[Phacoemulsification versus manual small incision cataract surgery: Anatomic and functional results]. / Phacoémulsification versus chirurgie de cataracte par mini incision manuelle : résultats anatomiques et fonctionnels.

PURPOSE: Prospective randomised study to compare the impact of phacoemusification (PHACO) and small incision cataract surgery (SICS) on endothelial structure (cell density and morphology) and refractive results (visual acuity, induced astigmatism). METHODS: Prospective study of 57 patients (63 eyes) over 20 months (May 2012-January 2014) undergoing surgery by 2 experienced surgeons. We included patients with senile or presenile cataracts, LOCS III class 2, 3 and 4. Patients were randomized into 2 groups based on their birth month (group 1: PHACO [33]; group 2: SICS [30]). All pre- intra- and postoperative data were collected prospectively. The minimum follow-up was 6 months. We used the SPSS 18.0 for statistical analysis. Statistical tests used included the test-t Student, the Anova test, the Mann-Witney non-parametric test and the Khi2 test. A threshold of significance was set at 0.05. RESULTS: The mean preoperative endothelial cell density was 2447.5±225 c/mm2 with no significant difference between the two groups (P=0.207). The mean percentage of hexagonality was 55.5±8.2% in groups 1 and 2. The most significant cell loss was during the first immediate postoperative period for both groups. At Day 15 postoperative, the decrease in cell loss was significant (P<0.001) with a mean loss of 312.9±208.9 c/mm2 (P<10-2). Postoperatively, the mean best-corrected visual acuity was 0.057 log MAR for all of our patients (P=0.170); no patient had an acuity ≤1/10. The mean astigmatism at the conclusion of follow-up was 1.08±0.42 D in group 1 and 1.51±0.55 D in group 2, with a significant difference (P=0.001). CONCLUSION: Both SICS and PHACO give excellent results, both anatomical and refractive. However, SICS appears to be more advantageous than PHACO in terms of speed, cost, and independence from technology, and appears to be better suited to dense cataracts and mass surgery.

[Ocular coloboma associated with cervico-oculo-acoustic syndrome]. / Colobome oculaire associé au syndrome cervico-oculo-acoustique.

INTRODUCTION: Cervico-oculo-acoustic syndrome is an uncommon syndrome consisting of Klippel Feil syndrome, deafness, and Duane syndrome. We relate a new case of cervico-oculo-acoustic syndrome. CASE REPORT: We report the case of 15-month-old girl referred for esotropia of the right eye. Ocular examination revealed type 1 Stilling Duane syndrome in the right eye, in which we also noted microcornea, iris coloboma, and papillary and inferior chorioretinal coloboma sparing the macular area. The left eye was normal. The physical examination revealed Klippel Feil syndrome characterized by an extremely short neck with limited movement, a low posterior head line and fusion of the cervical vertebrae on radiography. The association of hearing loss (due to agenesis of the external ear) with Klippel Feil syndrome and Stilling Duane syndrome confirmed the diagnosis of cervico-oculo-acoustic syndrome. CONCLUSION: This case is unique because of the association of cervico-oculo-acoustic syndrome with ocular coloboma of the right eye. This association has not been reported previously in the literature.

[Expression of intercellular adhesion molecule type 1 in the conjunctiva of diabetic patients: a preliminary study]. / Expression de la molécule d'adhésion intercellulaire de type 1 au niveau de la conjonctive des patients diabétiques: une étude préliminaire.

PURPOSE: Recent research has incriminated adhesion molecules in the pathogenesis of diabetic retinopathy. These molecules have been found to be expressed in many cells participating in inflammatory processes and neovascularization. The purpose of our investigation was to study the expression of intercellular adhesion molecule type 1 (ICAM-1) in the conjunctiva of diabetic patients without retinopathy in comparison with normal human conjunctiva. PATIENTS AND METHODS: Fifteen conjunctival biopsies were obtained from diabetic patients without retinopathy. The ocular fundus examination and retinal fluorescein angiography were normal. The normal human conjunctiva were taken from five patients undergoing senile cataract surgery. Immunohistochemical analysis consisted of indirect immunoperoxidase using the monoclonal antibody ICAM-1. RESULTS: The adhesion molecule ICAM-1 was immunolocalized in epithelial, vascular endothelial, and inflammatory cells. The expression of this molecule was different in diabetic patients for the same duration. In the normal human conjunctiva, the expression of ICAM-1 was very low. CONCLUSION: This preliminary study shows that ICAM-1 is present in the conjunctiva of diabetic patients without retinopathy and thus may add new insights into the pathogenesis of diabetic retinopathy.

[Analysis of optic nerve head by confocal scanning laser ophthalmoscope in ocular hypertension]. / Analyse de la topographie de la tête du nerf optique par l'ophtalmoscope laser à balayage confocal dans les hypertonies oculaires.

PURPOSE: To analyze optic nerve head topography using confocal the scanning laser ophthalmoscope (CSLO) in ocular hypertension in comparison to normal eyes. PATIENTS AND METHODS: We examined 25 patients with ocular hypertension and 27 normal controls. All of them had a complete ophthalmic examination. Optic nerve head analysis was performed by using a CSLO-type Heidelberg retina tomograph (HRT). The following stereometric parameters were evaluated: disc area, area and volume of cup, cup/disc ratio, area and volume of neuroretinal rim, mean and maximal cup depth, cup shape measure, height variation contour, mean retinal nerve fiber layer thickness, and retinal nerve fiber layer (RNFL) cross-section area. RESULTS: In ocular hypertension eyes, rim volume, height variation contour and RNFL thickness showed a statistically significant reduction compared to normal eyes. CONCLUSION: HRT appears to be an important tool in detecting early damage of retinal nerve fiber layer in ocular hypertension.