[Combined cataract-glaucoma operations. Extracapsular extraction and trabeculectomy versus phacoemulsification and trabeculectomy]. / Interventions combinées cataracte-glaucome. ECCE et trabéculectomie versus phacoémulsification et trabéculectomie.

This retrospective study was conducted to evaluate the results of Combined Surgery of Cataract and Glaucoma (triple procedure). The procedure of combined surgery were trabeculectomy and extracapsular extraction (14 eyes) versus trabeculectomy and phacoemulsification (15 eyes). The follow-up of both groups was at least 9 months and up to 16 months (mean: 12 months). The mean decrease of IOP was 12.4 mmHg and 8.9 mm Hg in the first and second group respectively. Instillation of Beta-blockers twelve months after surgery were more frequent in the first group (64.3%) than in the second (26.7%). Finally, the IOP values one year after surgery were equivalent in both groups (less than 19 mmHg in 93% of cases). The mean features to emphasize the delay of recuperation of the best corrected visual acuity: one month for phacotrabeculectomy, and three months for extracapsular with trabeculectomy. The frequency of complications was low in both groups. We observed more hyphemas but less secondary cataracts in the phacotrabeculectomy group. Phacotrabeculectomy could become a reference procedure for combined glaucoma and cataract surgery.

[Values and complications of peripheral deepenings in radial keratotomies]. / Intérêts et complications des approfondissements périphériques lors des kératotomies radiaires.

Single and double peripheral deepenings were used to increase the refractive effect of radial keratotomy (RK). The objective of this study was to statistically evaluate the effect and the complications of these surgical techniques. Simple and double peripheral deepenings were performed in 36 patients (52 eyes) and 14 patients (19 eyes) respectively. The functional results and the complications in these two groups were statistically compared with those of a control group which was comparable according to criteria of size, age, sex and preoperative myopia. The standard RK surgical technique was used in this control group. The difference of mean gain between the control group, and the single and double peripheral deepening groups, was 0.53 and 0.47 diopter, respectively. This difference was statistically significant. On the other hand there was no significant difference diopter gain between the single and the double peripheral deepening groups. There was a significant difference concerning spherical equivalent. The non corrected visual acuity was significantly higher in the peripheral deepenings groups, probably due to corneal topographic alterations generating multifocal corneas. The complication rate (micro-perforations, induced astigmatism, loss of best corrected visual acuity) was higher in the peripheral deepenings groups. The limited diopter gain (about 0.50 diopter) compared with the standard radial keratotomy surgical technique, the lack of decreased, reoperation rate and the increased rate complication justified peripheral deepenings surgery technique discussed by the authors.

[Results of reoperation for under correction of radial keratotomies. Apropos of 25 cases]. / Résultats des réinterventions pour sous correction des kératotomies radiaires. A propos de 25 cas.

Twenty-two under corrected patients (25 eyes) after radial keratotomy, were reoperated according to the Stan Franks surgical technique. The results and the possible factors of predictability of this method of reoperation were evaluated. The residual myopia was less than one diopter in 88% of cases (20% before reoperation). The non corrected visual acuity was superior or equal to 20/40 in 88% of cases (32% before reoperation). The mean dioptrie gain after reoperation was 1.30 diopters. Statistical analysis showed that the refractive gain significantly increased with: the initial residual myopia, the delay between the first radial keratotomy and the reoperation, the number of incisions concerned. Age, sex, corneal thickness, initial protocol and presumed cause of undercorrection were not correlated to the refractive gain. (concerning the mean dioptrie gain). The comparison between data derived from different studies, showed no significant differences between the techniques of reoperation. Induced astigmatism with loss of best corrected visual acuity in 12% of cases was the main complication. The causes of under correction after radial keratotomy, and the effectiveness of the Stan Franks method of reoperation are discussed. The authors emphasize the interindividual corneal reaction to radial keratotomy.

[Apical electrical resistance: parametric study of its variations]. / Résistance électrique apicale. Etude paramétrique de ses variations.

In this study 31 clinical cases were compared and a statistical analysis was realized based on variations of apical resistance points quantified in ohms. For each case the pulpal pathology and the type of irrigants used were systematically reported in a table. The electronic endodontic measures which are radiographically controlled, result from a numeric conversion of electrical signals. This numerization facilitates the memorization of the resistances measured at the sulcus and during endodontic root canal preparation. Analysis of the means and the standard deviations emphasizes the lack of reliability of precalibrated electronic devices or individually standardized instruments, used to measure the working length. This study also shows an ohms drop at the apical constriction, depending on the electrochemical pathological conditions of the canal or of the periapical area.

[Predictive value of tactile sense in electronic endodontometry]. / Valeur prédictive du sens tactile en endodontométrie électronique.

A statistical study has been conducted in order to study the benefit afforded by tactile sense in endodontometry. The study is based on 154 electronic measures (Dentometer, Endoradar, MEO2) and 90 tactiles ones, all radiographically controlled. Results show that: 1. The rate of good electronic measures is, as a whole, the same as tactile ones. 2. The risk of wrong measures is twofold in the case of narrow root canal, necrosis or molar treatment. 3. The risk lessens in the case of a pulpectomy when the electronic measure is associated with a tactile one: 48.38% success instead of 25%, in tactile sense: 48.8 success instead of 56.25%. Evidently, the study bring up to date the tactile perception in endodontometry in the case of pulpectomy.

Anatomical and roentgenological basis for the study of the lumbar spine with the body in the suspended position.

Roentgenological investigation of the lumbar spine was done in the standing and suspended position in 100 healthy adult male volunteers. Spinal and external morphology were studied. The aim of this work was to identify eventual correlations between the modifications of shape and size of the suspended lumbar spine and external morphology. Such correlations were sought to establish a functional approach to anthropometry. The results of this study demonstrated that the suspended position led to lengthening of the spine in 70% of the subjects examined, shortening of the spine in 22% and mainly straightening of the spine in 8%. Extension of the lumbar spine resulting from the suspended position is dependent upon tonic muscle activity and the relations between the observed spinal modifications and external morphology are difficult to establish. Nevertheless, anthropometric profiles and spinal features allow identification of certain influential external morphological parameters. Furthermore, the results of this study confirm those of others devoted to elongation of the lumbar spine under horizontal traction or suspension and lead to practical conclusions.