F) of 6.5. We found three cases of high myopia, one case of hyperopia and four trauma cases. All patients had a decrease in visual acuity. The average time to consultation was four weeks. The mean intraocular pressure was 8mmHg. The tear was found in the left eye in eight cases and in the right eye in five cases; two cases were bilateral. We performed intraocular surgery in five eyes and laser in four eyes. We achieved anatomical reattachment and functional improvement in all operated patients. COMMENTS AND CONCLUSION: The prognosis of a giant retinal tear remains guarded, especially if patients are seen and treated late. Laser photocoagulation of giant tears remains effective, especially in cases of early diagnosis.

[Evaluation of mean macular thickness by optical coherence tomography (SD OCT) in black Senegalese subjects]. / Évaluation de l'épaisseur maculaire moyenne par la tomographie en cohérence optique (SD OCT) chez le sujet mélanoderme sénégalais.

INTRODUCTION: Our goal was to evaluate the normal macular thickness in Blacks by OCT and to determine socio-demographic and clinical parameters which may influence it. MATERIALS AND METHODS: This was a multicenter, prospective, descriptive study over 6 months. It included Black adults followed in the ophthalmology departments of Abass Ndao and Aristide-Le-Dantec hospitals in Dakar. Included subjects had corrected visual acuity of 10/10 (0 logMAR) and P2 (+0.1 logMAR), clear ocular media, and no retinal abnormalities. We used the Topcon 3D 2000 OCT to measure the central thicknesses of the cornea (CT) and of the macula (MT), and cup to disc ratio (C/D) in each eye. Socio-demographic, clinical and tomographic data were collected on a survey form and correlated to the MT. The analysis was carried out by the Epi info 7 software. We used the Chi2 comparison test with a P value˂0.05. RESULTS: One hundred and nine patients were included. The mean age was 27.39 years with a male/female ratio of 0.65. The subjects were emmetropic in 54.13% of cases. The mean CT was 519.97µm, the mean C/D was 0.23, and the mean MT was 264.35µm. The P-value (P) was greater than or equal to 0.1 for all the factors studied. CONCLUSION: MT in our study was lower than that of Whites, and the various parameters studied did not demonstrate a statistically significant influence on MT.

[Perception of ocular blinding manifestations of sickle cell disease by practitioners in Dakar university hospital]. / Perception des lésions oculaires cécitantes de la drépanocytose par les praticiens hospitalo-universitaire de Dakar.

INTRODUCTION: In Senegal, 10% of the population are said to be carriers of hemoglobin S, the most widespread hemoglobinopathy in the world. It is responsible for potentially blinding ophthalmological manifestations. Few practitioners refer patients for ophthalmologic screening. The goal of our study was to assess the level of knowledge of practitioners of the blinding ocular lesions of sickle cell disease. MATERIALS AND METHODS: A cross-sectional prospective study was carried out over five months. It included Dakar university hospital practitioners aside from ophthalmologists. On the survey form, each practitioner specified his or her specialty and responded to eight questions regarding sickle cell patients seen in consultation, knowledge of the blinding lesions related to the disease, and ocular monitoring for blinding systemic diseases. The practitioners were divided into three groups: department of medicine and medical specialties (group I), surgery and surgical specialties (group II), and biology and functional testing (group III). The descriptive analysis was done with the EPI-INFO software version 6.04. RESULTS: The participation rate was 45.88%. Group I represented 45.29% of the sample, Group II 35.85% and Group III 18.86%. In all, 87.73% of practitioners saw sickle cell patients in consultation, 75.47% were aware of ocular involvement related to sickle cell disease, and 58.49% were aware of blinding lesions. 94.62% of practitioners saw sickle cell disease patients without systematically recommending ophthalmological consultation. CONCLUSION: Practitioners' level of knowledge of the blinding ocular lesions of sickle cell disease is considered to be low.

[Patients' quality of life after cataract surgery]. / Qualité de vie des patients après chirurgie de la cataracte.

INTRODUCTION: Our goal is to assess the Quality of Life (QL) of our patients after cataract surgery. MATERIALS AND METHODS: We performed a multicenter prospective study from July 2012 to December 2013 including patients undergoing cataract surgery, aged 18 and older. A survey sheet with sociodemographic data, clinical data and QL survey (VF-14) was given to each patient after surgery at day 7 (D7), one month (M1) and two months (M2) postoperatively. The final score was obtained by the following formula: QL=V (%)=(F __/__ C)×25. The data analysis was performed using SPSS software. RESULTS: A total of 100 patients were included, 56 men, and 61 years was the mean age. The mean QL score was 29.86% at D7, 73.97% at M1 and 81.21% at M2. Subjects between 18 and 30 years of age had a score of 90.15% vs. 82.52% at M2 for older patients. After optical correction, the quality of life scores increased from 83.22% at D7 to 93.18% at M2. Patients who did not have functional signs had a QL score of 83.94%. Anxious patients had a QL score of 44% at D7, 61.23% at M1 and 52.67% at M2. CONCLUSION: Good surgical outcomes require, in addition to clinical success, good quality of life. Several factors may influence this quality of life.

[Rare causes of childhood leukocoria]. / Les causes rares de leucocorie chez l'enfant.

PURPOSE: The purpose was to record the causes of leukocoria among children under 10years of age and to determine the proportion of rare causes of leukocoria. PATIENTS AND METHODS: This retrospective study was conducted over a period of ten years, from January 1, 2004 to December 31, 2013, in patients under 10years of age who were referred for leukocoria. RESULTS: Leukocoria represented one of the ten reasons for consultation among children under 10years of age. The mean age of our patients was 42.5months. In 76 % of cases, the leukocoria patients were children under 6years of age. Male patients were affected more commonly, with a sex-ratio of 1.5. Patients coming from Dakar and its suburbs represented two thirds of the total. Bilateral involvement represented 53.7 % of the total. Cataracts were responsible for 74.3 % of cases, retinoblastoma 20.58 %, retinal detachment 0.96 %, retinopathy of prematurity 0.96 %, pupillary membrane persistence 0.96 %, persistent hyperplastic primary vitreous 0.64 %, endophthalmitis 0.64 %, optic nerve coloboma 0.32 %, iris heterochromia 0.32 % and ametropia 0.32 %. DISCUSSION: The total percentage of rare causes was 5.12 % in our study, including one case of hyperopia. These etiologies, although rare, do exist. CONCLUSION: Rare causes of leukocoria require special attention. The discovery of leukocoria necessitates rigorous etiological work-up. Ametropia must be a diagnosis of exclusion.

[Senegalese experience with acute viral conjunctivitis]. / Expérience sénégalaise des conjonctivites virales aiguës.

PURPOSE: To study the epidemiological and clinical aspects of acute enteroviral and adenoviral conjunctivitis. PATIENTS AND METHODS: A prospective study was conducted between January 1st and October 31st, 2015, jointly between two Ophthalmology services and a virology laboratory, which identified 51 patients. Were included all patients who presented a painful red eye without loss of visual acuity associated with secretions,evolving for less than 4weeks RESULTS: The mean age was 32 years, and the sex ratio 1:1. Over half of our patients (61%) came from populous districts. A history of the virus "going around" was reported by 30 patients (59% of cases). Virological testing was positive in 35 patients (68.7% of cases). Over 90% of samples collected during the first week of clinical signs were positive. CONCLUSION: Viral conjunctivitis is a contagious condition, the spread of which is favored by promiscuity. Adenovirus and enterovirus are the main causative agents. They are present on an endemic scale in Senegal; thus, the need for better epidemiological surveillance in order to limit spread.

[Isolated microspherophakia in a Senegalese family]. / Microsphérophakie isolée dans une famille sénégalaise.

PURPOSE: To report the clinical investigation of isolated microspherophakia involving a Senegalese family in order to appreciate its functional impact. OBSERVATIONS: This is a rural family comprised of 7 members. The sibship included three girls and two boys. One of the girls, who lived in a distant zone, was unable to be examined. Of all the examined members of the family, only the father was unaffected by the illness. There was no consanguinity. The general medical examination was normal. The best-corrected visual acuity (VA) for the girls was 2/10. For one of the boys, BCVA was 8/10 for both eyes, and for the other, BCVA was 10/10 for the right eye and 8/10 for the left eye. The mother's VA was 10/10 and P2 without correction. Myopia and astigmatism were present in the 4 children of the sibship. During the examination, we noted the presence of small crystalline lenses, which were very round and presented an abnormal visibility of the lens equator and zonular fibers. The diagnosis of microspherophakia was confirmed by measurement of the lens diameters by ultrasound biomicroscopy. Complications were present in the girls, including pupillary block glaucoma and amblyopia for the elder, and retinal degeneration and amblyopia for the younger daughter. The elder daughter was managed medically with glaucoma drops. The younger daughter received optical correction and a prophylactic Argon LASER treatment. The two boys received optical correction. No treatment was recommended for the mother. CONCLUSION: Microspherophakia is a rare condition. Some serious complications can lead to amblyopia. A better multidisciplinary evaluation would allow for early detection and a better prognosis.

[Objective refraction in black children: cyclopentolate and tropicamide combination, a reliable alternative to atropine?]. / Réfraction objective chez l'enfant mélanoderme: l'association cyclopentolate et tropicamide, une alternative fiable à l'atropine ?

INTRODUCTION: Cycloplegia allows for an objective refraction in children. Atropine is the gold standard but causes prolonged blurred vision. Cyclopentolate is less effective but less disabling. Tropicamide is a weak cycloplegic. The purpose of this study was to evaluate a cyclopentolate and tropicamide combination (CTA) versus atropine for refraction in black children. MATERIALS AND METHODS: We performed a prospective study between October 2011 and July 2012 on all children seen in consultation. Objective refraction was performed after cycloplegia with cyclopentolate 0.5% combined with tropicamide 0.5%, and then after cycloplegia with atropine. RESULTS: Thirty-three patients were recruited, 14 boys and 19 girls. The average age was 9.9 years. The mean age of the patients was 9.9 years. Astigmatism was found in 96.9% of cases. It was 1.34±1.32 diopters with CTA and 1.35±1.22 diopters with atropine. The mean axis was 98.15 and 99.8, respectively. Hyperopia and myopia were found in 39 and 27 eyes, respectively with ACT (average 1.73 and 5.37 diopters), and in 41 and 19 eyes with atropine (average 2.06 and 6.11 diopters). DISCUSSION: There is a good correlation of results with regards to cylindrical and spherical refractive error between the two protocols. Atropine is the best cycloplegic, however ACT provides reliable results. CONCLUSION: The cyclopentolate-tropicamide combination is satisfactory for routine cycloplegia in children.

[Clinical and angiographical findings of age-related macular degeneration in Senegal. Preliminary results]. / Aspects cliniques et angiofluorographiques de la degenerescence maculaire liee a l'age au Senegal. Résultats préliminaires.

INTRODUCTION: Principal cause of legal blindness in industrialized countries, age-related macular degeneration (ARMD) have never been studied in West Africa. We report and analyse the clinical and angiographical characteristics of macular degeneration in our patients older than 50 years. MATERIAL AND METHODS: In this prospective study, we recruited during 13 months all patients presenting ARMD signs from our consultation department. Various clinic and angiography parameters were collected. The follow up varied between 6 and 20 months. RESULTS: The prevalence of this pathology was of 6.5 per 1000. Sex ratio was 0.36 and mean age 61.6 years (53 to 80 years). No familial history of ARMD was found. Three patients were more exposed to sun because of their profession, 9 had high blood pressure, 6 were hyperopes and 1 was smoking. A drop of visual acuity was noted in all cases but no metamorphopsies. Signs founded were miliar drusen (20 eyes), serous drusen (4 eyes), association of those two kinds (4 eyes) and retinal pigmented epithelium abnormalities (PE) (8 eyes) alone or associated with drusen. These signs were significant of age-related maculopathy (ARM). The fluorescein angiography confirmed the type of lesions and showed no signs of neovascularization. An aggravation of the pigment migration was noted in one case after 20 months. CONCLUSION: Age related macular degeneration doesn't seem frequent in our population of patients and shows essentially under its initial form of ARM even though facilitating factors seemed identical, excepted tobacco addiction, sun exposition and systemic hypertension. This study which short terms results we are presenting would need to be continue to give more precisions on those data.

[Local anesthesia in children's ocular surgery]. / Anesthésie loco-régionale dans la chirurgie oculaire de l'enfant.

PURPOSE: Present a Senegalese experience of local anesthesia in children's ocular surgery. PATIENTS AND METHODS: We conducted a retrospective study on 309 patients under 15 years of age, operated on in our department from June 1998 to December 2002. The type of anesthesia, general or local, was noted. The latter consisted in a retrobulbar and/or a peribulbar injection, with 4 ml of 50% of lidocaine 2% and bupivacaine mixture. RESULTS: Local anesthesia was given to 38.8% of patients, who had a mean age of 11.51 years, with a sex ratio of 2.4. The mean age of patients operated on with general anesthesia was 4.6 years. No complications were noted in the local anesthesia group. One operation was postponed because of lack of cooperation. In this group of operated patients, 62.5% had a cataract surgery, 16.7% a corneal laceration suture, and 10.0% mutilating surgery. COMMENTS: Because of our working conditions, local anesthesia, more than a choice, is almost obligatory. Our study shows that local anesthesia in children's ocular surgery has many advantages and few disadvantages. However, this study is limited because of a lack of information on the anesthesia and postoperative reactions. A prospective study based on a questionnaire completed by the anesthesiologist and the surgeon at the end of surgery will be necessary. CONCLUSION: Ocular surgery under local anesthesia is possible in children as young as 10 years of age. Good psychological preparation of the patient and the presence of the parents, from the consulting room to operating room, are required.

[Aniridia: five case studies]. / L'aniridie: à propos de cinq observations.

INTRODUCTION: Aniridia, or congenital absence of the iris, is a rare and severe ocular abnormality. We report five cases diagnosed in our department over the last 5 years and describe our clinical findings and attitude. OBSERVATIONS: The patients were two adults and three children, 8-45 years old at the time of diagnosis. Visual acuity ranged from light perception to 20/50. Aniridia was associated with other abnormalities in four cases: lens ectopy in one case, ptosis in three cases, microcornea in one case, macular hypoplasia in three cases and a pterygium coli associated with a pectus excavatum in one case. All patients had complications: corneal dystrophy in three cases, lens opacities in five cases, elevated intraocular pressure (IOP) in two cases, severe amblyopia with nystagmus or strabismus in three cases. Only patients with glaucoma received IOP-lowering medications. IOP was normalized in both cases and regular controls were instituted for all the other patients. DISCUSSION: Management of aniridia is complex in our regions because patients often consult late, at a stage that involves complications and amblyopia. First-intention surgical treatment of glaucoma is not always justified. CONCLUSION: Only genetic counseling, a close follow-up after an early diagnosis and adapted surgical techniques can improve the visual prognosis of aniridia patients.

[Senegalese experience of orbital cellulitis]. / Une expérience sénégalaise des cellulites orbitaires.

AIM: To show the etiological, clinical, and epidemiological aspects of orbital cellulitis at the ophthalmological clinic of A. le Dantec hospital. PATIENTS AND METHOD: This is a retrospective study conducted from January 1994 to October 2003. Sixty-eight patient records were used. We noted patients' civil status, past medical history, clinical and paraclinical examinations, treatment received before and at admission to the clinic, and progression. RESULTS: The incidence of orbital cellulitis was 8.9 cases per year. The average age of patients was 18 years and the sex ratio 2.78 in favor of males. Patients were hospitalized for a mean of 11 days. The fever was often stopped at admission. All patients had violent retrobulbar pain, associated with inflammatory exophthalmos in 77.8% of cases, and ophthalmoplegia in 67.2%. Two cases of diplopia were noted; 57.5% had sinusitis. Streptococcus was the bacterium found most frequently. In hospital, all patients received three antibiotics (ampicillin, aminoglycoside, metronidazole) and prednisone. In 51.5% of the cases, surgical treatment was necessary. Progression was favorable in 55.88% of the cases. Three patients died and 18 cases of blindness were noted. CONCLUSION: Orbital cellulitis is a young people's disorder with serious complications. This medical emergency requires a combination of effective antibiotics and a corticosteroid. Treating the source of infections is essential to avoid recurrence. In our practice, these three drugs in association in first intention was beneficial without an antibiogram.

[Compliance of medical treatment in primitive glaucoma open angle]. / L'observance au traitement médical dans le glaucome primitif à angle ouvert. Résultats préliminaires.

INTRODUCTION: Compliance to medical treatment expresses the patient's perception of the disease and the treatment prescribed by the doctors. Lack of compliance endangers chronic glaucoma care, which explains the importance it has been given these last years. The objectives of this survey were to evaluate the compliance of adult patients suffering from primary open angle glaucoma to discover the influential factors. MATERIALS AND METHODS: We conducted a survey at the ophthalmology clinic of Le Dantec Hospital from January 1997 to May 1998 among 31 adults being treated for primary open angle glaucoma. An indirect evaluation of the patients' compliance was made on the basis of a questionnaire after examination of their medical files. It was deemed good, average, or bad depending on: regularity of the patient's visits to the doctors, regularity of the treatment, respect of the doctor's prescription and the prescribed times for taking the medicine. The Chi square independence test was used to study the influence of the following factors: age, sex, residence, socioeconomic status, duration of symptom progression, level of instruction, counseling, and treatment. RESULTS: The patients' mean age was 60.5 years. Compliance was deemed good for 29% of the total cases, average for 32.3%, and bad for 38.7%. Only factors such as the regular visits to the doctor, the regularity of the treatment, and respect of the doctor's prescription and the prescribed times for taking the medicine were found to be influential (p<0.05). CONCLUSION: The medical treatment of primary open angle glaucoma, whether temporary or permanent, with a maximum of efficacy and a minimum of side-effects requires good compliance on the part of the patient. This compliance in turn requires a good doctor-patient relationship based on effective repeated counseling to educate patients, help them understand the disease, and act on the influential factors.

[Epidemiological and angiofluorographic aspects of diabetic retinopathy in Senegal]. / Aspects épidémiologiques et angiofluorographiques de la rétinopathie diabétique au Sénégal.

PURPOSE: Attempting to improve life expectancy among diabetics reveals degenerative complications, including diabetic retinopathy (DR) linked to microangiopathy. We assessed the incidence of diabetic retinopathy in its various forms amongst diabetics in Senegal. PATIENTS AND METHODS: We carried out a survey between March and October 1998. The 51 patients surveyed had been affected for more than 5 years. They were divided into two groups: insulin-dependent diabetes (IDD) and non-insulin-dependent diabetes (NIDD). Patients were aged 17-71 and included 27 IDD and 24 NIDD. Each patient was given both a biological checkup (blood sugar level, HBA1c, creatininemy, triglycerides, cholesterol, albuminaria and urinary glucose) and an ophthalmological checkup with angiography in fluorescence. RESULTS: Of the 51 patients studied, 26 presented a progression span of the disease of over 10 years. DR was detected in 62 eyes out of 102 (60.78%), with 37.25% of nonproliferating DR, 17.65% of preproliferating DR, and 5.88% of proliferating DR. Maculopathy was detected in 10 eyes (9.80%). Amongst the IDD patients, diabetic retinopathy accounted for 57.14% of diabetes, with a progression span of less than 10 years, compared to 84.62% for diabetes with a progression span of over 10 years. Amongst the NIDD patients, diabetic retinopathy accounted for 36.36% compared to 61.54%. DISCUSSION: Through these results, a connection can be made between diabetic retinopathy, the progression span of diabetes, the type of diabetes, and the other microangiopathies. We noted a rise in retinopathy that increased with the age of diabetes patients and their IDD group. CONCLUSION: A multidisciplinary support of diabetes ensures early detection of diabetic retinopathy; hence the need for closer collaboration between the endocrinologist and the ophthalmologist.

[Frequency of retinal changes in myopia in a black population]. / Fréquence des lésions rhegmatogènes chez le myope mélanoderme.

PURPOSE: Retinal detachment is the main complication of peripheral retinal lesions in myopia but seems rare in black people. We analysed peripheral retinal changes in myopia in a black population. MATERIAL AND METHODS: This study was conducted by a single ophthalmologist. The tests included a refraction, a retinal biomicroscopy (with a Volk lens and a 3-mirror Goldmann lens) and an indirect ophthalmoscopy. The results were compared by a chi square test. RESULTS: 50 people (100 eyes) were available for examination. The mean age was 28.21 years, the two extremes being at 11 and 54 years, with 68% females and 32% males. In 50 eyes the spheric equivalent was between -1 and -5.75 diopters (group I). In 50 eyes the spheric equivalent was greater than or equal to -6 diopters (group II). Snow was found in 16% of cases in group I and 34% of cases in group II (p = 0.0366). Tears were found in 2% of cases in group I and 12% of cases in group II (p = 0.116). Lattice degeneration was found only in group II. CONCLUSION: Retinal tear frequency was similar to the results of other authors. Comparative studies are necessary to evaluate the risk of retinal detachment in black populations.

[Contribution of the Kansas technique for reducing complications of mature cataract surgery]. / Apport de la technique de Kansas dans la réduction des complications de la chirurgie des cataractes mûres.

PURPOSE: We report our experience with the Kansas technique of phakosection which eliminates or limits most complications of classic manual extracapsular extraction. PATIENTS AND METHODS: This retrospective study included our first 80 patients undergoing surgery for mature cataract between May 1996 and May 1998 where we used the Kansas technique. We compared outcome with a group of 30 patients who underwent classic manual extracapsular extraction in a study performed in 1995 by the same surgeon in the same hospital. RESULTS: Per- and post-operative complications were significantly lower with phakosection. Functional rehabilitation was quicker, better and provided better patient comfort. DISCUSSION: Despite some difficulties encountered in a public hospital (viscoelastic excessively fluid and in small quantity, lack of suitable knives or reuse of sterilized disposable knives), we found that the Kansas technique is very well adapted to mature cataracts and our working conditions. CONCLUSION: Phakosection allowed us to give our patients with mature or very mature cataracts the benefit of small incisions. With a moderate increase in cost, this technique significantly reduced our per- and post-operative complication rates and gave quicker and better visual recovery. In our countries, this technique provides better care than phakoemulsification.