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Biomedical subjects

J L Menezo

Publications and source records attributed to J L Menezo.

At least 37 records · Page 2Linked to original sources
PubMed1995

Long-term results of surgical treatment of high myopia with Worst-Fechner intraocular lenses.

This retrospective study evaluated the results in 90 eyes that had a minuspower anterior chamber intraocular lens implanted to correct high myopia. Preoperative myopia ranged from -7.00 to -24.00 D. Postoperative spherical equivalent was -0.50 D; 80.5% of eyes were within 1.00 D of emmetropia. Two years postoperatively, no cataract formation, retinal detachment, glaucoma, or significant endothelial damage had occurred. We conclude that minus-power lenses can rapidly, safely, and predictably correct high myopia in phakic patients.

Adult↗
PubMed1995

Excimer laser photorefractive keratectomy for high myopia.

One hundred and thirty-three eyes of 103 patients had photorefractive keratectomy with a slit scan mode excimer laser for myopia ranging from -6.00 to -22.00 diopters (D). The epithelium was removed with 20% ethanol, and the ablation was done with a tapered profile surrounding the optical zone. Patients were divided into two groups based on preoperative myopia: Group A, -6.00 D to -12.00 D (88 eyes); Group B, -12.50 D to -22.00 D (45 eyes). In Group A, mean preoperative refraction was -9.59 +/- 1.79 D. Mean postoperative refraction was -0.29 +/- 1.47 D at one month, -0.85 +/- 1.68 D at three months, -1.17 +/- 2.04 D at six months, and -0.56 +/- 0.74 D at one year. Anterior stromal haze was greatest at the end of the first month; it diminished thereafter. This haze did not reduce the best corrected visual acuity in any eye in Group A. Mean preoperative refraction in Group B was -14.69 +/- 5.27 D. Mean postoperative refraction was -1.34 +/- 2.02 D at one month, -0.76 +/- 2.08 D at three months, -3.88 +/- 2.32 D at six months, and -5.50 +/- 5.00 D at one year. Three eyes in Group B lost one or two lines of best corrected visual acuity as a result of severe stromal haze and epithelial scarring. Group A's results were similar to those obtained in eyes with low myopia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Prospective trial of intraoperative mitomycin C in the treatment of primary pterygium.

AIMS: A prospective, randomised, double blind, placebo controlled study of intraoperative mitomycin C as adjunctive treatment of primary pterygium was conducted. METHODS: A total of 66 eyes of 54 patients with primary pterygium were treated with excision, with or without a single intraoperative application of mitomycin C (0.1 mg/ml for 5 minutes) to evaluate the efficacy and toxicity of this adjunctive treatment. The mean follow up was 14.1 months (range 12-23 months). RESULTS: Of the 36 eyes that underwent simple excision, 14 (38.8%) exhibited recurrences whereas only one of 30 eyes (3.33%) treated with excision and intraoperative application of mitomycin C had recurrence (p = 0.0006). Neither serious ocular complications nor systemic toxicity were noted in the mitomycin C treated group. CONCLUSION: Intraoperative mitomycin C appears to be an effective and safe adjunctive treatment of primary pterygium.

Adult↗
PubMed1994

Combined procedure for glaucoma and cataract: a retrospective study.

To ascertain the long-term effects of a triple procedure in the case of coexisting cataract and glaucoma, we did a retrospective study of 93 eyes that had cataract extraction, IOL implantation, and trabeculectomy within a ten-year period. Mean follow-up was 32.4 +/- 21.9 months. Mean postoperative intraocular pressure (IOP) was significantly lower than preoperatively, even though fewer medications were being used. One year after surgery, 60% of eyes had a best corrected visual acuity of 20/40 or better with an average improvement of 3.8 Snellen lines. Patients who had had surgery four or more years before the study had the highest percentage of eyes with an IOP exceeding 22 mm Hg. This group also had the poorest IOP control when no medications were used and when the patient took fewer medications than before surgery. The finding that IOP control decreases with postoperative time raises questions about the long-term success of the triple procedure in controlling IOP.

Adolescent↗
PubMed1994

High dose intravitreal foscarnet in the treatment of cytomegalovirus retinitis in AIDS.

The efficacy and tolerance of high dose intravitreal foscarnet for cytomegalovirus retinitis in patients with AIDS was studied. Foscarnet in a dose of 2400 micrograms was injected directly into the vitreous of 11 patients (15 eyes). Five patients had active retinitis (eight eyes, 53.3%), and received a 3 week induction therapy of six injections as the first step. Six patients had initial inactive retinitis (seven eyes, 46.7%), and received only maintenance therapy which consisted of a weekly injection. The main indications for intravitreal therapy were: myelosuppression, kidney toxicity, catheter related sepsis, or refusal of intravenous therapy. The patients were followed for a mean period of 16 weeks (range 8-28 weeks) and received a total of 304 injections. Vitreous foscarnet levels were measured by high performance liquid chromatography. After a 3 week course of induction therapy, complete resolution of the active retinitis was seen in 62.5% (5/8 cases), while 37.5% (3/8 cases) had partial resolution. No cases failed to respond or progress. The rate of relapse on maintenance therapy was 33% (five of 15 eyes) by 20 weeks, and two of these eyes did not respond to reinduction and progressed in involvement of the macula or optic nerve. Neither important local complications nor intraocular drug toxicity were observed. Vitreous foscarnet levels in two different patients were 896 mumol/l and 74.9 mumol/l at 22 3/4 hours and 42 1/2 hours after the injection. Intravitreal foscarnet appears to be a safe, effective, and useful alternative in patients with intolerance to intravenous and viral therapy.

AIDS-Related Opportunistic Infections↗
PubMed1992

Intravitreal foscarnet for cytomegalovirus retinitis in a patient with acquired immunodeficiency syndrome.

We treated a patient who had acquired immunodeficiency syndrome and cytomegalovirus retinitis of the left eye. After anesthetic had been topically administered, the patient received intravitreal injections of 1,200 micrograms of foscarnet. Plasma and vitreous foscarnet levels were measured by high-performance liquid chromatography. Systemic absorption of the drug was not evident. Elimination half-life from the vitreous after one injection was 54.0 hours. Vitreous levels remained above the mean 50% inhibition value for cytomegalovirus for approximately 56 hours and above the mean inhibition value for human immunodeficiency virus for approximately 241 hours. The patient's visual acuity improved from 20/30 to 20/25 in the left eye. Ophthalmoscopy showed the retinal lesion to have become inactive, and no reactivation occurred during the follow-up period of more than four months. The drug was well tolerated and no retinal toxicity was evident. We suggest an induction treatment regimen of two injections weekly for three weeks, followed by a maintenance treatment regimen of one injection weekly.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Effect of heparin surface modification of polymethylmethacrylate intraocular lenses on signs of postoperative inflammation after extracapsular cataract extraction. One-year results of a double-masked multicenter study.

PURPOSE: A heparin surface modified posterior chamber intraocular lens (IOL) was compared with a conventional polymethylmethacrylate (PMMA) IOL regarding postoperative complications caused by inflammation. METHODS: Five hundred twenty-four patients from 10 different centers were included in a parallel group, double-masked, multicenter study. RESULTS: The cumulative number of patients with inflammatory cellular deposits on their IOLs during the first postoperative year differed significantly in favor of the heparin surface modified group, with 29.8% of the patients having cellular deposits compared with 48.8% of patients in the control group. Cellular deposits were observed most frequently at 3 months after surgery, and the difference between the groups was most pronounced and statistically significant at this time. The same results were seen at 1 year, but the difference was not significant. The number of cellular deposits per patient, however, was significantly lower in the heparin surface modified group at 1 year. Cumulatively, there were significantly more patients with posterior synechiae in the PMMA group than in the heparin surface modified group during the 1-year follow-up. Complications were few and comparable between the groups. CONCLUSION: The results of this study indicate that heparin surface modification reduces the inflammatory response to PMMA IOLs.

Adult↗
PubMed1991

Disseminated Scedosporium inflatum infection in a patient with acute myeloblastic leukemia.

A case of disseminated Scedosporium inflatum infection occurring in a neutropenic patient with acute myeloblastic leukemia is reported. Scedosporium inflatum was isolated from skin lesions, blood, urine and vitreous cultures. Amphotericin B treatment was ineffective in avoiding hematogenous spread. At autopsy, hyphae and ovoid conidia with truncate bases consistent with the morphology of Scedosporium inflatum were found in the lungs, kidneys, myocardium, liver, thyroid, spleen, lymph nodes, brain and the left eye. This is the first report of disseminated Scedosporium inflatum infection and the first time this organism has been isolated from a patient in Europe.

Aged↗
PubMed1990

Cyclosporin A treatment of Behçet's disease: a long-term study.

Fourteen patients with Behçet's disease and bilateral eye involvement were treated for periods of between 30 and 38 months with low doses (5 mg/kg/day) of cyclosporin A (CyA). In patients who responded well, this dose was reduced to a maintenance dose of 2 mg/kg/day. There was a good response to treatment in 86% of patients, with complete disappearance of ocular attacks in 43% and a reduction in frequency and severity of attacks in a further 43%. Only one patient suffered a deterioration in visual acuity (0.2 in one eye) during treatment. The visual acuity of all the other patients (93%) either remained the same or improved. Attacks of buccal and genital aphthous ulceration were also less severe and less frequent during treatment with CyA, although they were proportionally more frequent than ocular attacks. The main side effects were a dose-dependent and reversible biochemical renal toxicity in 28% of patients, gingival inflammation in 14% of patients, and systemic arterial hypertension in 7% of patients. Hirsutism was observed in 100% of the female patients. We conclude that low doses of CyA administered over a long period of time constitute an effective therapeutic alternative that helps prevent evolution towards blindness in Behçet's disease, although it has the disadvantage as compared with chlorambucil that it does not inactivate the disease. The anti-inflammatory effect is therefore dose-dependent and persists only for as long as the drug is being administered.

Behcet Syndrome↗
PubMed1989

Penetration of 2% cyclosporin eyedrops into human aqueous humour.

The penetration into the eye and the systemic absorption of 2% cyclosporin eye drops were determined by polarisation immunofluorescent assay of cyclosporin in the aqueous humour and plasma of 30 patients at the time of cataract surgery. The results were then compared with the corresponding results after oral administration at a dosage of 5 mg/kg/day to three further patients. The maximum intraocular concentration (24 (SD 9) mg/l) was achieved four hours after topical administration. This level was slightly less than that found in aqueous humour (28 (SD 10) mg/l) 12 hours after systemic administration of the drug at a dosage of 5 mg/kg/day. Both these levels are below the minimum therapeutic level (50-100 mg/l). Topical application of cyclosporin A did not produce detectable levels in plasma at any time. These results indicate that the efficacy of cyclosporin A in the control of intraocular inflammation is attributable to its systemic immunoregulatory effect rather than to the local ocular effect.

Absorption↗