[Qualitative and quantitative study of ophthalmologic consultation in France: A multicenter descriptive survey]. / Étude qualitative et quantitative de la consultation ophtalmologique en France : enquête multicentrique descriptive.

This study aimed to precisely map current ophthalmologic consultation in France through systematic data collection in one consultation day. Nine ophthalmologic centers participated in the survey, performing 1148 observations of patients aged from 2 to 102 years old, with a mean of 55.12years old and a male/female distribution of 43.8 %/56.2 %. In general, the patients came in either spontaneously (28.8 %) or for follow-up (59.6 %). Emergency consultations comprised 5.7 % of all cases. Comorbidities or major risk factors were found. Most the patients already wore visual correction (82.6 %), mainly glasses (77.3 %). At the end of the consultation, 48.2 % received a prescription for new optical correction. During the interview, 53.3 % of patients reported visual symptoms, most frequently blurriness, distortion or loss of vision. 25.3 % of the patients experienced ocular symptoms such as pain, watery eyes or itching. An ophthalmic disease was the reason for the consultation in 77.1 % of all cases. Its management included medicinal and/or surgical treatment (45.6 % and10.5 % respectively). The necessary tests were performed on site the same day and only 2.6 % of the patients were given a prescription for additional testing to be performed elsewhere in a referral center. From a qualitatively and quantitatively representative sample, this survey describes ophthalmologic consultation in France today in terms of age, male/female distribution, reason for the visit, the proportion of visual correction and other diseases, diagnosis and treatment.

Two topical carbonic anhydrase inhibitors sezolamide and dorzolamide in Gelrite vehicle: a multiple-dose efficacy study.

The ocular hypotensive activities of the two potent topical carbonic anhydrase inhibitors sezolamide (previously known as MK-417) and dorzolamide (previously known as MK-507 and L-671,152) were compared formulated in Gelrite vehicle, a novel ophthalmic drug delivery system. This was a four-center, double-blind, randomized, placebo-controlled, parallel study in 73 patients with a diagnosis of bilateral primary open-angle glaucoma or ocular hypertension and a morning intraocular pressure (IOP) of greater than 23 mmHg in both eyes following washout of ocular hypotensive medications. Parallel 12-h modified diurnal curves were performed prestudy and on day 6, with a 4-h IOP curve on day 1. On day 6 the peak mean percentage decrease in IOP from baseline occurred 4 h after the dose of dorzolamide (22.1%) and 6 h after the dose of sezolamide (21.3%). There were no significant differences between 2% dorzolamide and 1.8% sezolamide at any time point, although the decrease in IOP for sezolamide tended to be slightly greater than that for dorzolamide. Duration of action of both compounds was, at most, slightly prolonged by the use of Gelrite vehicle when compared with former studies on sezolamide and dorzolamide.

[Radial keratotomy. Optical and functional results after a 5-year postoperative period]. / Kératotomie radiaire. Résultats optiques et fonctionnels à 5 ans postopératoires.

The authors report a retrospective study of R.K. surgery performed on 72 eyes for simple myopia by one surgeon, five years after surgery. Fifty-four cases were observed regularly at 1 year and 5 years post-operatively, which allowed an analysis of refractive and visual parameters, for myopias between-1.5 and 6 D before surgery. Five years after: 92.9% of eyes were within +/- 1 D of emmetropia; 5.7% of eyes were undercorrected by more than 1 D; 1.4% of eyes were overcorrected by more than 1 D and 88.7% of the cases had uncorrected visual acuity of 20/40 or more. In general, our refractive and keratometric results were stable between the first and fifth year post-operatively. We report only one case of real undercorrection, and one case of progressive hyperopia with loss of best spectacle corrected visual acuity. In this study, we observed a statistically significant decrease of 1/100 in the mean uncorrected visual acuity, which is explained by remyopisations. All but one of them were less than 1 D. The review of long term results of R.K. is difficult because of the many different methodologies and protocols. However all of them show a unpredictable continuous increase in the effect of surgery in the hyperopia direction. Prolonged wound healing seems to be the most probable reason for this progressive hyperopia.

[Organotypic culture of human corneal epithelium. Preliminary results]. / Culture organotypique d'épithélium cornéen humain. Résultats préliminaires.

The authors compared the growth of limbal and central explants removed from human cornea. Epithelial growth began on the third day, was greater during the first week and was subsequently slightly invaded by fibroblasts. This study demonstrated that peripheral corneal epithelial cells growth better than central cells. In this study, the cytologic and histologic features of the cells were examined. However, epithelial immunofluorescence staining by anti-cytokeratin antibodies was rather poor. This in vitro system may provide a suitable model for epithelial human corneal cell culture, allowing further biocompatibility studies.

[Reoperation after radial keratotomy. When is it indicated?]. / Réintervention après kératotomie radiaire. Quand la faire?

In a series of 719 patients who underwent radial kératotomies, the authors report the results of pericentral deepenings 1 month and 1 year postoperatively because of undercorrection postoperatively. The improvement of residual myopia was 68.6% in the first group and 64.8% in the second group. There was no statistically difference between these two results. The dioptric improvement did not exceed 1.5 dioptre in all cases.

[Corneal transplantation and histocompatibility of the HLA system]. / Kératoplasties transfixiantes et le système HLA d'histocompatibilité.

The HLA antigens appear to be involved in the rejection of corneal allografts. A relationship exist between HLA compatibility and the corneal rejection-free transplant survival. Eleven corneal transplants are performed on the basis of the best available HLA A and B match. Rejection-free transplant in this group is compared to a control group. The estimate rejection-free survival is 82%.

[Non-freeze myopic keratomileusis. Retrospective study of 27 consecutive operations]. / Kératomileusis myopique non gel. Etude rétrospective de 27 interventions consécutives.

27 consecutive cases of non freeze myopic keratomileusis (using Barraquer Krumeich Swinger Set) were performed by one surgeon on 22 patients in a retrospective study. 4 per operative complications were noticed. Visual acuity with and without correction, astigmatism before and after surgery were reviewed preoperatively, at 1 week, 1 month, 3 months, 6 months and 1 year postoperative. The preoperative myopia (mean +/- standard deviation) was -15.55 +/- 5.46 D, the average postoperative residual myopia was: at 1 week -0.43 +/- 3.58 D, at 1 month -1.18 +/- 4.15 D, at 3 month -4.44 +/- 4.80 D, at 6 month -5.43 +/- 5.51, at 1 year -6.95 +/- 4.81 D. Visual acuity without correction was always better postoperatively. The best visual acuity (with correction) was preoperatively 0.38 +/- -0.22 at 1 week postoperative 0.21 +/- 0.09, at 1 month 0.35 +/- 0.16, at 3 month 0.31 +/- 0.15, at 6 month 0.32 +/- 0.15, at 1 year 0.34 +/- 0.17. Further investigation is monitoring to assess the predictability and stability of non freeze keratomileusis.

[Ocular toxoplasmosis and AIDS. A case report]. / Toxoplasmose oculaire et SIDA. A propos d'un cas.

Ocular toxoplasmosis is uncommon in the natural course of AIDS. We report here in a case of a 27 year old man with cerebral toxoplasmosis involvement with neurological signs and coma. After an initial improvement with a sulfadiazine and pyriméthamine treatment, we noticed a foveal chorioretinitis with hyalitis in the right eye which deeply decreased the visual acuity (less than 20/400) strongly suggesting a toxoplasmic etiology. Then specific aspects such as serology, acquired or congenital toxoplasmosis, treatment are reviewed.

[Aspects and prospects of human corneal epithelium culture]. / Aspects et perspectives de la culture organotypique d'épithélium cornéen humain.

This study used peripheral human corneal epithelium in tissue culture. Cells were observed in cytology, histology and by immunofluorescence staining. This in vitro-system may provide a suitable model to study biocompatibility but also to collect free human corneal cells.

[Our experience with myopic implants. Initial optical results]. / Notre expérience des implants myopiques. Premiers résultats optiques.

28 patients with high myopia (over-10 dioptries) were implanted in anterior chamber with a myopic IOL. 3 months postoperatively the visual acuity without correction was equal to the preoperative acuity. With a light correction, especially of residual astigmatism, we noticed a gain of acuity of 0.2.

[Non-freezing myopic keratomileusis. Results of 27 consecutive operations]. / Kératomileusis myopique non gel. Résultats de 27 interventions consécutives.

27 consecutive cases of non freeze myopic keratomileusis were performed on 22 patients in a retrospective study. 4 per operative complications were noted. Visual acuity with and without correction, keratometry, astigmatism, pachymetry, esthesiometry before and after surgery were reviewed at 1 week, 1 month, 3 months, 6 months and 1 year post operatively.

[Bone choristoma of the choroid: a diagnosis to keep in mind]. / Le choristome osseux de la choroïde: un diagnostic à évoquer.

Choroid osteoma was described for the first time by GASS in 1978. Today only 53 cases were reported in 39 patients. Using 3 new cases recently discovered in our region, we try to assess with the help of the already published data, the main points of the disease and its diagnostic.

[Presentation of an apparatus to measure lens opacity: Opacity Lensmeter 701. Preliminary study]. / Présentation d'un appareil de mesure de l'opacité cristallinienne: l'Opacity Lensmeter 701. Etude préliminaire.

The Opacity Lensmeter is a new instrument permitting the measurement of lens opacity. This preliminary report was performed on 98 patients (195 phakic eyes). Age, sex, lens opacity and retinal sensibility (using automated perimetry with the Octopus 2000 R) were assessed. A correlation between age and lens opacity was found in a simple linear regression model on 186 eyes (available data): opacity = 0.00423 square (age) + 5.18. An another more precise correlation was found in 138 eyes, excluding those with anterior segment abnormalities and corneal opacity: opacity = 0.0035 square (age) + 5.17. No statistical differences were observed between lens opacity and sex nor were left/right differences significant. No conclusion was possible concerning retinal sensibility and measured lens opacity because of the small sample (25 eyes). This easily handled instrument may be helpful in daily practice to evaluate opacity in lens pathology. Furthermore, it should be useful for the interpretation of the respective role of cataract and retinal damage in P.O.A.G. loss of retinal sensibility.

[Fetal bradycardia during pregnancy. Apropos of 2 cases without fetal distress]. / Bradycardie foetale en cours de grossesse. A propos de deux cas sans souffrance foetale.

The authors report two cases of fetal bradycardia discovered at the beginning of the 8th month. The pregnancy history was normal. Sonography was helpful in the etiological diagnosis. It concerns a case of atrial extrasystole and another case of physiological bradycardia. The evolution was satisfactory with normal, spontaneous, vaginal delivery. During the pregnancy, the tracing combined a severe bradycardia around 80, a flat rhythm and an areactive rhythm. There was alternation with normal rhythms. The pregnancy history was reassuring. At the beginning of labor, the cardiac rhythm was normal. In the opposite case, vaginal delivery could only be advocated after determination of the capillary pH.