[Prevalence and causes of pain after cataract surgery: Comparison of 1st and 2nd eyes]. / Analyse de la douleur et ses déterminants après chirurgie de cataracte : comparaison de l'intervention du 1er et du 2e œil.

INTRODUCTION: In our practice, patients undergoing bilateral cataract surgery complain of more significant pain after the 2nd eye surgery. The goal of this study was to compare postoperative pain between the 1st and 2nd eyes with cataract surgery under topical anesthesia and to identify the causes of this pain. PATIENTS AND METHODS: We conducted a prospective observational study between May and September 2015. We included 69 consecutive adults scheduled for bilateral cataract surgery under topical anesthesia within 2 months by the same surgeon. A self-assessment questionnaire of anxiety (the Amsterdam Preoperative Anxiety and Information Scale [APAIS]) was completed before each procedure. Postoperative pain was assessed by the visual analogue scale (VAS) in the recovery room. RESULTS: Among the 69 included patients (mean age: 70±1.3 years), 13 (19%) experienced more pain after the 2nd eye procedure. The median VAS was 0 (EI: 0-1) after the first eye versus 0 (EI: 0-2) after the second eye (P=0.836). The patients with the most pain after the second eye surgery had a median anxiety score of 5 (EI: 4 to 9.5), which was comparable to those without pain (P=0.589). On bivariate analysis, women had more pain after second eye surgery (27%) than men (4%) (P=0.026). However, this association lost its significance when the analysis was adjusted for the level of anxiety (adjusted OR 7.7, 95% CI [0.91; 64.6]). In fact, women were more anxious [median anxiety score of 6 (EI: 4 to 8.5)] before 2nd eye surgery than men [median score: 4 (EI: 4-6); P=0.013]. DISCUSSION: Pain levels appeared to be very moderate on both sides when measured postoperatively, as opposed to statements often made in the immediate postoperative period. There is a discrepancy with the literature data. However, each study had small sample sizes. CONCLUSION: We did not find any significant difference in pain between 1st and 2nd eye cataract surgery under topical local anesthesia. While postoperative pain appeared greater among women, we have noted the possible influence of anxiety, which could justify specific preoperative support.

[Lens biomaterials for cataract surgery]. / Biomatériaux dans la chirurgie du cristallin.

The first lens implantations were performed by Sir Harold Ridley in 1949 using rigid poly-methyl-methacrylate (PMMA) lenses. This biomaterial was used exclusively for more than 30 years. In the early 1970s, Charles Kelman introduced phacoemulsification, reducing the incision size and beginning biomaterial diversification, including foldable materials. More than 50 years after the introduction of PMMA, the range of biomaterials used for intraocular lenses remains extremely limited. Among the materials tested, acrylic polymers and silicon elastomeres are the only remaining materials used for optics. In vivo tolerance is no longer the sole criterion in choosing biomaterials: clinical performance now plays a major role, including injection abilities, optical qualities, and long-term postoperative intraocular behavior. Together with lens design, the analysis of the physical and chemical characteristics of biomaterials will contribute to the choice of the best intraocular lens.

[Progressive cone dystrophy: electrophysiological changes in female carriers]. / Dystrophie progressive des cônes: altérations électrophysiologiques chez les femmes transmettrices.

The authors evaluated a family with X-linked progressive cone dystrophy and special attention was paid to female carriers. Twenty-four members of the family were examined. One generation II--male and five generation III--males were affected. Two generation II--females who, in each case had affected children, but who were asymptomatic, underwent electrophysiological evaluations. The electroretinograms were found to be subnormal in both patients with alterations of cone-mediated responses and color vision. The discovery of abnormalities in female carriers emphasized the necessity of systematically performing electroretinography, together with color vision testing and pedigree examination, when assessing so called sporadic cone dystrophy or in cases where the modes of inheritance are not clear.

[Xerophthalmia caused by self-induced deficiency]. / Xérophtalmie carentielle volontaire.

The case is described of a 36 years old woman with bilateral xerophthalmia secondary to his diet. She presented a perforation of the left cornea which required an emergency penetrating keratoplasty. The treatment is described.

[Penetrating keratoplasty using the Hanna trephine. Anatomic and functional results]. / La kératoplastie transfixiante avec le trépan de Hanna. Résultats anatomiques et fonctionnels.

The survey of 21 penetrating keratoplasty, using Hanna trephine is reported. Corneal transparency, astigmatism, visual acuity are studied.

[Central areolar choroid dystrophy]. / A dystrophie choroïdienne aréolaire centrale.

Central areolar dystrophy is a dominantly inherited macular dystrophy characterized by a bilateral, symmetrical, well circumscribed loss of choroidal and retinal tissues. A family presenting such degeneration is studied on three generations in initial and late stages. Clinical, functional and angiographic datas are characteristic: earliest changes and evolution are analysed.

[Hereditary pseudo-vitelliform macular degeneration. Apropos of 3 familial cases]. / Hérédo-dégénérescence maculaire pseudo-vitelliforme. A propos de 3 cas familiaux.

3 cases have been analysed, 2 sisters and one brother, 2 of which presented a macular lesion that could be related to best's disease. Certain clinical, EOG and angiographic characteristics rule out this diagnosis and statistic the diagnosis of pseudovitelliform degeneration.

[Xerophthalmia caused by self-induced deficiency disease]. / Xérophtalmie carentielle volontaire.

Xerophthalmia is no longer seen in Europe since the 19th century. We report the case of a female patient, aged 33, of french nationality, who presented a clinical picture of major vitamin A deficiency, self-induced and with ocular complications. An untreated long standing depressive condition appeared to be the major etiologic factor. Perforation of a desmetocele necessitated penetrating keratoplasty. Histologic corneal and conjunctival aspects are reported. Oral prescription of vitamin A resulted in considerable clinical improvement. Only 3 similar cases have been previously reported. Clinical manifestations of xerophthalmia are described along with preventive and curative therapy.