[Prevalence of bullous keratopathy in pseudophakia with indications for corneal graft from 1984 to 1988].
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Biomedical subjects
Publications and source records attributed to F Lagoutte.
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The amebic keratitis with Acanthamoeba are until now rare, but however increasing as their diagnosis is better, and the contact lens wearers more numerous. The authors present the clinical and parasitological features of cases they did diagnose since 1986. In the immunological sphere, the T4 lymphocytes were 20% less than the normal for the first patient, and the third one had a very low level of immunoglobulins A. In the evolution sphere, the first one did received a keratoplasty; the second one has been successfully treated with propamidine isethionate; for the third one, the treatment with propamidine isethionate was nonuseful and a keratoplasty which was finally performed did show off numerous amebic cysts. In the parasitologic sphere, Acanthamoeba polyphaga was isolated from the first case, Acanthamoeba quina from the second one and Acanthamoeba lugdunensis from the last one. These last two cases are the first which did permit to isolate these amoebae, morphologically near to the first species.
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Treatment of perforated and preperforated corneal ulcers is a difficult task. As emergency penetrating keratoplasty results in poor visual outcome, surgical glue has been suggested as an alternative solution, but poor corneal tolerance for cyanoacrylate made this treatment non satisfactory. We treated 15 corneal ulcers (11 perforations, 2 descemetoceles and 2 deep ulcers) with a fibrin glue. Cicatrisation was obtained in 14 cases by this technic. In one case, cicatrisation was not satisfactory and penetrating keratoplasty was performed 3 days later. This method permits healing of the corneal perforation without the necessity of performing penetrating keratoplasty either if the perforation is distant from the visual axis or if penetrating keratoplasty is contraindicated. In other cases it permits a later penetrating keratoplasty to be performed an a quiet eye. We think this technic can be useful in corneal perforations less than 2 mm in diameter and in chronic deep ulcers difficult to heal.
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