Comparison of refractive outcomes obtained with two swept-source OCT-based optical biometers after cataract surgery: A study of 152 eyes.

PURPOSE: To compare two swept-source OCT optical biometers, the Anterion® (Heidelberg Engineering GmbH, Heidelberg, Germany) and the IOLMaster 700® (Carl Zeiss Meditec AG, Jena, Germany), in the analysis of biometric data, intraocular lens (IOL) calculation and postoperative spherical equivalent predictability. METHODS: This was a real-life, single-center, retrospective study including 152 eyes of 81 consecutive patients referred for cataract surgery. All patients were examined with the IOLMaster 700® and the Anterion®. Biometric data (axial length [AL], anterior chamber depth [ACD], mean keratometry [Km], K1 [flat keratometry], K2 [steep keratometry] and axis, TK1 [flat total keratometry], TK2 [steep total keratometry], central pachymetry, lens thickness [LT], white-to-white distance [WTW]), IOL calculation with the SRK/T formula, and postoperative refractive outcome at 1 month were compared. RESULTS: All biometric measurements were significantly different between the two biometers. Correlations were excellent for AL, pachymetry, ACD, LT and keratometry measurements, and for the IOL calculation (r>0.96, intraclass correlation coefficient=1). The IOL power for emmetropia was similar between both biometers when the SRK/T formula was used (20.84±3.24D versus 20.86±3.29D, P=0.61). The mean postoperative spherical equivalent prediction error calculated using the SRK/T formula was 0.03±0.5D for the IOLMaster 700® versus 0.01±0.47D for the Anterion® (P=0.12). CONCLUSIONS: This study showed excellent correlation and agreement for the biometric measurements and the IOL power calculation with the SRK/T formula between both biometers.

[Late steroid-induced ocular hypertension after intravitreal dexamethasone implants: A series of 20 cases]. / Hypertonie cortisonique tardive sous implants de dexaméthasone : à propos de 20 cas.

INTRODUCTION: Steroid-induced ocular hypertension (OHT) occurs in approximately one third of cases after dexamethasone implant (DEXi) injection. Among these, more than one fifth occur after the third DEXi intravitreal injection (IVI). Our goal was to analyze the clinical profiles of these late responders. MATERIAL AND METHODS: A real-life, retrospective, observational study was conducted to assess demographic characteristics and intraocular pressure (IOP) responses in late responders (IOP ≥ 21mmHg, n DEXi ≥ 4). The following parameters were analyzed: IOP 2 months after IVI and number of glaucoma medications needed. The IOP response compared to baseline was defined as low (< +6mmHg), moderate (≤ +15mmHg) or high (> 15mmHg). RESULTS: Late steroid-induced OHT occurred in 20.8% of cases. Twenty eyes (18 patients) were included. The mean duration of follow-up was 3.8±1.9 years. They received a mean number of 9.5±4.2 IVI. The first OHT peak, measured at 25.3±3.2mmHg (21-31), occurred after 6.8±2.3 IVI. Approximately 65% of OHT spikes occurred between the fourth and sixth IVI; 35% occurred later. At maximum, 1.7±1.0 glaucoma medications and 0.75±0.79 SLT procedures were required to control the OHT, with no filtering surgery required. The ratio of "low," "moderate," and "high" responders was 5%, 85% and 10% respectively. CONCLUSION: Late steroid-induced OHT occurs after at least 3 DEXi in one fifth of multi-injected patients, requiring long-term IOP monitoring. This case series identifies mostly moderate responder profiles, whose IOP rise often remains well-controlled with medical management or laser treatment (SLT).

[Neurocysticercosis of spinal manifestation. Apropos of a case]. / Neurocysticercose à révélation spinale. A propos d'un cas.

A case of spinal extramedullary cysticercosis with location in basal cisterns is reported. It was revealed by a severe sciatalgia and studied with MR imaging which is precious for the diagnosis and the follow-up. Cerebral cisternal arachnoiditis is the main problem in this racemose form where long medical treatment is necessary.

[Ballistic approach in head injuries caused by missiles]. / Approche balistique des plaies crânio-cérébrales par projectiles.

If the missile head injury treatment is relatively well codified, wound ballistic, on the other hand, is not well known of neurosurgeons. Different means of study and tissue simulants are being listed. In face of numerous contradictory results, we shall only retain the M.L. Fackler method with 10% gelatin. Experimental results will depend on: 1. Missile parameters. For instance, in soft homogeneous tissue, one can discern shells with an uncertain path, full jacketed bullets which tumble after a variable "neck", and non jacketed missiles which cause wound through "mushrooming" and/or fragmentation effect. Buckshot wounds obey the rule "all or none". 2. Body reactions, particularly the clash with a hard material like bone, which can overturn everything described in soft tissues. These wound ballistic notions have lead us to formulate two pathogenic hypothesizes, allowing us to understand sometime case reports which had first seemed paradoxical: the brain structure, enclosed in the skull will not able to survive any major temporary cavity, the more or less deep missile pathway through the skull will be very different according to the type and energy of the missile, and to the hardness of pierced bone.