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J Haut

Publications and source records attributed to J Haut.

At least 55 records · Page 3Linked to original sources

[Retinal detachment in pseudophakia. Analysis of 164 cases].

The authors present a study of 164 pseudophakic retinal detachments followed up at least six months after surgery. All the parameters were statistically evaluated. It shows that preoperative general patterns are similar to those described previously. This study was mainly concerned with finding factors which might influence anatomical success. Only proliferative vitreo-retinopathy was statistically correlated with the quality of the results. In contrast, the demonstration and localisation of retinal tears, IOL design and even vitreous loss do not influence the prognosis.

Adolescent↗

Five-year results of the first 159 consecutive phakic chronic open-angle glaucomas treated by argon laser trabeculoplasty.

159 phakic eyes with chronic open-angle glaucoma were treated by argon laser trabeculoplasty and followed for 5 years. According to our criteria of failure, 31 eyes were failures at 1 year (19%), 47 eyes at 2 years (30%), 66 eyes at 3 years (41%), 77 eyes at 4 years (48%) and 82 eyes at 5 years (52%). In the 77 eyes still controlled at 5 years, the intraocular pressure drop was 6.57 mm Hg and the initial medical treatment could be tapered or stopped in only 33 of the cases (43%). In the 82 failures, there was a greater percentage requiring surgery for pressure control during the first year after laser treatment: 16 trabeculectomies in 31 failures (52%). The initial mean intraocular pressures of 7 failures needing surgery during the first 2 months (27.22 mm Hg) and of the 27 failures needing surgery during the 5 year follow-up (24.41 mm Hg) were higher than the initial mean intraocular pressure of the 77 successful cases (22.67 mm Hg). In the 159 eyes followed for 5 years, 19% (31 eyes) to 6% (5 eyes) new failure cases per year were encountered and the initial good results obtained by argon laser trabeculoplasty persisted for about 5 years in half of the cases.

Adult↗

[Surgical treatment of non-traumatic retinal detachment in children under 15 years of age].

Etiological and clinical features of 151 retinal detachments in childhood are studied and discussed. Results of surgical management of 92 of them, after at least a 6 month follow-up, especially after ablation of silicon oil when used temporarily, are described. Clinical aspects of the contralateral eyes and their prophylactic treatment is also studied. Though surgical techniques have done great strides, prognosis of retinal detachment in childhood is still desperately poor. Proliferative vitreo-retinopathy, frequent, early and very progressive, is the leading complication and cause of failure in surgical of these retinal detachment. In this series of 151 retinal detachments, only 38% have achieved long term retinal reattachment because of it. If high grade (C-D) proliferative vitreo-retinopathy is associated 14.5% only achieved long term reattachment though 86% it when proliferative vitreo-retinopathy was moderate or absent. It is for this reason that we wish to emphasize the need to inform practitioners and "at risk" families. Strict and systematic follow-up of the "at risk eye" is essential. The most complete surgery at the outset seems to be the best way of managing high-grade proliferative vitreo-retinopathy associated with retinal detachments.

Age Factors↗

[Surgical treatment of traumatic retinal detachment in children under 15 years of age].

The clinical features and results of surgical management of 68 out of a series of 101 cases of traumatic retinal detachment in childhood are described and analysed. Follow-up, in particular after the removal of silicon oil used temporarily, was always been longer than six months. Cases were divided into three groups: contusions, ocular injuries without foreign body and with foreign body. Cases of retinal detachment related to traumatic aphakia, severe myopia and associated with proliferative vitreo-retinopathy were also studied. The prognosis of retinal detachment in childhood, the main characteristics of which are late diagnosis and the early and rapid growth of proliferative vitreo-retinopathy appears to be worse in this series than usually published figures. Proliferative vitreo-retinopathy is the leading cause of surgical failure. The long term retinal reattachment rate did not exceed fifty per cent and the functional success rate was only thirty-three per cent. It is for this reason that the authors wish to emphasize the need for the provision of information to families and to ophthalmologists responsible for the management of these "high risk eyes". It is felt that the most complete surgery possible should be performed at the outset when proliferative vitreo-retinopathy exists.

Adolescent↗

[Preventive treatment of retinal detachment of the contralateral eye. Results of 5 years follow-up of 109 eyes].

In 1987, we presented a study of 141 eyes treated prophylactically following retinal detachment in the fellow eye. A hundred and nine of these patients are reviewed with a minimum follow-up of five years. Only the evolution was studied, whether a peripheral retinal lesion was present or not at the time of prophylactic treatment. The examiner noted if new lesions had occurred, or if lesions present at the time of the first examination had developed: lattice degeneration or snail track developing into a retinal tear, hole or tear causing a retinal detachment, contained or not by laser treatment. Our study contained sixty two myopes. Fifty eyes had visible, dangerous lesions, and fifty nine a normal retina. Forty five circular barrages with four anterior radial rows returning to the ora serrata were performed, and sixty four barrages with tight anterior grids and a localised barrage of visible lesions. The results were judged on one criterion only: retinal detachment requiring emergency surgery. Only one retinal detachment occurred behind the barrage, caused by proliferative vitreoretinopathy due to multiple tears, and surgical results were good. Eight tears appeared in front of the barrage, five of these in healthy retina. Two very posterior tears behind the barrage were blocked with no problem by laser treatment. Four localised detachments occurred in front of the barrage, three of these without anterior grid treatment. The advantage of this is undeniable since out of sixty three cases treated in this way, only three tears were seen to be blocked by the laser shots, and one anterior localised detachment where the anterior grid was insufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Preventive treatment using laser of age-related macular degeneration of the contralateral eye after age-related macular degeneration of the first eye].

Since 1982, and with informed patient consent, we have photocoagulated confluent drusen and limited serous pigment epithelium detachment (SPED) in the fellow eye of ten patients suffering from advanced, disciform type, age-related macula degeneration (ARMD). This treatment was only carried out on appearance of metamorphopsia. Photocoagulation was performed with either the green ray of the argon laser, or the yellow ray of a dye laser. Spots of about 200 microns were placed in a grid-like fashion among the drusen. No complications were observed due to the treatment. The follow-up period on these ten patients, eight women and two men, mean age 77 years, was two to eight years, and the three patients have died. The drusen disappeared completely in three patients and partially in one. The functional results seemed favorable in three cases. In one case of confluent drusen associated with SPED and serous retinal detachment, vision improved remarkably from 0.3 to 0.5 with a Parinaud 2, with a follow-up of five years. In another case, the improvement was from 0.4 to 0.7 but the patient died after only a few months. In another case, vision has been stable for five years. The vision of the seven remaining patients deteriorated; three cases showed central areolar sclerosis, and one case a localised new vessel with vision less than 0.1. In three cases vision dropped to 0.2 and Parinaud 6, but they have been stable for at least four years (eight years for one patient).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Preventive chemo-antibiotic treatment of postoperative endophthalmitis in planned open eyeball surgery. Apropos of 2,337 cases].

A protocol combining chemoprophylaxis and antibioprophylaxis has been used since January 1st, 1990 for all patients (2,337 cases) undergoing planned open eyeball surgery (except emergencies). The chemoprophylaxis is local, by eyedrops (picloxidin) during the days before surgery, and by eyewash of the conjunctival cul-de-sac with iodized polyvidone immediately before surgery. The systemic antibioprophylaxis associates two bactericidal antibiotics with a wide spectrum and good intraocular penetration, active on 89 to 90% of the bacteria incriminated in postoperative endophthalmitis: a ureidopenicillin, piperacillin, and a fluoroquinolone, ciprofloxacin; the adverse effects are minimal. Although the sample size does not allow statistical, analysis the results of this study (the absence of any endophthalmitis) are very encouraging in comparison with those of the literature, those of the same department during the years before the protocol, and those of the other departments in the same hospital which carry out the same surgery under the same conditions.

Anti-Bacterial Agents↗

[A case of tuberculoma of the orbit with sphenoidal origin].

We report the case of an orbital and sphenoidal tuberculosis observed in a young Indian man living in France. The orbital disease is presenting as an orbital mass with a radiologic bony lytic aspect, without systemic manifestation. A malignant process was suspected. The diagnosis was obtained by the culture for Mycobacterium tuberculosis of the biopsy specimen. Orbital involvement in tuberculosis is a rare manifestation in developed countries. Most cases reported in the literature were reported from Asia and Africa. Orbital tuberculosis may become established in one of two ways: primarily by heamatogenous spread to cause a periostitis or a tuberculoma of the orbital tissues, or secondarily by direct extension from neighbouring structures. It occurs in patients with or without associated pulmonary tuberculosis. Mycobacterium tuberculosis should be considered in the differential diagnosis of inflammatory orbital diseases. This diagnosis is based on clinical feature, positive tuberculin skin test and positive culture in resected tissues. The complete resolution of the disease with the specific antituberculous drugs emphasizes the point that tuberculosis must be evocated.

Adolescent↗

[Use of perfluoro-octane liquid in the treatment of giant tears with inversion of the retina: preliminary results].

Five consecutive cases of giant tears with retinal inversion were easily and successfully treated using vitrectomy and silicone oil injection after repositioning of the retina with perfluoro-octane. The good initial results show the interest of this technique compared with the incarcerations or with the manipulation of the retina and of the perfluoro-octane compared with the other liquid perfluorocarbons.

Adult↗

Treatment of glaucoma with high intensity focused ultrasound.

Focused high intensity therapeutic ultrasound has been used since 1982 by Coleman and all, to treat patients with uncontrollable intraocular pressure. Three mechanisms may be responsible for lowering intraocular pressure: decreased aqueous humor production in the ciliary epithelium, transscleral outflow of aqueous humor, and increased uveal outflow. We began the use of focused ultrasound to treat glaucoma in April 1987. Up to now (April 1988), we have treated 220 patients. We describe results from patients that had a follow up of 3, 6, 12 months. Successful treatment resulting in pressure less than 20 mm Hg, was obtained in over 80% of patients treated at 90 days post treatment and of 50% after 6 and 12 months. The complication rate is low. Retreatment is safe and effective. Additionally, the use of U.S. to open closed filtering blebs, recently postoperative, has been a success in 90% of the treated eyes after 3 months. The follow-up period of this study is short which makes conclusions about long-term effects and side effects not possible.

Follow-Up Studies↗

Twenty-five cases of relaxing retinotomy using a nanosecond Nd Yag laser (Yag-retinotomy).

The results of the first 25 retinotomies performed with a nanosecond Nd Yag Laser (Nanolas, Biophysic Medical) between September 1986 and July 1987 are described. This technique was chosen in order to avoid additional surgery and anesthesia in patients requiring a relaxing retinotomy. Treated eyes were usually filled with silicone oil. Simple contact anesthesia and a three-mirror lens were sufficient. Energy was set at 10-15 mJ, 50 Hz burst mode, 10 degrees cone angle. The aim of the treatment was to eliminate a residual inferior traction, to remove silicone oil (19 cases), or to obtain reapplication at the posterior pole. Results were positive in 18 cases and negative in 7, but unsuccessful Nd Yag laser treatment may be corrected with surgical retinotomy. The main complication is hemorrhage, which usually subsequently decreases and does not affect the prognosis.

Adolescent↗

Retinal and choroidal ischemic syndrome, digestive tract and renal small vessel hyalinosis, intracerebral calcifications and phenotypic abnormalities: a new family syndrome.

A new family syndrome is described that affected three of seven siblings and another patient who had been abandoned at birth but came from the same area of France. All four patients were young women with a very peculiar phenotype, poikiloderma and greying of the hair, and idiopathic non-arteriosclerotic cerebral calcifications. Pathological studies demonstrated small-vessel hyalinosis due to basal membrane thickening, mainly in the digestive tract, kidneys and calcified areas of the brain. The clinical and biological expressions of these vascular changes varied. Peripheral retinal ischemic syndrome and chorioretinal scars were found in the ocular fundi of three patients. Malabsorption and protein-losing enteropathy was the main problem in all four, and was the cause of one patient's death. A subarachnoid hemorrhage due to a right sylvian aneurysm also occurred in two of the three sisters and was lethal for one. Nephropathy with renal failure and systemic hypertension is the major problem of the two surviving patients.

Abnormalities, Multiple↗

Study of a new series of large relaxing retinotomies.

Silicone oil injection followed by retinotomy was performed in a second series of 37 patients with retinal detachment and advanced proliferative vitreoretinopathy. The retina posteriorly to the retinotomy was attached in 16 eyes with at least 18 months of follow-up. Ambulatory vision or better vision was restored in 12 eyes. The size and the site of the retinotomy depend on the size and the site of the retraction.

Adolescent↗

[Surgery of idiopathic epiretinal macular membranes. A retrospective statistical study of the functional result. Apropos of 42 treated cases].

Presentation of 42 glial idiopathic epiretinal macular membranes, surgically removed. Complications are rare. The functional improvement is greater if the operation is carried out when the visual acuity is low but the final result is better if eyes are operated when the visual acuity is still good. The main difficulties are the impossibility to detach the membrane, and the iatrogenic tears, which often need an internal tamponade by intraocular silicone oil.

Adult↗