[Blepharoplasty]. / La blépharoplastie.

INTRODUCTION: We report a study of satisfaction index of 50 patients operated of blepharoplasty without complications. MATERIAL AND METHODS: After a reminder of the anatomy of ageing palpebral and periorbital area, we describe the surgical techniques used to carry out the interventions according to the preoperative cosmetic assessment. The material used is the CO2 laser in continuous mode or the radio frequency in cut-coagulation mode. RESULTS: In 88% of cases, the results correspond to aesthetic expectations of the patients. Other criteria of satisfaction are detailed (treatment of the associated wrinkles, fear of changing of the glance). CONCLUSION: The plastic surgery of the eyelids and the glance is very valorizing for the surgeon. Patients' satisfaction and recognition are in general excellent. This is often the first step in the world of anti-age medicine and surgery.

The short-wavelength mechanisms of Stiles in age-related macular degeneration.

Clinical measurements by the increment-threshold technique of W.S. Stiles are reported in five cases of age-related macular degeneration. Measurements were made on a modified Tübingen perimeter using 1 degree, short-wavelength targets presented on a red field.

[Bilateral exophthalmos diabetes insipidus: Erdheim-Chester disease. Clinical and radiological findings]. / Exophtalmie bilatérale-diabète insipide: la maladie d'Erdheim-Chester.

The authors report a case of a 61-year-old man presenting bilateral exophthalmos and diabetes insipidus. A retro-orbital biopsy revealed nonspecific fibrocollagenic infiltration. The diagnosis of Erdheim-Chester disease was evoked when a multivisceral affection (retroperitoneal and mediastinal periaortic fibrosis) with specific bone localization became evident. The histopatholgical study of a bone biopsy showed xanthogranulomatous infiltration. The patient died a few months later of an intercurrent infection.

[Surgical follow-up and importance of information and consent on behalf of patients undergoing esthetic blepharoplasty]. / Suites opératoires et importance de l'information et du consentement éclairé des patients dans les blépharoplasties esthétiques.

INTRODUCTION: Plastic surgery of the eyelids aims to improve the cosmetic aspect while correcting either an excess of palpebral skin, or an orbital septum dehiscence with fat porf2p4on in the palpebral spaces, after evaluation of horizontal and vertical palpebral laxity. PATIENTS AND METHODS: The authors describe follow-up of upper and lower lid blepharoplasty by cutaneous and conjunctival approaches respectively, with case descriptions and a review of the literature. RESULTS: A "calendar" is made of the different phases of healings, to the final aesthetic aspect desired. DISCUSSION: The patients wishes as to technique and results of blepharoplasty must be discussed and understood. The surgeon must forewarn of eventual per and postoperative complications (hemorrhage, infection), but also the usual follow-up (hematoma, edema, scarring ...). This allows to avoid aggravation of the patients "legitimate" worrying when he/she looks in the mirror! CONCLUSION: The authors underline the importance of patient information concerning the pre and postoperative aspects of aesthetic blepharoplasty.

[Treatment of choroid melanoma by Gamma-Knife radiosurgery]. / Traitement du mélanome choroïdien par radiochirurgie Gamma-Knife.

Conservative treatment of uveal melanomas by Gamma Knife Radiosurgery is based on the use of cross fire technique with 201 Cobalt60 sources. A following of 13 months is available for the first case operated by Gamma-Knife Surgery in France. Technical baselines and one year preliminary results are reported. The diagnosis of uveal melanoma T3NOMO was established by converging results of clinical examination, angiography and echography. The definition of the target was based on stereotactic MRT examination. We delivered a dose of 50 Gys to the marginal isodose (50%). Today, one year after treatment the tumor decreased, the visual function was preserved. There were no side effect or complication.

Bilateral acute angle-closure glaucoma after dexfenfluramine treatment.

We report the case of a patient with narrow angles who had an attack of bilateral acute angle-closure glaucoma precipitated by dexfenfluramine, a serotoninergic drug developed for appetite suppression. Although the exact mechanism remains uncertain, the pupillary block observed in our case may be the result of the serotoninergic or indirect parasympatholytic properties of the drug on the iris sphincter muscle. Serotonergic psychoactive drugs should be prescribed cautiously in patients with known narrow angles and should be monitored by an ophthalmologist.