[Treatment by horseshoe pattern photocoagulation of diabetic cystoid macular edema]. / Traitement par photocoagulation en fer à cheval de l'oedème maculaire cystoïde diabétique.

Eighty cases Diabetic Cystoid Macular Edema, with or without central spaces underwent photocoagulation from 1978 to 1989 using a horseshoe or ring pattern. Initial visual acuity ranged from 20/25 for far vision and 20/20 for near vision to a central scotoma, with an average of 20/60 for far vision and 20/50 for near vision. As initial treatment, we performed 63 horseshoe pattern and 13 ring pattern photocoagulation around the macula; an additional photocoagulation was carried out in 29 cases, one month to seven years later (average of 18.3 months), either on medial to the previous treatment (18), or closing the initial horseshoe pattern (10) or resulting in focal treatment (13), or associating any of these three. The cystoid macular edema disappeared in 47 cases, decreased in 15 cases, and remained in 14 cases, with a follow up ranging from 6 months to 10.5 years (average of 41.6 months). The post laser visual acuity range from 20/25 for far vision and 20/20 for near vision, to a central scotoma again, with an average of 20/60 for far and near visions. During the follow up various reasons of visual impairment were observed: cataract, intravitreal hemorrhage, epiretinal membrane, macular pucker and macular ischemia. Our results compared with the published ones concerning a grid pattern photocoagulation are encouraging. It is very important to stress that this photocoagulation is only aimed toward the macular edema itself: if necessary it should be associated with a grid pattern or a focal photocoagulation aimed toward extramacular edema.

[Is vitrectomy cataractogenic? Study of changes of the crystalline lens after surgery of retinal detachment]. / La vitrectomie est-elle cataractogène? Etude des modifications du cristallin après chirurgie du décollement de la rétine.

In order to assess the relationships between vitrectomy and postoperative crystalline lens changes we reviewed the records of 298 selected cases of operated retinal detachments in phakic eyes. We compared two groups: 155 eyes were operated with cryotherapy, vitrectomy and gas injection. 143 eyes received cryotherapy and retro-hyaloid fluid-gas exchange. Follow-up of at least 12 months and detailed description of the lens were available in 90 cases and 82 cases of the two groups respectively. Postoperative lens changes were as follows: nuclear sclerosis occurred in 63% of the vitrectomised eyes, mild in 14%, moderate in 16%, severe in 32%. In contrast, nuclear sclerosis occurred in only 4% of the non vitrectomised eyes, all these cases were noted as moderate. Posterior subcapsular opacities occurred in 4.5% of the vitrectomised eyes versus 2.4% of the non vitrectomised eyes. Nuclear sclerotic changes were correlated with vitrectomy and longer follow-up. Posterior subcapsular cataract was correlated with vitrectomy and larger intraocular gas bubble.

[Intolerance to encircling. 19 cases of section or ablation of encircling]. / Intolérance au cerclage. A propos de 19 cas de section ou ablation de cerclage.

Removal of ten encircling scleral buckles and section with relaxation of nine encircling buckles are displayed. Only episcleral buckles with oval or round silicone sponge exoplants are analyzed. Besides infection (three eyes), removal or section was required because of too tight encircling elements (16 eyes). Anterior buckles created by invagination of encircling elements, without horizontal shortening avoids this risk of constriction.