[Aberrometry and contrast sensitivity after cataract surgery: aspherical IOL evaluation]. / Aberrométrie et sensibilité aux contrastes chez le patient pseudophaque. Evaluation d'un implant asphérique: étude comparative.

PURPOSE: We report a prospective clinical study investigating efficacy in terms of aberrometry and contrast sensitivity of the aspherical IOL (SW60AT) versus the standard IOL Alcon (SN60AT). PATIENTS AND METHODS: Twenty patients in each group underwent phacoemulsification of both eyes. Both eyes of each patient received an aspherical IOL (SW60AT) or a similar standard IOL (SN60AT). The integrity of ocular function was assessed with clinical examination before surgery. Postoperative examination (1 month after the second surgery) included best visual acuity, an aberrometry with a 5-mm pupil (Bausch and Lomb), and a contrast vision (Zalonghi scale) in scotopic place examination. RESULTS: We noted no statistically significant difference between the two groups before surgery. Best spectacle-corrected visual acuity improved in both groups with no difference (8.15/10+/-1.39/10 and 7.95/10+/-1.54/10 for the aspheric group eyes and 7.85/10+/-2.13/10 and 7.60/10+/-2.14/10 for the standard group eyes). Otherwise, a statistically significant difference was found for the Z40 aberration with RMS=0.0095 with SW60AT versus RMS=0.07625 with SN60AT. The pupils had a similar size in both groups. There were no statistically significant differences for contrast sensitivity between two IOLs; nevertheless, contrast vision seemed to be better with the aspherical lens (33.15+/-6.85 points and 32.15+/-6.95 points for the standard group eyes and 36.05+/-3.63 points and 35.70+/-3.93/10 points for the aspheric eyes). CONCLUSION: The quality of vision can be objectively increased with the aspherical IOL because of less spherical aberration.

[Study of pupillary motility after implantation of an iris claw lens (Artisan) in a phakic population with severe myopia]. / Etude de la motilité pupillaire chez le sujet phaque porteur d'un implant Artisan.

PURPOSE: To assess the effect of the Artisan lens on pupillary motility in a highly phakic myopic population. PATIENTS AND METHODS: Eleven patients (21 eyes) were enrolled in a nonrandomized prospective study between September 2002 and August 2003, with a 6- to 11-month follow-up. A portable Colvard pupillometer was used to measure pupil diameters before and after surgery under two different light conditions: one with scotopic surroundings with absolute darkness in the examination room and the other maximal simulated photopic surroundings, caused by the instillation of a pilocarpine 2% drug until a nonreactive myosis could be observed. Under such light conditions, both the horizontal and vertical pupil motion ranges were measured. Measures were then sorted into five temporal segments in order to have enough samples per temporal segment for a cohesive data analysis. Mean values and confidence intervals were then derived per temporal segment according to Student's law. Constraints on the pupil motion range were identified. RESULTS: After implantation of an Artisan lens, the pupil motion range was limited to both horizontal and vertical axes. For the horizontal axis, the motion range was 4.3+/-0.2mm (p=0.1) before claw implantation and was 2.7+/-0.5mm (p=0.1) 9 months after claw implantation. For the vertical axis, the motion range was 4.46+/-0.28mm before claw implantation and 3.08+/-0.89mm 9 months after claw implantation. CONCLUSIONS: The Artisan lens durably restrains the pupil in its motion range and introduces a noticeable oval deformation under extreme light condition variations. This side effect is, however, not visible under regular conditions but only in maximal photopic surroundings.

[Macroprolactinemia, a variety of hyperprolactinemia. Apropos of 5 cases]. / Macroprolactinémie, une variété d'hyperprolactinémie. A propos de cinq observations.

Macroprolactinemia, due to increased circulating levels of large molecular weight forms of prolactin, results in elevated level of immuno-reactive prolactin. The big variants have only weak biological activity; thus macroprolactinemia appears as a case of hyperprolactinemia without clinical significance as demonstrated by the five patients described. The diagnosis is based upon chromatography which separates the hormone and its variants. This disorder produces a pitfall in the diagnostic evaluation of hyperprolactinemia.

[Cardiac tamponade in severe hypothyroidism. A rare cause]. / Tamponnade cardiaque au cours d'une hypothyroïde sévère. Une cause rare.

Pericardial effusion frequently occurs in patients with hypothyroidism, and this fully justifies the use of echocardiography at the time of diagnosis and during the follow-up of hypothyroidism. Signs indicating that the pericardial effusion is poorly tolerated are rare, and the development of pericardial tamponade is exceptionally reported. A case of tamponade in an elderly woman with severe hypothyroidism is described here. Some physiopathological particularities are emphasized, together with the value of echocardiography for the diagnosis and that of pericardial drainage for the treatment.

[Gastric bezoar in diabetes mellitus. 3 cases (author's transl)]. / Bézoard gastrique au cours du diabète sucré. 3 observations.

Diabetic gastroparesis is the gastric manifestation of diabetic autonomic neuropathy and may result, on rare occasions, in the formation of a bezoar. This was the case in 3 patients (two women aged 36 and 66 and a 19-year-old man) whose insulin-dependent diabetes was complicated with neuropathy. All patients had marked glycaemic instability apparently related to digestive function. In one patient, a stable normoglycaemic state was obtained by continuous intravenous administration of carbohydrates until the bezoar had disappeared. In the other two patients, who had a long history of neglected digestive disorders, the bezoars provided intractable. In diabetics with dyspeptic symptoms, and particularly when neuropathy is present, it would be advisable to investigate for gastroparesis in order to prevent the development of a bezoar by dietetic and therapeutic measures.

[Interest of the use of pain drug in hyperalgic ophthalmic herpes zoster (author's transl)]. / Intérêt d'un médicament de la douleur dans les zonas ophtalmiques hyperalgiques.

In ophthalmic herpes, very frequent residual pain may be the cause of severe facial neuralgia which may persist for many years. These cases of neuralgia often occur in the elderly and raise difficult therapeutic problems. Tiapride which is a neuro-visceral mediator of the substituted benzamide family gave excellent results in 3 cases of ophthalmic herpes zoster in the elderly. The dosage was 200 to 300 mg daily by the intramuscular route, then by the oral route. Tolerance was excellent.