Rotational stability and clinical outcomes after implantation of a new monofocal toric intraocular lens with double C-loop design.

PURPOSE: To investigate rotational stability and visual outcomes of patients unilaterally or bilaterally implanted with a new monofocal toric intraocular lens (IOL). SETTING: Ophthalmology service, clinique Beausoleil, avenue de Lodève, Montpellier. DESIGN: Single-center retrospective study. METHODS: This study included patients who underwent routine cataract surgery with the PODEYE toric (BVI/PhysIOL SA, Liège, Belgium) IOL using the ZEISS CALLISTO eye®. Biometry and keratometry data, refractive outcomes, rotational stability, and astigmatism correction were recorded. IOL rotation was evaluated using an image analysis technique. Postoperative assessments were performed at 1 week, 1 month, and 4 to 6 months after surgery. RESULTS: Clinical outcomes of 102 patients (136 eyes) were analyzed. Patients had a mean age of 74 years. Of the included eyes, 25% had an axial length greater than 24.5mm. Median postoperative IOL rotation from baseline (surgery) was 2̊. With the exception of one outlier (15̊ rotation), IOL rotation was ≤ 6̊ (1 month) and ≤ 10̊ (4-6 months) in 100% of the eyes. No surgical IOL re-positioning was required. Median postoperative corrected distance visual acuity was -0.08 logMAR, and median postoperative subjective cylinder was between 0.25 and 0.50 D. CONCLUSION: The PODEYE toric IOL showed high rotational stability, allowing for correction of corneal astigmatism during cataract surgery.

[Posterior capsule opacification, glistenings and visual outcomes: 3 years after implantation of a new hydrophobic IOL]. / Performances visuelles, glistening et opacification capsulaire postérieure : 3 ans après l'implantation d'un nouvel implant hydrophobe.

PURPOSE: To evaluate the visual outcomes, the incidence of glistenings and posterior capsule opacification in a series of consecutive eyes with a new blue light-filtering hydrophobic acrylic intraocular lens (IOL) SETTING: Service d'ophtalmologie, clinique Beausoleil, avenue de Lodève, Montpellier. DESIGN: Retrospective, cross-sectional study. METHODS: This study included a series of 66 eyes that underwent routine cataract surgery with PODEye (PhysIOL SA, Liège, Belgium) monofocal IOL implantation between May 2011 and November 2011. These eyes were compared for glistenings with patients implanted with Acrysof material IOL (Alcon, Fort Worth, USA) who had a routine postoperative examination between January 2015 and August 2015. The safety of the IOL was assessed by visual acuity outcomes, as well as rotational stability, centration and postoperative medication. The incidence and severity of glistenings were evaluated with the slit lamp. Glistenings and PCO were graded subjectively (0=absent; 1=moderate; 2=dense). Follow-up was 3 years. RESULTS: The mean visual acuity after PODEye implantation was 0.98±0.05 (n=50) in decimal notation at 1 year, 0.98±0.06 at 1 week, (n=66), 1.00±0.01 at 3 weeks (n=64) and 0.99±0.02 at 3 months (n=59). The IOL displayed stable positioning in all axes. Glistenings of grade 2 were absent in the G-Free/PODEye group, whereas they were significantly present in the Acrysof group. One out of 43 eyes at 3-year follow-up underwent YAG capulotomy at 37 months. Sixty-six percent of eyes had no PCO (grade 0) at 3 years. CONCLUSIONS: The PODEye IOL was safe and stable. Glistenings grade 2 or more were not found with this blue light-filtering hydrophobic acrylic IOL. PCO occurrence was low at three years.

Chronic pramipexole treatment induces compulsive behavior in rats with 6-OHDA lesions of the substantia nigra and ventral tegmental area.

Dopamine replacement therapy (DRT) reduces motor symptoms in Parkinson's disease (PD), but also induces impulsive-compulsive behavior (ICB) in up to 25% of PD patients. These non-motor side effects of DRT generally follow a gradual transition from impulsive to compulsive-like-i.e. repetitive, compelled, and non-pleasurable-behavior. Here, we investigated the effect of chronic pramipexole (PPX) treatment on the onset of compulsive-like behavior, measured via the post-training signal attenuation (PTSA) procedure, in rats with dopaminergic lesions. Accordingly, we aimed to mimic chronic DRT in a PD context, and obtain data on the brain regions that potentially sustain this type of compulsive behavior pattern in rats. We observed that the lesion or treatment alone did not induce compulsive lever pressing in rats. However, rats with lesions of the substantia nigra and ventral tegmental area as well as with chronic PPX treatment developed strong compulsive lever-pressing behavior, as measured via PTSA. Furthermore, when chronic PPX treatment was discontinued before the PTSA test, the lesioned rats showed the same level of compulsive behavior as sham-operated rats. In fact, lesioned, treated, and compulsive-like rats showed significantly higher Fos expression in the orbitofrontal cortex and dorsal striatum. Thus, chronic PPX treatment in PD rats induced a strong compulsive-like behavior. Furthermore, Fos expression mapping suggests that the behavior was sustained via the activation of the orbitofrontal cortex and dorsal striatum.

[Evaluation of visual performance after implantation of a double C-Loop toric intraocular lens]. / Évaluation des performances visuelles après implantation d'une lentille intraoculaire torique à double anse en C.

PURPOSE: This study aims to demonstrate the safety and the efficacy of the Ankoris posterior chamber intraocular lens to correct corneal astigmatism at the time of cataract surgery. MATERIAL AND METHODS: In this retrospective study, 52 eyes among the first 64 consecutive ones implanted with the Ankoris met the inclusion criteria. The retrospective analysis of these cases consisted mainly of the determination of the improvement in visual acuity and postoperative refraction. The analysis of the astigmatism correction itself was carried out by the Alpins method. The rotational stability of the implant was analyzed by the difference between the IOL orientation after one day and 3 months. RESULTS: The safety index, defined as the postoperative divided by preoperative best visual acuity, was greater than one in all cases, with a mean of 1.96. The ratio of the postoperative uncorrected visual acuity with the preoperative best-corrected acuity was 1.72. The final postoperative astigmatism was -0.40 ± 0.28 D. The percentage of astigmatism corrected was 99.3%. The error vector amplitude was 0.1 D with a nearly null orientation. The mean rotation was 2.16 ± 1.95°. CONCLUSION: The Ankoris IOL demonstrates, in this relatively large cohort, all necessary elements to establish that the IOL was able to correct corneal astigmatism at the same time as cataract surgery.

[Evaluation of a new intraocular lens platform: centration and rotational stability]. / Évaluation d'une nouvelle plateforme d'implant intraoculaire: centrage et stabilité rotatoire.

PURPOSE: To assess the rotational stability and centration of a single-piece hydrophilic acrylic intraocular lens (IOL) during the first postoperative year. SETTING: Clinique Beausoleil, 117, avenue de Lodève, 34070 Montpellier, France. DESIGN: Retrospective case series. METHOD: The POD AY 26% monofocal aspheric yellow intraocular lens is designed to facilitate its intraoperative orientation within the capsular bag. This study consists of a retrospective analysis of 117 consecutive eyes implanted with this IOL to determine its postoperative stability. Data collected include ocular biometry, patient history, IOL power, pre- and postoperative visual acuity and refraction, and slit lamp photos after one and three weeks, and 3 and 12 months. RESULTS: Mean postoperative visual acuity was 0.95 after 3 months and remained stable after 1 year. The refraction was also stable over time, although a slight effect related to corneal healing could be observed (0.1D). The mean absolute rotation of the implant was 2.5 ± 2.6°. The position of the center of the implant relative to the pupillary center expressed as a vector was 0.01 mm at 70°. CONCLUSION: This new IOL design is as stable as a C-Loop IOL but provides much better maneuverability during implantation. It provides physiologic centration and good rotational stability over 1 year. It would be a perfect platform for a toric optic.

Assessment of metabolic changes in the striatum of a rat model of parkinsonism: an in vivo (1)H MRS study.

Degeneration of the dopaminergic neurons of the substantia nigra pars compacta in Parkinson's disease induces an abnormal activation of the glutamatergic neurotransmission system within the basal ganglia network and related structures. The aim of this study was to use proton MRS to show metabolic changes in the striatum of 6-hydroxydopamine-lesioned rats, a rodent animal model of Parkinson's disease. Animals were examined before and after extensive lesioning of the nigral dopaminergic neurons and after acute administration of L-3,4-dihydroxyphenylalanine. No significant alterations in glutamate concentrations, assessed by the MR signal dominated by glutamate with minor contributions from glutamine and gamma-aminobutyric acid, could be measured. The total choline/total creatine ratio was found to be reduced in the striatum of the ipsilateral hemisphere.

Brain GABA editing by localized in vivo (1)H magnetic resonance spectroscopy.

Editing of GABA by (1)H MRS in a specific brain area is a unique tool for in vivo non-invasive investigation of neurotransmission disorders. Selective GABA detection is achieved using sequences based on double quantum coherence (DQC). Our pulse sequence makes accurate measurements without artefacts due to spatial localization. The sequence was tested on a phantom solution. The effect of vigabatrin, a specific inhibitor of GABA transaminase, was measured in rat brain and GABA detection was performed in vivo in monkey brain using this procedure. Rats were split into two groups. In the control group, the rats had access to water and, in the other group (vigabatrin, VGB, rats), animals were allowed free access to drinking water containing vigabatrin. After 3 weeks of treatment, rats were anesthetized for in vivo NMR spectroscopy investigation. At the end of the experiment, brains were quickly removed, freeze-clamped and extracted with 4% perchloric acid. One part of the acid extract was used for GABA concentrations assessment by ion exchange chromatography with ninhydrin detection. The second was used for high-resolution NMR analysis. By chromatography measurements, the GABA concentration was 1.23+/-0.06 micromol/g for controls, while for vigabatrin-treated rats the GABA concentration was 4.89+/-1.60 micromol/g. The NMR in vivo results were closely correlated with the NMR ex vivo (r=0.99, p<0.01) and chromatography results (r=0.98, p<0.01). The correlation between ex vivo results and chromatography results was also high (r=0.99, p<0.001). This pulse sequence performed GABA editing from a 376 microl voxel located on the right basal ganglia area in a non-human primate brain. This in vivo GABA editing scheme can thus be proposed for accurate measurement of brain GABA concentrations.

Antidyskinetic effect of magnesium sulfate in MPTP-lesioned monkeys.

The antiparkinsonian action of an NMDA receptor antagonist, magnesium sulfate (50, 100, and 200 mg/kg), alone and in association with levodopa was explored in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned parkinsonian and control rhesus monkeys. At the three doses tested, magnesium sulfate decreased levodopa-induced dyskinesia [cumulative dyskinetic scores after levodopa: 129 +/- 13; after levodopa and magnesium sulfate: 65 +/- 14 (50 mg/kg), P < 0.001; 64 +/- 10 (100 mg/kg), P < 0.001; 66 +/- 21 (200 mg/kg), P < 0.001, compared to levodopa administration alone]. These results show that magnesium sulfate importantly reduces levodopa-induced dyskinesia.

Assessment of motor behavior using a video system and a clinical rating scale in parkinsonian monkeys lesioned by MPTP.

The best current model of Parkinson's disease is the primate treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Quantification of animal movement is important for the study of severity of parkinsonian syndrome induced by MPTP and response to drug treatments. Both require clinical rating scales that measure motor behavior with well-defined objective items. However, evaluations using these scales depend on the observer scoring the different items, according to his/her experience. The video image analyzer system, which produces an activity curve in correlation with the visual study of animal motor behavior, offers an automatic evaluation method that is observer-independent and reproducible. Using such an system we defined items correlated with those used in clinical rating scales that are sensitive to animal motor changes, decrease in movements with MPTP intoxication and alleviation afforded by levodopa: global locomotor activity and specific activities (climbing, social interactions, eating and drinking behaviors).

Treatment of cytomegalovirus retinitis in AIDS patients using intravitreal injections of highly concentrated ganciclovir.

PURPOSE: Intravitreal injections of ganciclovir provide a useful adjunct or alternative treatment for cytomegalovirus retinitis in AIDS patients when toxicity or progression is seen with systemic administration of antiviral drugs. To avoid transient increase in intraocular pressure that may impair optic nerve vascularization in long-term treated patients, we modified conventional procedures by injecting a smaller volume of a more concentrated ganciclovir solution. PATIENTS AND METHODS: We used intravitreal injections of 350 micrograms of ganciclovir in a final volume of 50 microliters, in 156 eyes from 111 AIDS patients, 14-53 years old, presenting with necrotizing retinitis despite systemic antiviral agents or who had become intolerant to systemic treatment. RESULTS: Patients underwent a total of 2,890 injections. The mean number of injections was 25.9 +/- 3.2 by patient, with a maximal duration of 32 months (with a total of 220 injections in 1 patient). Forty-five of the 111 patients received bilateral intravitreal injections, 8 had more than 80 injections each. The only major complications were 4 cases of endophthalmitis causing a total loss of vision in 2 eyes, 1 retinal detachment and 3 cases of slow progression of retinitis resulting in optic nerve atrophy despite treatment. We observed a very low rate of amaurosis and ocular pain. Relapse occurred after 2-3 weeks whenever treatment was stopped, so that intravitreal ganciclovir was not discontinued until the patient's death or reintroduction of systemic treatment. CONCLUSIONS: This procedure confirmed the good efficacy of intravitreal ganciclovir in halting progression of retinitis. Injection of a smaller volume of ganciclovir reduced repeated amaurosis and ocular pain. It was considered by patients as improving their comfort and quality of life, thus increasing their compliance to treatment and reducing side effects as compared to usual protocols.

[Intraocular pressure during vitrectomy in diabetic patients]. / La pression intraoculaire au cours des vitrectomies du diabétique.

23 eyes underwent vitrectomy for diabetic proliferative retinopathy complications: vitreous hemorrhage with or without tractional retinal detachment. After 6 months of follow-up, 64% of eyes had final visual acuities of 1/40 or better. Preoperative iris neovascularization and preoperative detachment of the macula have a worse prognosis. Decrease of peroperative complications is allowed by checking of intraocular pressure during vitrectomy.

[Intraocular pressure during vitrectomy in the diabetic patient]. / La pression intraoculaire au cours des vitrectomies du diabétique.

23 eyes underwent vitrectomy for diabetic proliferative retinopathy complications: vitreous hemorrhage with or without tractional retinal detachment. After 6 months of follow-up, 64% of eyes had final visual acuities of 1/40 or better. Preoperative iris neovascularization and preoperative detachment of the macula have a worse prognosis. Decrease of peroperative complications is allowed by checking of intraocular pressure during vitrectomy.