[Conjunctival limbal autograft versus simple excision with intra-operative mitomycin C in pterygium surgery: a comparative study]. / L'autogreffe conjonctivo-limbique versus l'exérèse simple avec mitomycine C dans la chirurgie du ptérygion : étude comparative.

PURPOSE: The purpose of our study is to evaluate the long-term anatomical and functional results of conjunctival-limbal autograft (AGCL) compared to simple excision with intraoperative mitomycin C. PATIENTS AND METHODS: We conducted a prospective comparative study of 60 eyes of 60 patients presenting with primary pterygium. These patients were divided into two groups, matched according to the age and the stage of the pterygium. Thirty eyes of 30 patients were treated with conjunctival limbal autograft (AGCL group), and 30 eyes of the other 30 patients were treated with simple excision with intraoperative mitomycin C (MMC group). Minimum follow-up was 24 months. RESULTS: The mean age of our patients was 50.6 and 51.3 years in the AGCL and MMC groups, respectively. A male predominance with male to female ratio of 1.5 was noted in both groups. We found more pterygium recurrences in the MMC group. Indeed, seven patients (23.3%) in the MMC group experienced a recurrence. In comparison, we found only a single recurrence (3.33%) in the AGCL group with a statistically significant difference (P=0.026). With regard to postoperative complications, we noted three inflammatory granulomas in the AGCL group (10%). In the MMC group, we observed two cases (6.66%) of delayed corneal healing with superficial punctate keratitis and epithelial defect and one case (3.33%) of symblepharon. There was no statistically significant difference in mean visual acuity gain between the two groups (AGCL: 1.76 lines; MMC: 2.82 lines; P=0.133). CONCLUSION: Pterygium surgery by excision with conjunctival limbal autograft is an effective technique offering a low rate of long-term recurrences and few complications.

[Proliferative diabetic retinopathy inauguring gestational diabetes]. / Une rétinopathie diabétique proliférante inaugurant un diabète gestationnel.

INTRODUCTION: Diabetic retinopathy is one of the diabetic microangiopathy complications generally occurring after insulin-dependent diabetes has evolved for a few years. OBSERVATION: We report a 24-year-old pregnant woman with severe proliferative diabetic retinopathy discovered at the time of the gestational diabetes diagnosis. Argon laser photocoagulation of retinal ischemic territories was initiated. The disease progressed to vitreous haemorrhage in the right eye. DISCUSSION: Proliferative diabetic retinopathy is exceptionally present at the time of the gestational diabetes. We did not find any similar case in the literature. CONCLUSION: Fundus examination seems necessary at the onset of gestational diabetes. It can prevent blindness in young women.

[Urgent penetrating keratoplasty in perforated infectious corneal ulcers]. / Kératoplastie transfixante à chaud dans les ulcères cornéens infectieux perforés.

PURPOSE: To evaluate anatomical and functional prognosis of urgent penetrating keratoplasty in perforated infectious corneal ulcers. METHODS: Seven eyes of seven patients had an urgent penetrating keratoplasty for perforated infectious corneal ulcers. Anatomical success was defined by eradication of infection and preservation of eye from enucleation and phthisis bulbi. Corneal graft survival was defined by the presence of a clear graft. RESULTS: The patients'mean age was 40.5 years. Four eyes had bacterial corneal ulcer and three eyes had herpetic corneal ulcer. Anatomical success was obtained in six eyes. The graft remained clear in two eyes. Graft rejection was noted in four eyes after a mean period of 4.5 months. Postoperative complications were ocular inflammation (one eye), ocular hypertension (three eyes), cataract (one eye), peripheral anterior synechiae (one1 eye), graft ectasia (one eye), bacterial infection (one eye) and recurrent herpetic keratitis (one eye). The mean follow-up period was 22 months, ranging from 9 to 32 months. CONCLUSION: Urgent penetrating keratoplasty can preserve eye integrity and eradication of the infectious process in a large part of perforated bacterial and herpetic corneal ulcers. Visual rehabilitation is often a secondary objective. Adapted antimicrobial treatment reduces graft reinfection and steroid treatment reduces the frequency of some complications, especially graft rejection.

[Epidemiology and development of macular edema in the diabetic]. / Epidemiologie et evolution de l'oedème maculaire chez le diabétique.

Macular edema is the first cause of blindness in diabetics. Macular edema is defined by macular thickening or deposits of hard exudates. On 1000 diabetics examined over 2 years, 60 patients had a macular edema of which we retained 38 cases(54 eyes). All the patients had an ophthalmologic examination with a retinal angiography. Laser photocoagulation with green Argon laser was instituted in 50 eyes. 63% had background rethinopathy. Total or partial regression of the edema happened in 84.4%. Laser photocoagulation decrease by the half vision loss risk. Interest of early detection and treatment to decrease blindness incidence of macular edema in diabetics.

[Prognosis of retinoblastoma. Report of 50 cases]. / Le pronostic du rétinoblastome. A propos de 50 cas.

PURPOSE: The aim of this study was to analyze the factors influencing the prognosis of retinoblastoma. MATERIALS AND METHODS: In 50 children with retinoblastoma, 69 eyes were reviewed. All patients had a full ophthalmic examination, a B-scan ultrasound, a computerized tomography scan and a pediatric examination. We performed enucleation in 47 eyes (with a histopathological study), external beam irradiation in 16 eyes, curitherapy in 4 eyes, cryotherapy in 3 eyes, and adjuvant chemotherapy in 7 cases. RESULTS: The global survival rate was 87.5%. The main aggravating factors were: the size of the tumor and the extraretinal involvement with extension within the chroid, the sclera, and the optic nerve. CONCLUSION: The prognosis of retinoblastoma mainly depends on the extraretinal invasion.