[Analysis of the efficacy of early probing in the treatment of symptomatic congenital lacrimal duct obstruction in infants. Apropos of 92 cases]. / Analyse de l'efficacité du sondage précoce dans le traitement de l'obstruction congénitale des voies lacrymales symptomatique du nourrisson. A propos de 92 cases.

INTRODUCTION: Nasolacrimal duct obstruction (NLDO) is a common clinical problem (5 to 6% of newborns). Dacryostenosis is a partial or complete block in the nasolacrimal duct. PATIENTS AND METHODS: The records of 68 patients (92 cases) of NLDO with/without mucocele were reviewed. The probing was performed early and according to the same technique. RESULTS: The age at the time of probing ranged from 0 to 7 months (mean 4.6 months). The cure rate was 91.3% and the failure rate was 8.70%. DISCUSSION: Our results are consistent with other reports in the literature. The cure rate was higher with a earlier probing and was good after a second tentative of probing. A multiple obstruction of nasolacrimal system was cause of a failure. This was not the case with mucocele. The optimal timing of the probing is discussed in this report and we preferred to perform the probing to 4 at 6 months. CONCLUSION: We showed a high cure rate with early probing in our series. These results should be confirmed by a prospective randomised study (in process in our institution).

[Double irradiation for macroscopic radioresistance or recurrence of melanomas of the posterior uvea: clinical, ballistic, therapeutic and prognostic aspects. Series of 19 cases among 462 patients]. / Double irradiation pour radiorésistance macroscopique ou récidive dans les mélanomes de l'uvée postérieure: aspects cliniques, ballistiques, thérapeutiques et pronostiques: A propos de 19 cas sur 462 patients.

We describe two comparative series of patients treated with double-dose betaraysbrachytherapy (106 Ruthenium) between 1983 and 1994, and double-dose proton beam therapy between 1991 and 1996. The indications for double-dose irradiation with the same radio-element corresponded to "macroscopically abnormal" situations: immediate and prolonged radioresistance, recurrence or secondary radioresistance. Thirteen cases are called series 1 (Ruthenium) and 6 cases are called series 2 (protons). The series 1 allows a more reliable study as far as follow-up is higher (5.8 to 7.5 years) than in series 2 where the follow-up is shorter (13.6 to 29 months). Although double-dose irradiation was macroscopically efficient in 11 out of 13 cases in series 1, and in 3 out of 6 cases in series 2 (stabilization or decrease of tumour height measured before the second therapeutic session), 2 patients are deceased and 1 has a metastatic disease in the group "recurrence" of Ruthenium serie. Another one has also a metastatic disease in the group "recurrence" of protons series. Nevertheless double-dose radiotherapy allows a complementary decrease or stabilization of tumour height after a first session. It also decreases the indications for enucleation if there is no severe anatomic complications, when a tumour does not regress or recurs after a first session of radiations.

[Acute open-angle glaucoma in a woman with AS hemoglobinopathy]. / Glaucome aigu à angle ouvert chez une femme porteuse d'une hémoglobinopathie AS.

A 64-year-old black woman presented unilateral acute ocular hypertension. Gonioscopy showed a blood clot obstructing Schlemm's canal. Intraocular pressure returned to normal values after resorption of the blood clot. Hemoglobin electrophoresis found a sickle-cell trait, raising the hypothesis that the obstruction of outflow was probably due to the mechanism of sickling.