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Biomedical subjects

J Collignon-Brach

Publications and source records attributed to J Collignon-Brach.

At least 19 recordsLinked to original sources
PubMed2000

[Non perforating trabecular surgery with reticulated hyaluronic acid implant].

Non perforating trabecular surgery (NPTS) with reticulated hyaluronic acid implant (Skgel) allows aqueous humor to leave anterior chamber through a thin trabeculo-Descemet's membrane into a sclerocorneal space filled with Skgel implant and then via the outflow physiological channels. Good IOP results are obtained with less or without external filtration decreasing the incidence of per- and postoperative complications described after trabeculectomy. This surgery is actually only indicated for primary open angle glaucoma, the trabeculectomy still remaining the gold standard procedure for the other glaucoma cases.

Aged↗
PubMed1998

Ambulatory blood pressure monitoring in glaucoma patients. The nocturnal systolic dip and its relationship with disease progression.

PURPOSE: This study was designed to uncover a new sensitive and specific factor for predicting the progression of glaucoma. METHODS: The 24-hour ambulatory blood pressure and diurnal curve of intra-ocular pressure were recorded in seventy patients: 51 primary open angle glaucoma (POAG) and 19 normal tension glaucoma (NTG). The mean systolic, diastolic and average arterial blood pressure were calculated, along with the nocturnal dip of systolic pressure and diastolic blood pressure. Two-year disease progression was assessed for all patients by means of retrospective analysis of visual fields defects on repeated perimetries. RESULTS: Abnormal (absence or increased) nocturnal dip of systolic blood pressure was found to be correlated with disease progression in POAG and NTG patients with a sensitivity of 86% and a specificity of 85%, whereas no significant correlation was found for the other risks factors envisaged. Furthermore, a significant relationship between stable visual field defects and the use of diuretics/laser procedure was evidenced. CONCLUSION: The nocturnal dip of systolic blood pressure should be considered as a predictive factor of disease progression in NTG and POAG. Further prospective studies are needed to ascertain whether dip normalization could help slow down the visual field loss in these patients.

Aged↗
PubMed1998

[Glaucoma and cataract--surgery at two times].

Cataract surgery in glaucoma patients remains a controversial subject. Indication of surgery depends on the type and severity of glaucoma. Surgical results depend on: the technique used for cataract extraction (extracapsular or phacoemulsification), the type of filtration procedure (trabeculectomy or deep sclerectomy) as well as of the site of the surgical incision, the use of antifibrotic agents and on the surgeon's experience. As cataract extraction alone reduces the intraocular pressure in glaucoma patients (especially in angle closure glaucoma) and trabeculectomy alone reduces intraocular pressure more than combined surgery with less complications, we recommend for controlled glaucoma patients cataract extraction alone and for uncontrolled glaucoma patients a two step procedure consisting in first a trabeculectomy and second a cataract extraction. The use of an antimetabolites not necessary. The recent use of topical anesthesia permits a two staged surgery with less inconvenience.

Cataract↗
PubMed1998

[Interest in the Heidelberg Retinal Flowmeter for measuring the retinal and papillary blood flow].

The Heidelberg Retina Flowmeter is a combination of Doppler flowmetry and laser scanning technology. It is new non-invasive method performing a high definition topography of perfused microvessels of the retina and optic nerve head with simultaneous evaluation of blood flow. Recent studies prove significant decrease of optic nerve head blood flow and juxtapapillary blood flow in primary open angle glaucoma.

Blood Flow Velocity↗
PubMed1996

[Surgery for glaucoma and endophthalmitis].

The incidence of endophthalmitis after glaucoma surgery appears to be related to surgical procedures. After trabeculectomy the incidence is low from 0.06% to 0.2% but trabeculectomy with adjunctive antimetabolites increases the risk to 3% or more. Early onset endophthalmitis is due to the penetration of germs from patient's own external flora during the surgery, especially staphylococcus epidermidis.

Endophthalmitis↗
PubMed1994

Longterm effect of topical beta-blockers on intraocular pressure and visual field sensitivity in ocular hypertension and chronic open-angle glaucoma.

In a prospective, randomized study, nineteen patients with ocular hypertension (n = 14) or chronic open-angle glaucoma (n = 5) were treated with either betaxolol 0.5% or timolol 0.5% in both eyes twice daily. Visual field sensitivity and intraocular pressure were assessed with the Octopus perimeter (program G1) and applanation tonometry, respectively, at 3, 6, 12, 24, 36, and 48 months during treatment. Four of the nineteen patients (two timolol-treated and two betaxolol-treated) were lost to follow-up after the 36-month examination. Whereas both drugs reduced the intraocular pressure, the decrease in the timolol-treated group was statistically more pronounced than in the betaxolol-treated group at month 3, 6, and 48 (p < 0.03). In both treatment groups, the visual field mean sensitivity (MS) index decreased slightly during the first six months of treatment, but remained so only in the timolol-treated group at all subsequent examinations. In the betaxolol-treated group, there was a statistically significant increase in MS at the 12, 24, 36, and 48 month visits (p < 0.01). These findings suggest that factors other than IOP alone may determine visual field outcome.

Administration, Topical↗
PubMed1993

[Mitomycin C in glaucoma surgery].

Glaucoma filtering surgery fails because of scarring of the filtering bleb. Fibroblasts proliferation from the episclera and Tenon capsule play an important role in the scarring process. The use of antimetabolites in glaucoma filtering surgery have a beneficial effect on the lowering of intraocular pressure especially in eye at poor surgery prognosis. They inhibit the fibroblasts proliferation and subsequent scarring of filtering bleb. 5 fluorouracil improves chance of success with filtering surgery but the necessity of multiple subconjunctival injections has many disadvantages including discomfort for the patient and ocular surface problems such as corneal defect and conjunctival wound leak. Mitomycin C with its focal applications limits the toxic effects to tissue directly exposed to the drug. A single intra-operative application leads to a more hypotensive effect with less corneal complications which are two major advantages of this treatment (Kitazawa and al.): Success rate at one year without medical treatment: 88% with MMC-40% with 5 FU. Different tissue culture studies as well as clinical studies demonstrate that the antiproliferative effect of MMC is 100 times more powerful than 5 fluorouracil. Mitomycin C might probably interfere with other steps in the wound healing process. Mitomycin C seems to be a better treatment than 5 fluorouracil. Nevertheless long term randomized prospective human studies are necessary to confirm it.

Adult↗
PubMed1992

Long-term effect of ophthalmic beta-adrenoceptor antagonists on intraocular pressure and retinal sensitivity in primary open-angle glaucoma.

Timolol (TIM) and betaxolol (BET) were evaluated for their effects on both intraocular pressure and retinal sensitivity as determined from visual fields in a randomized two-year parallel study in 20 patients with primary open-angle glaucoma. All treatments were twice-daily in both eyes. TIM was more effective than BET as an ocular hypotensive agent throughout the two year period. With regard to retinal sensitivity as measured by automated visual fields, there was a decrease in retinal sensitivity in the first six months in the TIM and BET treatment groups by 0.5-0.6 dB, and 0.2-0.3 dB, respectively. However, at the one and two year visits, retinal sensitivity increased 0.8-0.9 dB in the BET treatment group only. It appears that ocular hypotensive efficacy may not relate to retinal sensitivity within a period of two years or less in patients with mildly to moderately elevated intraocular pressure. Further work may reveal the reliability of this observation, and its clinical relevance.

Aged↗
PubMed1990

[Primary open-angle glaucoma. Effects of an eyedrop combining timolol and pilocarpine on the ocular pressure].

In a limited group of open angle glaucoma patients treated twice daily with timoptol 0.5% and having by this treatment a mean intra-ocular pressure of 21-22 mmHg, the association of timoptol 0.5% with pilocarpine 2% respectively, lowered the intra-ocular pressure to an average of 17.8 mmHg and 16.6 mmHg after one and three weeks of continuous treatment. For this study, the patients have been divided into 3 groups: A group treated with timoptol 0.5% alone throughout the 49 days of the study. A group treated with timoptol 0.5%-pilocarpine 2% (timpilo 2) from day 21 to day 49. A final group treated with timoptol 0.5% until day 21 and then with timoptol 0.5%-pilocarpine 4% (timpilo 4) through out day 49. These patients stopped the treatment before the end of the study. Intra-ocular pressures were measured on days 0, 21 and 49. We found a higher drop of pressure (-4.8 mmHg) in the timpilo 2 group than in the timoptol 0.5% group (-1 mmHg) before instillation as well as 2 hours afterwards (-5.25 mmHg and -2 mmHg respectively). The secondary local effects were due to miotics agents. The secondary systemic effects were those inherent to beta-blockers. These results are comparable with a multicentric study of 220 patients, therefore statistically significant.

Aged↗
PubMed1984

Corneal endothelial cell density in acute angle-closure glaucoma.

The endothelial cell density of 44 eyes after an acute attack of angle-closure glaucoma is statistically lower than the cellular density of 174 control eyes. The decrease in endothelial cell density increases the risk of edematous corneal dystrophy, more specially after surgery (e.g. cataract extraction). The modifications in corneal endothelial cell density are compared with the alterations of the iris after a crisis of angle-closure glaucoma.

Acute Disease↗