[History of intravitreous surgery].
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Biomedical subjects
Publications and source records attributed to H Saraux.
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Study of two patients with spontaneous detachment of the choroid. In addition to detachment of the choroid, case 1 had a flat anterior chamber. Corticotherapy gave some improvement but after 3 months, surgical management was necessary. In case 2 enucleation was performed on the basis of positive echographic findings. Histological findings, the main clinical features and the therapeutical approach are discussed.
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We observed in 13 young patients a serous or hemorrhagic paramacular detachment of one third to one half disc diameter size. In eight, we have seen also atrophic choroidal scars. In one patient the serous detachment occured at the site of a previously studied choroidal scar. Our cases resemble the presumed ocular histoplasmin choroiditis described in American literature. In our cases histoplasmosis can be excluded. Visual prognosis is dependent upon proximity of the choroidal lesion to the fovea. In most cases this prognosis is poor. The term juvenile hemorrhagic ocular choroidopathy is suggested for the disease.
The results of argon laser photocoagulation performed on 20 eyes with ischemic or edematous central retinal vein occlusion were analyzed. In patients with ischemic occlusion, neovascularization improved after treatment but they derived no benefit as far as visual acuity is concerned. In the group with enematous occlusion, visual acuity and macular edema improved after treatment. However, 6 of 8 patients of this group had prior urokinase treatment.
An experimental study, by angiography of the anterior segment of rabbit's eye, estimates the permeability of the hemato-aqueous barrier, using fluorescein. A trauma of the eye (contusion) leads to a rapid and significant increase in this permeability. However, local pretreatment, using an ophthalmic solution of 0,33% indometacine, almost completely stabilizes the hemato-aqueous barrier, even for elements as diffusible as fluorescein. These results suggest that application of a similar preparation to the human eye could be useful in the treatment of ocular contusions, chemical burns and angle-closure glaucoma. But the best perspective could be the application of the indometacine solution to the eye, before an operation, to reduce the sideeffects of surgery relative to the surgical break of the hemato-aqueous barrier.
Prevention of malignant glaucoma: in first case report lens extraction and trabeculectomy was followed by a malignant glaucoma; in the second case report pars-plana vitrectomy and trabeculectomy was successful. The role of a vitreous posterior blockage is discussed.
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We study the arterial vascularization of the trunk of the optic nerve partialarly in its anterior part in human. We injected in the carotids, a mass of colored an radio opaque substance, in the whole cadaver that allows simultaneously a visual study and a radiologic control of the results. This one is completely insufficient to allow a study of details; so we used the diaphanisation as described by Spalteholz; we were able to confirm Hayreh's results: the ophthalmic artery has a variable pathway according to individus but overcrosses the most frequently the optic nerve. The posterior ciliary arteries have also an origin pathway very variable; the posterior external ciliary is the most commonly present. The central retinal artery takes its origin the ophthalmic artery no more than half of the cases, and elsewhere from a common trunk with the ciliary arteries, or even from branches of those last arteries. It always penetrates the nerve in its inferior face and is responsable of its vascularization in periphery by the man of its pial branches and in depth by its intra neural branches.
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A report of a family in which three generations were affected by on autosomal dominant corneal dystrophy. The authors studied two fragments of a recurrence on a graft where they noted the presence of granular material. Histochemical studies were negative. Electron microscopy showed the presence of deposits of crystalline appearance resembling those of Groenouw type I dystrophy.
Ultrastructural study of two cases of persistent hyperplastic primary vitreous. Behind posterior lens capsule we find a connective tissue where fibroblasts present an intense activity. Numerous vessels and neuro-ectodermal tissue were noted.
Two cases of persistent hyperplastic primary vitreous have been managed by the vitreous cutter Sukon "Alternating" with a pars-plana approach.
Study of six cases of vitreous touch syndrom with histopathology of five buttoms of kératoplasty. Light and electron-microscopy demonstrate many alterations of Descemet's membrane, which is thickened, devided in sheets. In one specimen there was a retrocorneal fibrous membrane and "fibroblast like cells". These findings support the mechanism of endothelial fibrous metaplasia as the origin of the retrocorneal fibrous membrane during vitreous touch syndrom.