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Dot C, Schweitzer C, Labbe A, Lignereux F, Rozot P, Goguillot M, Bugnard F, Brezin AP. Reply. Ophthalmology 2023; 130:e43-e44. [PMID: 37737813 DOI: 10.1016/j.ophtha.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/24/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Affiliation(s)
- Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.
| | - Cédric Schweitzer
- CHU Bordeaux, Department of Ophthalmology, Univ. Bordeaux, ISPED, INSERM, U1219 - Bordeaux Population Health Research Centre, Bordeaux, France
| | - Antoine Labbe
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - François Lignereux
- Department of Ophthalmology Santé Atlantique, Nantes Polyclinic, Nantes, France
| | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
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Brézin AP, Monnet D, Lignereux F, Rozot P, Jilet L, Abdoul H. Impact of a handpiece with a built-in fluidics pressure sensor on phacoemulsification: a multicentre prospective comparative study. BMJ Open Ophthalmol 2023; 8:e001431. [PMID: 37973548 PMCID: PMC10661016 DOI: 10.1136/bmjophth-2023-001431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE We assessed whether the immediate pressure adjustments provided by a phacoemulsification handpiece with a built-in pressure sensor (Active Sentry, AS) could decrease the amount of energy delivered in the eye during cataract surgery. METHODS AND ANALYSIS The Study of Active Sentry in Cataract Surgery was a multicentre prospective clinical trial. The Centurion system (Alcon Labs) was used and we compared phacoemulsifications performed with the AS handpiece with procedures using a sensor placed in the phacoemulsifier (non-AS). The primary outcome measure was the cumulative dissipated energy (CDE) used during the procedures. The secondary outcome measures were the total, longitudinal and torsional ultrasound (US) times, the duration of the surgery and the amount of fluid used during the surgeries. RESULTS The study analysed 1432 (800 AS and 632 non-AS) procedures. The mean patient age was 72.4±10.0 years. The median CDE was respectively 6.3 (IQR 3.5-9.9) and 6.7 (IQR 4.5-11.5) with and without AS (p=0.0001). The median US time was, respectively, 48.0 s (IQR 34.0-68.0) and 55.0 s (IQR 38.0-80.0) with and without AS (p<0.0001). Torsional and longitudinal US times were reduced with AS. The median duration of the procedure was, respectively, 9.0 min (IQR 7.0-12.0) and 10.0 min (IQR 7.0-13.0) (p=0.0002) with and without AS. The median balanced salt solution volume used was 52.0 cm3 (IQR 41.0-72.0) and 57.0 cm3 (IQR 42.0-81.0) with and without AS (p=0.0018). CONCLUSION The phacoemulsifications performed with a pressure sensor built in the handpiece delivered less energy in the eye and were shorter. TRIAL REGISTRATION NUMBER NCT04732351.
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Affiliation(s)
- Antoine P Brézin
- Université Paris Cité, Ophtalmologie, Hôpital Cochin, Paris, France
| | - Dominique Monnet
- Université Paris Cité, Ophtalmologie, Hôpital Cochin, Paris, France
| | | | | | - Lea Jilet
- Université Paris Cité, URC Paris Centre, Paris, France
| | - Hendy Abdoul
- Université Paris Cité, URC Paris Centre, Paris, France
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Brézin AP, Labbe A, Schweitzer C, Lignereux F, Rozot P, Goguillot M, Bugnard F, Dot C. Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study - FreYAG1 study. BMC Ophthalmol 2023; 23:417. [PMID: 37845645 PMCID: PMC10578013 DOI: 10.1186/s12886-023-03134-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
RATIONALE Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy (Nd:YAG-caps) is the gold standard for the treatment of PCO (Posterior Capsule Opacification). There is a lack of real-world data about Nd:YAG-caps use. PURPOSE This study's objectives were to estimate Nd:YAG-caps incidence in France, to describe the patient characteristics, and to analyze the time between surgeries and capsulotomies. SETTING The study was based on data extracted from the EGB database, a 1/97th sample representative of the French population. DESIGN observational, retrospective, cohort study using national claims data. METHODS French adult patients who underwent Nd:YAG-caps between 2014 and 2017 were selected. Main outcomes were the number of patients and procedures performed and the risk factors associated with early Nd:YAG-caps. RESULTS During the study period, Nd:YAG-caps were performed in 8,425 patients accounting for 10,774 procedures. The extrapolation to the French population led to estimate that 253.103 patients had Nd:YAG-caps, representing 312.103 procedures in 2017. The mean age at Nd:YAG-caps was 75.1 (± 10.2) years. About 36% of patients presented at least one ocular comorbidity. Nd:YAG-caps was performed within 2 years after surgery in 33.0% of patients and within one year in 9.8% of patients. Patients with Nd:YAG-caps within the first year (OR CI95 0.721 [0.673-0.772]) or in the first two years (OR CI95 0.721 [0.673-0.772]) were younger than patients with later Nd:YAG-caps and had a more frequent history of treated ocular diseases (OR 1.516 and 1.178, respectively). CONCLUSIONS This study brought new real-world and large-scale data regarding Nd:YAG-caps use and gave an updated insight into the patients' characteristics.
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Affiliation(s)
- Antoine P Brézin
- Department of Ophthalmology, Université Paris Cité, Cochin Hospital, APHP, 27 rue du faubourg Saint-Jacques, Paris, 75014, France.
| | - Antoine Labbe
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Cédric Schweitzer
- Department of Ophthalmology, CHU Bordeaux, Univ. Bordeaux, ISPED, INSERM, U1219 - Bordeaux Population Health Research Centre, Bordeaux, F-33000, France
| | | | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
| | | | | | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
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Dot C, Schweitzer C, Labbé A, Lignereux F, Rozot P, Goguillot M, Bugnard F, Brézin AP. Incidence of Retinal Detachment, Macular Edema, and Ocular Hypertension after Neodymium:Yttrium-Aluminum-Garnet Capsulotomy: A Population-Based Nationwide Study-The French YAG 2 Study. Ophthalmology 2022; 130:478-487. [PMID: 36581227 DOI: 10.1016/j.ophtha.2022.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To estimate the incidence and assess the risk factors associated with 3 adverse events (AEs) after neodymium:yttrium-aluminum-garnet posterior capsulotomy (Nd:YAG-caps): ocular hypertension (OHT), macular edema (ME), and retinal detachment (RD). DESIGN Observational cohort study using a nationwide claims database. PARTICIPANTS Adults who underwent Nd:YAG-caps between 2014 and 2017, with no ocular disease history in the year before. METHODS Patients who underwent Nd:YAG-caps were identified using data from the French national representative sample and followed up for 12 months postprocedure. The time to AE was assessed using the Kaplan-Meier method. Factors associated with AE were assessed using Cox models. MAIN OUTCOME MEASURES Neodymium:YAG-caps epidemiology, patients' characteristics, proportion of patients with AE, and hazard ratios (HRs) associated with variables identified as factors associated with AEs. RESULTS During the study period, 6210 patients received Nd:YAG-caps (7958 procedures). The mean age (± standard deviation) at Nd:YAG-caps was 75.0 (± 10.3) years. The 3-month and 12-month overall AE rates (≥ 1 AE of interest) were 8.6% and 13.3%, respectively. Among patients with ≥ 1 AE of interest, 68.4% of AEs occurred within 3 months post-Nd:YAG-caps. Three-month rates were ≈5% for OHT and ME. Retinal detachment remained ≤ 0.5% over follow-up. Cox models showed that patients with Nd:YAG-caps performed within 1 year after cataract surgery had a higher risk of AEs than those with later Nd:YAG-caps (hazard ratio [HR], 1.314 [1.034-1.669], P = 0.0256), notably ME (HR, 1.500 [1.087-2.070], P = 0.0137). Diabetic patients were more at risk of OHT (HR, 1.233 [1.005-1.513], P = 0.0448) and ME (HR, 1.810 [1.446-2.266], P < 0.0001) than nondiabetic patients. Patients with Nd:YAG-caps performed between 1 and 2 years after cataract surgery were more at risk of OHT than patients with later Nd:YAG-caps (HR, 1.429 [1.185-1.723], P = 0.0002). CONCLUSIONS According to a national claims database, OHT and ME were the most frequent AEs of interest post-Nd:YAG-caps, mainly observed within 3 months postprocedure, highlighting the need for a close follow-up during this period or a delayed capsulotomy. Diabetes and an early Nd:YAG-caps after cataract surgery were among the main drivers for AE occurrence. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.
| | - Cédric Schweitzer
- CHU Bordeaux, Department of Ophthalmology, University of Bordeaux, ISPED, INSERM, U1219-Bordeaux Population Health Research Centre, Bordeaux, France
| | - Antoine Labbé
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - François Lignereux
- Department of Ophthalmology Santé Atlantique, Nantes Polyclinic, Nantes, France
| | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
| | | | | | - Antoine P Brézin
- Department of Ophthalmology, Cochin Hospital, APHP, Paris, France
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Rozot P. Consultation Section: Cataract. November consultation #2. J Cataract Refract Surg 2019; 45:1686-1687. [PMID: 31706524 DOI: 10.1016/j.jcrs.2019.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guell J, Behndig A, Pleyer U, Jaulerry S, Rozot P, Pisella PJ, Robert PY, Lanzl I, Pourjavan S, Aguiar C, Fernandez J, Grabner G, Mencucci R, Chiambaretta F, Labetoulle M. Systemic exposure to intracameral vs topical mydriatic agents: in cataract surgery. Clin Ophthalmol 2019; 13:811-819. [PMID: 31118559 PMCID: PMC6501990 DOI: 10.2147/opth.s189671] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The objective of this study was to compare systemic exposure to tropicamide/phenylephrine following intracameral or topical administration before cataract surgery. Patients and methods Mydriatics exposure was calculated in patients randomized to intracameral fixed combination of mydriatics and anesthetic ([ICMA]: tropicamide 0.02%, phenylephrine 0.31%, and lidocaine 1%, N=271) or mydriatic eye drops ([EDs]: tropicamide 0.5% and phenylephrine 10%, N=283). Additional doses were permitted if required. Mydriatic plasma levels were determined by mass spectrometric HPLC in 15 patients per group before and after administration. Results Most ICMA patients (73.6%) received a single dose (200 µL) representing an exposure to tropicamide of 0.04 mg and phenylephrine of 0.62 mg. None of these patients received additional mydriatics. In the control group (three administrations), the exposure was 0.45 (11.3-fold higher than ICMA) and 10.2 (16.5-fold higher) mg. When additional ED was used in this group (9.2% of patients), it was 37.5-fold higher for tropicamide (10 drops, 1.5 mg) and 54.8-fold higher for phenylephrine (10 drops, 34 mg) than the recommended ICMA dose. Tropicamide plasma levels were not detectable at any time point in ICMA patients while it was detectable in all ED patients at 12 and 30 minutes. Phenylephrine was detectable in 14.3% of ICMA patients compared to all ED patients at least at one time point. More ED patients experienced a meaningful increase in blood pressure and/or heart rate (11.2% vs 6.0% of ICMA patients; P=0.03). Conclusion Systemic exposure to tropicamide/phenylephrine was lower and cardiovascular (CV) effects were less frequent with ICMA. This could be of particular significance in patients at CV risk.
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Affiliation(s)
- Jose Guell
- Cornea and Refractive Surgery Unit, Instituto de Microcirugía Ocular, Barcelona, Spain,
| | - Anders Behndig
- Department of Clinical Science/Ophthalmology, Umeå University Hospital, Umeå, Sweden
| | - Uwe Pleyer
- Universitäts-Augenklinik, Charité Campus Virchow-Klinik, Berlin, Germany
| | | | | | | | | | - Ines Lanzl
- Chiemsee Augen Tagesklinik, Prien, Germany
| | | | | | | | - Gunther Grabner
- Universitätsklinik Für Augenheilkunde Und Optometrie, Der Paracelsus, Austria
| | - Rita Mencucci
- AOU Careggi, Clinica Oculistica, Università Degli Studi di Firenze, Firenze, Italy
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Abstract
This study was designed to improve the understanding of the mechanisms that govern the origin of retinal detachment (RD) by examining the quantitative composition of proteins in the subretinal fluid (SRF). Inflammation proteins and immunoglobulins (Ig) were titrated from SRF and sera in 25 patients with RD The following concentrations were found in SRF: total proteins 16 g/l; albumin 12.6 g/l; pre-albumin 0.37 g/l; transferin 1.8 g/l in 68% of cases; haptoglobin and alpha 2 macroglobin were present in only one SRF: alpha 1 antitrypsin 0.86 g/l in 48%; orosomucoid 0.57 g/l in 32%; IgG 2 g/l in 52%; Ig A 0.17 g/l in 88% and IgM 15.9 mg/l in 56%. Correlations were found between the duration of detachment and the concentration of total proteins (p < 0.01). The extent of RD was correlated with the concentration of IgG or IgA in the SRF (p < 0.01). These findings suggest that the correlation between the Ig concentration and the extent of RD is an argument for the participation of choriocapillaris in the genesis of SRF
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Affiliation(s)
- J P Berrod
- Clinique Ophtalmologique, Hôpital Central, C.H.U., Nancy, France
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Chiambaretta F, Pleyer U, Behndig A, Pisella PJ, Mertens E, Limao A, Fasce F, Fernandez J, Benmoussa SE, Labetoulle M, Cochener B, Hartani D, Mohabeddine S, Smaili A, Lazreg S, Daghbouche M, Benmoussa SE, Meziane M, Grabner G, Findl O, Sallet G, Mertens E, Pourjavan S, Tassignon MJ, Gohier P, Milea D, Mazit C, Delemazure B, Colin J, Bouchut P, Cochener B, Chiambaretta F, Buffet JM, Muselier A, Pey C, Robert PY, Duquesne N, Normand F, Rozot P, Perone JM, Salaun N, Allieu S, Lenoble P, Weber M, Bosc JM, Berard A, Bonicel P, Laroche L, Cochereau I, Boureau-Andrieux C, Williamson W, Mercie M, L'Herron F, Muraine M, Uzzan J, Gain P, Le Bot B, Lebrun T, Jaulerry S, Malacaze F, Bourcier T, Francoz N, Kampik A, Liekfeld A, Lanzl I, Mencucci R, Menchini U, Beltram G, Szaflik J, Lobo MC, Trigo JM, Aguiar C, Alio J, Fernandez J, Vila JC, Torras J, Güell JL, Laurell CG, Nuijts R, Rosen P. Pupil dilation dynamics with an intracameral fixed combination of mydriatics and anesthetic during cataract surgery. J Cataract Refract Surg 2018; 44:341-347. [DOI: 10.1016/j.jcrs.2017.12.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/14/2017] [Accepted: 12/19/2017] [Indexed: 11/16/2022]
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Mendicute J, Kapp A, Lévy P, Krommes G, Arias-Puente A, Tomalla M, Barraquer E, Rozot P, Bouchut P. Evaluation of visual outcomes and patient satisfaction after implantation of a diffractive trifocal intraocular lens. J Cataract Refract Surg 2016; 42:203-10. [PMID: 27026443 DOI: 10.1016/j.jcrs.2015.11.037] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/01/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate clinical outcomes after the implantation of a diffractive trifocal intraocular lens (IOL). SETTING Nine European ophthalmology centers. DESIGN Prospective noncomparative interventional multicenter study. METHODS The trifocal diffractive AT LISA tri 839MP IOL was implanted in eyes with bilateral cataract. Monocular and binocular visual performance was assessed as was the level of perceived photic phenomena, patient satisfaction, and spectacle dependence 1 month and 3 months postoperatively. RESULTS The IOL was implanted in 208 eyes of 104 patients. The mean binocular uncorrected distance visual acuity improved from 0.44 logMAR ± 0.30 (SD) to 0.02 ± 0.10 logMAR and 0.03 ± 0.09 logMAR at 1 month and 3 months, respectively (P < .01). The mean binocular uncorrected intermediate visual acuity (80 cm) improved from 0.51 ± 0.30 logMAR to 0.09 ± 0.13 logMAR and 0.10 ± 0.15 logMAR at 1 month and 3 months, respectively (P < .01). The mean binocular uncorrected near visual acuity improved from 0.67 ± 0.31 logMAR to 0.16 ± 0.14 logMAR and 0.15 ± 0.14 logMAR, respectively (P < .01). Among the more frequently perceived photic phenomena were halos; however, approximately 75% of patients were not bothered by them. More than 90% of patients were satisfied with the outcome. Spectacle independence at all distances was higher than 90%. CONCLUSION This IOL provided excellent visual outcomes and high refractive predictability at all distances, including intermediate, leading to high levels of patient satisfaction and spectacle independence. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Javier Mendicute
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany.
| | - Alexander Kapp
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Pierre Lévy
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Gero Krommes
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Alfonso Arias-Puente
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Mark Tomalla
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Elena Barraquer
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Pascal Rozot
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
| | - Pierre Bouchut
- From Hospital Universitario Donostia (Mendicute), San Sebastián, Instituto Médico Quirúrgico Oftalmológico (Arias-Puente), Madrid, and the Clínica Barraquer (Barraquer), Barcelona, Spain; Cabinet Dr. P. Lévy (Lévy), Montpellier, Cabinet Dr. P. Rozot (Rozot), Marseille, and Clinique Thiers (Bouchut), Bordeaux, France; Augenzentrum Michelfeld (Kapp), Michelfeld, Augen-Laser-Klinik Lohr GmbH (Krommes), Lohr, and Evangelisches und Johanniterklinikum Niederrhein GmbHundKlinik für Refraktive und Ophthalmochirurgie (Tomalla), Duisburg, Germany
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Cochener B, Vryghem J, Rozot P, Lesieur G, Chevalier JP, Henry JM, David T, Lesueur L, Gatinel D, Ganem C, Blanckaert J, Van Acker E, Heireman S, Ghekiere S. Clinical outcomes with a trifocal intraocular lens: a multicenter study. J Refract Surg 2014; 30:762-8. [PMID: 25375849 DOI: 10.3928/1081597x-20141021-08] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 09/02/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the clinical results and safety obtained with a new type of multifocal intraocular lens (IOL) using a trifocal design to achieve pseudoaccommodation. METHODS A pilot observational study of patients with a trifocal IOL (FineVision; PhysIOL, Liege, Belgium) implanted by 1 of 12 surgeons between March and December 2010. Visual outcomes that were assessed postoperatively included uncorrected and corrected distance, intermediate, and near visual acuity. RESULTS One hundred ninety-eight eyes of 99 patients were analyzed. Patients were observed for an average of 6.44 ± 4.67 months (range: 0.2 to 17 months). Preoperative corrected distance visual acuity was 0.22 ± 0.26 logMAR. At the final follow-up visit, corrected distance visual acuity was 0.01 ± 0.10 logMAR, uncorrected distance visual acuity was 0.01 ± 0.06 logMAR, uncorrected intermediate visual acuity was 0.08 ± 0.10 logMAR, and mean uncorrected near visual acuity was 0.00 ± 0.04 logMAR. Postoperative binocular uncorrected distance visual acuity was 0.01 ± 0.07 logMAR, uncorrected intermediate visual acuity was 0.06 ± 0.08 logMAR, and uncorrected near visual acuity was -0.03 ± 0.04 logMAR. Postopeative mean residual sphere was 0.21 ± 0.48 diopters (D), with a residual cylinder of -0.24 ± 0.31 D. Postoperative spherical equivalent was 0.11 ± 0.36 D. CONCLUSIONS The results demonstrated that the trifocal FineVision IOL is able to restore near, intermediate, and distance visual function.
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11
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Bardet E, Chang D, Amzallag T, Rozot P, Febbraro JL, Korobelnik JF, Schweitzer C. [The alpha: a risk factor for failure of cataract surgery?]. J Fr Ophtalmol 2014; 38:179. [PMID: 25443402 DOI: 10.1016/j.jfo.2014.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- E Bardet
- Service d'ophtalmologie, CHU de Bordeaux, 12, rue Dubernat, 33404 Bordeaux, France.
| | - D Chang
- 762, Altos Oaks Dr, Los Altos, CA 94024, États-Unis
| | - T Amzallag
- Institut ophtalmique de Somain, 28, rue Anatole, 59490 Somain, France
| | - P Rozot
- CHU de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | | | - J F Korobelnik
- Service d'ophtalmologie, CHU de Bordeaux, 12, rue Dubernat, 33404 Bordeaux, France
| | - C Schweitzer
- Service d'ophtalmologie, CHU de Bordeaux, 12, rue Dubernat, 33404 Bordeaux, France
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12
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Bodnar ZM, Rozot P, Leishman L, Ollerton A, Michelson J, Plasse-Fauque S, Werner L. Calcification of a hydrophilic acrylic intraocular lens: case report with laboratory analysis. J Fr Ophtalmol 2013; 36:e113-7. [PMID: 23688611 DOI: 10.1016/j.jfo.2012.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 11/05/2012] [Accepted: 11/07/2012] [Indexed: 11/26/2022]
Abstract
We analyzed a single-piece plate-type hydrophilic acrylic posterior chamber intraocular lens (IOL) that was explanted due to a progressive loss of vision, which occurred 6 years after uncomplicated phacoemulsification. Gross and light microscopy, as well as anterior segment optical coherence tomography (OCT) revealed granular deposits below the IOL surface. Light scattering, as measured with Scheimpflug photography and densitometry analyses was found to be increased; spectrophotometry demonstrated a decrease in the light transmittance of the explanted lens. The granular deposits within the IOL material were found to be composed of calcium by histochemical methods (alizarin red and Von Kossa stains). To our knowledge this is the only report of calcification of this IOL design.
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Affiliation(s)
- Z M Bodnar
- John A.-Moran Eye Center, University of Utah, 65, Mario-Capecchi Drive, Salt Lake City, 84132 Utah, USA
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13
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Cochener B, Vryghem J, Rozot P, Lesieur G, Heireman S, Blanckaert JA, Van Acker E, Ghekiere S. Visual and refractive outcomes after implantation of a fully diffractive trifocal lens. Clin Ophthalmol 2012; 6:1421-7. [PMID: 22969289 PMCID: PMC3437955 DOI: 10.2147/opth.s32343] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this study was to record the visual outcomes of patients treated by six surgeons after implantation of a trifocal lens. Methods The setting for this study comprised six ophthalmology units and eye clinics in Belgium and France, with a coordinating center in France, and data management and statistical analysis in France and Belgium. Ninety-four eyes from 47 patients were implanted with a trifocal FineVision® intraocular lens by six surgeons. Monocular and binocular, uncorrected and best distance-corrected, and photopic and mesopic visual acuity was measured, as well as the defocus curve between +4 D and −4 D with best distance correction. Results Near and far monocular visual acuities were similar to the data published after bifocal intraocular lens implantation. Intermediate vision was improved, and was demonstrated by scores of near visual acuity as well as far visual acuity with defocus −1.5 D-add lens. Far vision is maintained in mesopic conditions. Conclusion The trifocal intraocular lens provides good far, intermediate, and near visual acuity.
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14
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Rozot P. December consultation #2. J Cataract Refract Surg 2010. [DOI: 10.1016/j.jcrs.2010.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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Colin J, El Kebir S, Eydoux E, Hoang-Xuan T, Rozot P, Weiser M. Assessment of patient satisfaction with outcomes of and ophthalmic care for cataract surgery. J Cataract Refract Surg 2010; 36:1373-9. [PMID: 20656162 DOI: 10.1016/j.jcrs.2010.02.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 02/09/2010] [Accepted: 02/16/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess patient satisfaction with cataract surgery care. SETTING Private and public health ophthalmic centers, France. METHODS This prospective longitudinal multicenter observational study enrolled patients attending consultation for a preoperative visit from September 2007 to February 2008. Patients were eligible if they had uncomplicated cataract and agreed to participate. At the preoperative visits, medical data and disease history were collected. At the first postoperative visit (at 1 to 7 days), the following data were collected: patient status, surgical procedure, and follow-up (patient management, complications, medications). Patients completed a questionnaire after each visit to assess satisfaction with their management and follow-up before, during, and after surgery (up to 30 days postoperatively). RESULTS Of the 781 patients enrolled by 91 ophthalmologists, 41 were excluded for not meeting eligibility criteria, leaving 740 patients in the statistical analysis. Cataract extraction was by phacoemulsification. The incision was 2.2 to 3.2 mm in 94.7% of cases, and the intraocular lens was acrylic in 96.3% of cases. Anesthesia was mainly topical (56.8%) or local (42.1%). The most frequent postoperative treatments were nonsteroidal antiinflammatory eyedrops and combined steroidal and antibacterial eyedrops (95.9% and 94.7%, respectively). Most patients (96.4%) said the surgery results met their expectations, and 67.2% reported being able to perform activities they could not do preoperatively. Overall, 98.2% of patients said they were satisfied with their management. CONCLUSION Assessment of the management and follow-up of patients having cataract surgery showed that the care provided was in accordance with the expectations of French patients. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Joseph Colin
- Service d'Ophtalmologie, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France.
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16
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Werner L, Dornelles F, Hilgert CR, Botelho F, Conte PF, Rozot P, Andrenyak DM, Mamalis N, Olson RJ. Early opacification of silicone intraocular lenses: Laboratory analyses of 6 explants. J Cataract Refract Surg 2006; 32:499-509. [PMID: 16631065 DOI: 10.1016/j.jcrs.2005.12.137] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Accepted: 08/11/2005] [Indexed: 11/23/2022]
Abstract
PURPOSE To report laboratory analyses of 6 intraocular lenses (IOLs) explanted from patients who had visual disturbances caused by early postoperative opacification of the lens optic. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS Six patients with 3-piece silicone lenses presented with optic cloudiness as early as a few hours after implantation. The lenses were implanted in 4 locations in Brazil and in France. The lenses in Brazil were stored at the same location before implantation. Gross and microscopic analyses were performed (dry and hydrated states). One half of each specimen underwent gas chromatography/mass spectrometry (GC/MS) analysis and/or extraction by isopropyl alcohol or acetonitrile. One lens also underwent scanning electron microscopy (SEM) with energy dispersive x-ray spectroscopy (EDS). The IOLs were examined for the presence of contaminants or deposits that could cause fast optic opacification. RESULTS The IOLs showed a white optic discoloration in the hydrated state but became transparent on complete dehydration. Suspect exogenous chemical compounds were identified in GC/MS analyses; general classes included terpenes and ketones, typically found in industrial cleaning agents and fumigants. Surface analysis (SEM and EDS) did not show any significant deposits on the external surfaces and sagittal cut in 1 of the specimens. CONCLUSIONS Most IOLs are enclosed in semipermeable packages to allow sterilization by ethylene oxide gas. During cleaning or disinfection of storage rooms, aerosolized solutions may introduce chemicals through the package and onto the IOLs. This may cause surface changes in the IOL, promoting opacification by water ingress in the aqueous environment. Cleaning and disinfection procedures of IOL storage areas should be monitored carefully.
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Affiliation(s)
- Liliana Werner
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
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17
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Kohnen T, Allen D, Boureau C, Dublineau P, Hartmann C, Mehdorn E, Rozot P, Tassinari G. European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens. Ophthalmology 2006; 113:584.e1. [PMID: 16483658 DOI: 10.1016/j.ophtha.2005.11.020] [Citation(s) in RCA: 207] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Revised: 11/04/2005] [Accepted: 11/08/2005] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To report the safety and effectiveness of the AcrySof ReSTOR apodized diffractive intraocular lens (IOL), model MA60D3, when implanted into the capsular bag. DESIGN Multicenter European study including university clinics, eye hospitals, and private ophthalmic surgical centers. PARTICIPANTS One hundred twenty-seven subjects implanted in cataractous eyes in an open multicenter study. INTERVENTION After phacoemulsification, the foldable 3-piece hydrophobic acrylic apodized diffractive IOL was implanted in the capsular bag using a Monarch injector with an A-cartridge. The mean preoperative patient age was 68.4+/-12 years. Intraocular lens implant power ranged from 18.0 to 25.0 diopters (D) in 0.5-D increments. MAIN OUTCOME MEASURES Distance visual acuity (VA), near VA, spectacle dependence, unwanted visual symptoms, and patient satisfaction. RESULTS At the 6-month postoperative visit, binocular (both eyes simultaneously) mean uncorrected distance and near logarithm of the minimum angle of resolution VAs for the MA60D3 were 0.04+/-0.14 and 0.09+/-0.12 (n = 118), respectively. In addition, 88.0% and 84.6% of ReSTOR subjects achieved spectacle independence for distance and near vision, respectively. Glare and halos were reported as severe by only 8.5% and 4.2% of patients, respectively. Ninety-two percent of patients stated that they would choose to have the same lens implanted again after the first implant, and 95.7% answered likewise after the second implant. CONCLUSIONS The AcrySof ReSTOR MA60D3 IOL demonstrated excellent near VA without compromising distance vision. Spectacle independence and patient satisfaction were high, whereas unwanted photic phenomena were clinically acceptable.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
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18
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Abstract
A year after routine phacoemulsification and insertion of a soft posterior chamber IOL, a 59-year-old woman developed progressive moderate myopia. A syndrome of late capsular block was diagnosed following biomicroscopic examination, which was treated by Nd YAG laser posterior capsulotomy. The myopia disappeared immediately. This observation was illustrated with optical coherence tomography (OCT) developed for the anterior segment. After capsulotomy, the IOL moved backwards by 448 microm, which corresponds exactly to a--1D induced myopia.
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Affiliation(s)
- P Rozot
- Clinique Monticelli, Marseille, France
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19
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Baikoff G, Rozot P, Lutun E, Wei J. Assessment of capsular block syndrome with anterior segment optical coherence tomography. J Cataract Refract Surg 2005; 30:2448-50. [PMID: 15519107 DOI: 10.1016/j.jcrs.2004.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2004] [Indexed: 10/25/2022]
Abstract
A 59-year-old woman developed progressive, moderate myopia 1 year after routine phacoemulsification and insertion of a soft posterior chamber intraocular lens (IOL). After biomicroscopy, late capsular block was diagnosed and treated with a neodymium:YAG laser posterior capsulotomy. The myopia disappeared immediately. This case was illustrated using optical coherence tomography developed for the anterior segment. After capsulotomy, the IOL moved backward by 448 microm, corresponding to -0.75 diopter of induced myopia.
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20
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Sommer S, Sablon JC, Zaoui M, Rozot P, Hosni A. [Interferon beta-1b retinopathy during a treatment for multiple sclerosis]. J Fr Ophtalmol 2001; 24:509-12. [PMID: 11397988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Ocular adverse effects of interferon are described during the treatment of malignant diseases and chronic viral hepatitis with interferon alpha. At this time, there is no report of these effects during multiple sclerosis treatment with interferon beta-1b. The authors report a bilateral retinopathy during this treatment. The production of neutralizing antibodies during interferon beta-1b treatment leads to a decrease in diminution of therapeutic efficacy. When treatment failure occurs, neutralizing antibodies are to be tested.
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Affiliation(s)
- S Sommer
- CHR N.D. de Bonsecours, 1 pl Ph de Vigneulles, 57038 Metz cedex 1
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21
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Sommer S, Badet JC, Zaoui M, Naoun-Hubert I, Rozot P. [Birdshot chorioretinopathy associated with tamoxifen retinal toxicity]. J Fr Ophtalmol 2000; 23:494-7. [PMID: 10844311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We report a case of Birdshot retinochoroidopathy associated with ocular toxicity due to tamoxifen. Adverse drug effects were suspected due to the presence of yellow-white dots in the paramacular region and the fovea and by modifications of the retinal epithelial pigments. Ocular toxicity should be suspected as it may be reversible if recognized and stopped early. Other adverse ocular effects are described and the pathogenic mechanism of tamoxifen retinopathy analyzed.
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Affiliation(s)
- S Sommer
- Service d'Ophtalmologie, CHR N.D, de Bonsecours, 1 place Ph. de Vigneulles, 57038 Metz cedex 1
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22
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Zaoui M, Cordebar B, Naoun-Hubert I, Sommer S, Rozot P. [Central retinal vein occlusion in a patient treated with antiandrogenic drug]. J Fr Ophtalmol 2000; 23:42-4. [PMID: 10660647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Central retinal vein occlusion (CRVO) is usually seen in older adults and is often associated with systemic vascular disease, this is much less evident in young people. A case report of a 28-year-old woman presented a central retinal vein occlusion in her left eye. This young woman was treated with antiandrogenic drug. Investigations revealed an abnormality of the hemostatic system. The central retinal vein occlusion was resolved and the fundus assumed a normal appearance one-month after the primary episode. Retinal vascular occlusions with antiandrogenic drug may be due to three mechanisms: increased platelet cell aggregation, alteration of fibrinolytic system and vascular endothelium hyperplasia.
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Affiliation(s)
- M Zaoui
- Service d'Ophtalmologie, CHR Notre Dame de Bonsecours, 1, place Philippe de Vigneulles, 57038 Metz Cedex 1
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Sommer S, Rozot P, Wagner M, Xenard L, Poveda JD. [Uveitis in Whipple disease: Identification of Trophyrema whippelii by PCR]. J Fr Ophtalmol 1998; 21:588-90. [PMID: 9833225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Whipple's disease is a multisystem bacterial disease usually characterized by malabsorption, diarrhea and polyarthritis. Ocular manifestations include uveitis, vitreitis, retinis, myositis, papilledema and optic atrophy. We report a case of a chronic bilateral vitreitis in a 63 year-old man who had been treated for a Whipple's disease with gastrointestinal involvement 30 years before. The jejunal biopsy was negative but the polymerase-chain-reaction (PCR) revealed the presence of Trophyrema Whippelii in the vitreous prelevement of both eye. This new, original strategy of PCR is specific and more sensitive than histological diagnosis.
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Affiliation(s)
- S Sommer
- Service d'Ophtalmologie, CHR Metz Thionville, Hôpital N.D. de Bonsecours, Metz
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24
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Sommer S, Delemazure B, Wagner M, Xenard L, Rozot P. [Bilateral ischemic optic neuropathy secondary to acute ergotism]. J Fr Ophtalmol 1998; 21:123-5. [PMID: 9759393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We report a case of a 31 year-old man who presented a bilateral ischemic optic neuropathy associated with headaches and severe systemic hypertension. This episode appeared after administration of ergotamine tartrate and macrolides. This medication probably led to a vasospasm which occurs in patients with hypertension. The cardiovascular and serum lipid evaluations were normal. A migraine optic neuropathy can be evoked.
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Affiliation(s)
- S Sommer
- Service d'Ophtalmologie, Hôpital N.D. de Bonsecours, Metz
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25
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Herrmann B, Rozot P, Baylac F, Civit T, Reynal C, Ketema MA. [Lipogranuloma of the orbit. Apropos of a case]. J Fr Ophtalmol 1996; 19:780-4. [PMID: 9033904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We present a case of orbital lipogranuloma with a supero-nasal retrobulbar localisation associated with axial proptosis and major choroidal thickening. No clinical sign of inflammation, neither orbital nor in the posterior segment, was revealed. The systemic work-up as well as paraclinical data were within normal limits. The diagnosis was made after histopathologic examination of the biopsy taken via superior orbit. Outcome was favorable following long-term systemic corticotherapy. Orbital lipogranuloma is a rare particular form of orbital pseudotumour of unknown etiology. It is characterized, histologically, by orbital fat necrosis. Pathogenesis remains controversial. The differential diagnosis includes iatrogenic lipogranulomas secondary to sinus surgery (paraffinoma), orbital granulomas in sarcoidosis and Wegener's disease and orbital lymphomas. The prognosis is usually good following treatment with steroids.
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Affiliation(s)
- B Herrmann
- Service d'Ophtalmologie, Hôpital Notre-Dame de Bon-Secours, CHR Metz-Thionville
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Abstract
BACKGROUND A study of the characteristics and the results obtained in 99 consecutive eyes operated on for rhegmatogenous retinal detachment associated with aphakia or pseudophakia in order to find the predictive factors of poor anatomical and functional results. METHODS The authors retrospectively reviewed the files of 99 consecutive cases of aphakic and pseudophakic retinal detachment operated on by the same surgeon between January 1992 through July 1993 with a minimum follow-up of 6 months. Multivariate and chi square analysis were carried out. RESULTS Of the pseudophakic eyes, 25 had an anterior chamber lens and 48 had a posterior chamber lens. The posterior capsule was disrupted using a Yag laser in 58% of those with an posterior chamber lens but only 14% of them developed detachment within 6 months. The rate of vitreous loss was 27% with 5% in case of intracapsular extraction, 31% in case of extracapsular extraction and 54% in case of phacoemulsification. PVR was present in 30% of the patients and 51% of detachments occurred more than 24 months as a mean after cataract surgery. The overall anatomic reattachment rate was 88% with no significant difference between the aphakic and the pseudophakic patients, either with an anterior chamber of posterior chamber lens. Visual results were significantly worse in the anterior chamber lens group and in the aphakic eyes (P < 0.02). Negative prognostic indicators for reattachment included poor preoperative vision, extension of the retinal detachment to the macula (P < 0.05) and grades B, C or D proliferative vitreoretinopathy (P < 0.01). In addition to the above factors, eyes with vitreous loss, anterior chamber lens, aphakia and a larger extent of the retinal detachment had a poor visual outcome. CONCLUSION Most aphakic or pseudophakic retinal detachment can now be reattached with either scleral or vitreo retinal surgery. The main difficulties are the localisation of the breaks and the treatment of PVR. Indirect ophthalmoscopy associated with vitrectomy does well in cases of an opacified posterior capsule. In cases of severe PVR long term internal tamponade either with C3F8 or silicone oil improves anatomical results but the functional results remain inferior.
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Affiliation(s)
- J P Berrod
- Centre Hospitalier Universitaire de Nancy, Service d'Ophtalmologie A, France
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27
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Hamon F, Thiery D, Berrod J, Rozot P. P 449 Results of flicker test in alcohol and smoking addiction, fonctionnal amblyopy, multiple sclerosis, and glaucoma. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90709-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
This study evaluates the efficiency of fluid-air exchange on the reattachment of the retina and clarifies the possibility that a posterior retinotomy is a cause for intra- and postoperative complications. A consecutive series of 211 eyes with retinal detachments due to P.V.R. (47%), diabetic traction, perforating trauma, macular hole or giant tears is presented. All eyes underwent pars plana vitrectomy, fluid-air exchange, internal drainage of subretinal fluid, laser endophotocoagulation and scleral buckling of the tears; 56% of the eyes were phakic and 55% underwent a posterior retinotomy, 54% underwent tamponade with C3F8 and 46% with silicone oil. Intraoperatively the retina was completely flattened in 91% cases. The causes of incomplete reattachment were residual membranes (6.6%), poor visualization (1.4%) and suprachoroidal hemorrhage (1%). These complications were isolated as being the cause of the bad final results (p < 0.001). Postoperatively, the retina remained attached in 66% of cases after the first procedure and with further surgery in 81% (mean follow up 16 months). Best corrected visual acuity was improved in 73% of eyes, unchanged in 17%, and worse in 10%. Complications were retraction of the retinotomy site in 3 cases and peripheral choroidal hemorrhage in 4 cases. We concluded that fluid air exchange with internal subretinal fluid drainage was an efficient and safe technique even if a posterior retinotomy was necessary.
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Affiliation(s)
- J P Berrod
- Service d'Ophtalmologie C.H.U. de Nancy, Hôpital Central C.O 34, France
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29
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Guibal A, Wahl D, Rozot P, Bouvier P, Vaillant P, Mouget B, Conroy T, Vaillant G, Raspiller A, Schmitt J. Manifestations ophtalmologiques révélatrices d'un adénocarcinome pulmonaire. À propos de 2 observations. Rev Med Interne 1992. [DOI: 10.1016/s0248-8663(05)81100-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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George JL, Raspiller A, Lesure P, Sirbat D, Rozot P, Berrod JP. [Oculomotor disorders and enlargement of the extraocular muscles]. Ophtalmologie 1989; 3:167-8. [PMID: 2641101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aetiologic conditions for enlargement of extra ocular muscles are graves' orbitopathy, acute or subacute myositis as a subgroup of inflammatory orbital pseudotumor, and sometimes lymphoid or metastatic tumor. The distinction of these aetiologies can be made on clinical versus CT Scan or IRM grounds with two different patterns of oculomotor disfunction. Restrictive extensibility, which found expression in the antagonist field, is typical of grave's myopathy, sequelae of subacute myositis or acute myositis of the superior oblique. Deficiency of the enlarged muscle's contractibility is typical of a recent and transient myositis involving a rectus muscle or of a rare tumor of an extraocular muscle.
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31
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Jeancolas D, Berrod JP, Guldenfels Y, Rozot P, Raspiller A. [Medium-term results of radial keratotomies and discussion]. Bull Soc Ophtalmol Fr 1988; 88:1369-71. [PMID: 3269275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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George JL, Rozot P, Berrod JP. [Measurement of exophthalmos. A trial of correlating Hertel-x-ray computed tomography]. Bull Soc Ophtalmol Fr 1988; 88:1129-32. [PMID: 3252996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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