[Intraocular pressure decrease after manual small incision cataract surgery]. / Baisse de la pression intraoculaire après chirurgie manuelle de la cataracte par petite incision.

PURPOSE: We decided to evaluate the decrease in intraocular pressure six months after cataract surgery. MATERIALS AND METHODS: We evaluated patients' IOP using an applanation tonometer. The patients then underwent cataract surgery. Six months after cataract surgery, we reevaluated the IOP by the same method, and we determined the post-operative change. RESULTS: Among the 147 operated eyes, 123 eyes or 83.67% exhibited a decrease in IOP. The mean preoperative IOP for the operative eye was 15.61±4.5mmHg; the mean post-operative IOP was 12.57±3.5mmHg; the mean IOP decrease after surgery was 3.16±4mmHg, for a mean decrease of 20%. This decrease is statistically significant, P<001. The decrease in IOP varies proportionally to the initial IOP. In glaucomatous patients, the mean preoperative IOP was 23.16±5.68mmHg and mean post-operative IOP was 14.5±2.7mmHg, a decrease of 37.39%. CONCLUSION: The decrease in IOP after cataract surgery was generally moderate. However, this IOP decreased proportionally to the initial IOP, thus giving significant decreases for higher IOPs. This decrease in IOP, well known after phacoemulsification, was also obtained after Manual Small Incision Cataract Surgery, a surgical technique which is increasingly employed in developing countries.

[Abducens nerve palsy in spontaneous intracranial hypotension]. / Paralysie du nerf abducens secondaire à une hypotension intracrânienne spontanée.

Described by Schaltenbrand (1940), spontaneous intracranial hypotension is an unusual syndrome, sometimes revealed by an abducens nerve palsy motivating the patient to consult emergency ophthalmology services. The Authors report the case of a 50-Year-old Turkish woman who presented with diplopia due to a left abducens nerve palsy. These symptoms were associated with headache and nausea. Brain magnetic resonance imaging demonstrated diffuse pachymeningeal enhancement with gadolinium. A lumbar puncture showed low spinal fluid pressure (6 cm H2O), leading to the diagnosis of palsy by spontaneous intracranial hypotension. First, a classic treatment was prescribed with no result: increased water intake, corticoid therapy, and rest. Then a blood patch consisting of an injection of autologous blood by lumbar puncture between the third and fourth lumbar vertebrae to plug the spontaneous leak of spinal fluid, with success. A review of the literature provides information on the physiopathological mechanism, the clinical and imaging symptoms, and the treatment.