[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.

Aircrew fitness decisions and advances in refractive surgery techniques.

Refractive surgery is a well mastered technique for the correction of ametropia. The results in terms of recovery of visual acuity are generally very satisfactory. However, when patients are applicants for pilot training it is necessary to consider the structural effects of the operation and its repercussions on the visual function. Since 1981, we have examined 273 eyes of subjects applying to flight crew. The alterations, in the corneal structure, in the sensitivity to contrasts, and in the resistance to glare have dampened the former enthusiasm of the operated. We have evaluated the functional and clinical consequences of each individual case as well as the administrative decisions made concerning these applicants. The outcome is that on average one of three applicants obtained a dispensation within a time limit ranging from 1 to 5 years after surgery, according to the field applied for.

[Systematic detection of anti-HIV antibodies in donors before keratoplasty: justification and practical modalities]. / Dépistage systématique des anticorps anti-HIV chez le donneur avant kératoplastie: justification et modalités pratiques.

We recall the medical obligation to perform an HIV serology on corneal donors before keratoplasty. The ways to take samples of blood from a deceased person and the techniques which detect HIV antibodies are discussed. We emphasize on the contribution of preservation mediums in order to complete the investigations on the etiology of the death in non urgent keratoplasty. We also insist on the contribution of ELISA techniques to rapidly obtain the HIV serology in non urgent corneal grafts. The real risks of transmitting HIV virus during keratoplasty are discussed.