[Keratoconus: what happens with older patients?]. / Kératocône: que deviennent les patients âgés?

INTRODUCTION: Keratoconus is a degenerative corneal disease that is most often seen in young patients. The object of the present study was to analyze the demography of keratoconus patients. PATIENTS AND METHODS: We conducted a prospective study at Bordeaux University Hospital from January 2001 to September 2001. The study included all the consecutive patients with a diagnosis of keratoconus, detected previously or during the current examination. Inclusion criteria included evidence of unilateral or bilateral abnormal corneal steepening with videotopography. RESULTS: We included 121 patients. The results showed a mean age of 33.4 years in males and 37.1 years in females. The number of patients older than 50 was low: 3 out of 83 (3.6%) males and 6 out of 38 (15.7%) females. CONCLUSION: Two hypotheses on the low number of older patients can be suggested. 1) Keratoconus, which is a collagen disorder of the corneal stroma, may be associated with other undetected systemic diseases, which could induce premature death. Different studies have suggested a relationship between keratoconus and mitral valve prolapse. In this case, we can propose preventive treatment. 2) These patients, who have been informed of the nature and the therapeutical modalities of their disease, no longer consult at the hospital, but are followed by their local ophthalmologists.

S/e-PTFE episcleral buckling implants: an experimental and histopathologic study.

To investigate tissue changes induced by the implantation of a silicone band coated with expanded polytetrafluoroethylene (S/e-PTFE) used as scleral buckling, an experimental and histopathological study was performed in rabbits. The right eyes of eight rabbits were implanted for 28-85 days with S/e-PTFE. No complications were encountered in any of the eyes, so histopathological examinations could be performed. Encapsulations combined with numerous giant cells were found to be surrounding the implants in seven eyes, and deposits from the mineral salts of calcium were found in three eyes, forming granulomas possibly caused by irregularities of the implant surface. The porous structure allowed a peripheral colonization by fibrovascular tissue. Taking into account the histological results, the use of this material does not appear suitable. However, this inflammation was limited and did not merge on surrounding tissues.