[Ambulatory ocular surgery]. / La chirurgie oculaire ambulatoire.

Out-patient ocular surgery exists in numerous countries and is currently making its debut in France. The authors note, from a series of 286 out-patients lens implantation operations, that the rate of complications does not significantly differ from that of in-patient procedures. These figures corroborate the results published in the United-States. The procedures applies only to motivated patients in good health and non-handicapped who well understand instructions. The selection of patients is done with the concurrence of the anesthesiologist. The anesthesia is local, occasionally preceded by a suitable sedative. The procedure takes place in an adapted surgical center of which there are several types. The check-out of the patient is within one to four hours after the operation. The constraints posed by equipment and facilities are significant since the responsibility dwells at all times with the surgeon. Caution must be exercised in all phases. The economic advantages of out-patient ocular surgery are not obvious in the current managerial context all the more so because the investment (in equipment and facilities) is costly. Nonetheless, a desired positive secondary effect would be the freeing of hospital beds for other uses. As a parallel, out-patient ocular surgery responds to a new patients demand to be treated rapidly and in an up-to-date manner (both medically and in terms of reception, waiting periods and check-out). The quality of the all procedure is increased.

[Combined operation: cataract and glaucoma with implantation. Results of a series of 28 cases]. / L'opération combinée: cataracte et glaucome avec implantation. Résultats d'une série de 28 cas.

28 eyes underwent a combined procedure: trabeculectomy, extra-capsular cataract extraction and implantation of a posterior chamber intraocular lens. With a minimum of 9 months follow-up, 23 eyes had intraocular pressure controlled of all antiglaucoma medications, and 4 additional eyes achieved control with only the use of timolol maleate drops. (1 eye was lost to follow-up.) Preoperative near visual acuity was less than Parinaud 5 (Jaeger 7) in all eyes. Post-operative near visual acuity was Parinaud 2 (Jaeger 1) in 17 eyes. Senile macular degeneration was responsible for less than Parinaud 2 visual acuity in 4 additional eyes. An extracapsular extraction has advantages over the intracapsular method, both in terms of less post-operative vitreoretinal complications for the cataract extraction itself, and for the creation of a functional trabeculectomy by keeping the vitreous away from the filtration site. Use of a posterior chamber intraocular lens implant as part of the combined procedure appears to be highly acceptable. Complications and limits of the combined procedure are discussed.