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Biomedical subjects

J-P Adenis

Publications and source records attributed to J-P Adenis.

7 recordsLinked to original sources

[Use of mitomycin C (MMC) for dacryocystorhinostomy interventions].

Mitomycin C (MMC) has been described as having a positive effect in different types of dacryocystorhinostomy (DCR) surgery such as external DCR, endonasal and transcanalicular DCR. MMC, an antineoplastic antibiotic, acts as an alkylating agent by inhibiting DNA, RNA and protein synthesis. Topical use of MMC can modulate the scarring process, which is useful in glaucoma surgery and pterygium excision. In DCR, MMC is also useful because it reduces the scarring process and thus prevents the occlusion of the osteotomy site related to the fibroblast activity. An increase in the success rate for long-term results has been observed by different authors, resulting from a larger osteotomy size as well as a decrease in the density and cellularity of the mucosa. No complications have been seen with topical use of MMC.

Cicatrix↗

[Clinical signs of dysthyroid orbitopathy].

Dysthyroid ophthalmopathy is an inflammatory disease of the orbit, combined or not with thyroid disorders. However, pure ophthalmologic forms exist, and the diagnosis can be made by the ophthalmologist. The diagnosis is made by examining eyelid malposition, oculomotor disorders, inflammatory signs, proptosis measurement, and by the search for optic nerve pain. We discuss the NOSPECS classification, which can evaluate the severity and progression of the disease.

Exophthalmos↗

[Complications of dysthyroid ophthalmopathy].

The complications of dysthyroid ophthalmopathy should be known and screened in every patient since they can worsen visual prognosis and are critical to the decision for treatment. Ocular surface alteration can result from eyelid malposition, blinking deficiency, eye dryness, and proptosis. Oculomotor disorders are detected by coordimetry or a forced duction test. Optic neuropathy can be compressive or glaucomatous. Intraocular pressure elevation can result from elevation of intraorbital pressure, indentation by an enlarged muscle, or increased backflow in episcleral veins.

Diplopia↗

[Orbital fat decompression techniques].

Fat removal orbital decompression (FROD) was first described by Olivari in 1988. Through a blepharoplasty approach, fat pads from the five palpebral pockets, as well as intraconal fat, are carefully removed. The main complications are retrobulbar hemorrhage and postoperative diplopia. The best indications are patients with wide orbits without compressive optic neuropathy. FROD is an inescapable procedure in a balanced approach to surgical orbital decompression.

Blepharoplasty↗

[Optic nerve sheath decompression in optic neuropathy complicating idiopathic intracranial hypertension: a new focus].

Optic nerve sheath decompression is a surgical procedure only used in optic neuropathy complicating idiopathic intracranial hypertension. We describe this technique and compare it with the classic technique of cerebrospinal liquid derivation. Several points contrast optic nerve sheath decompression and cerebrospinal fluid derivation: there is no biomaterial, it is limited to the orbital area, and intracranial pressure remains unchanged. The complications are different, yet analysis of the literature shows the same efficacy in terms of visual function. We recommend a practical management of optic neuropathy complicating idiopathic intracranial hypertension, depending on the functional severity and the therapeutic efficacy. The surgical indication should only concern serious optic neuropathy not responding to medical therapy, with the choice of the surgical technique belonging to the surgeon.

Decompression, Surgical↗

[Antiviral therapy adjustment in corneal recipients using antibody testing in the aqueous humor].

INTRODUCTION: In corneal recipients with herpes infection, acyclovir given for 1 year postoperatively prevents viral reactivation and improves graft outcome. The indication for prophylactic antiviral therapy relies on the preoperative diagnosis of herpes. However, many patients present with corneal scars featuring sequelae of herpes without a proven history of herpes. Here we report the results of a prospective study of anti-herpes simplex virus (anti-HSV) and varicella zoster virus (VZV) antibody testing in the aqueous humor at the time of corneal transplantation to refine the indication of the antiviral treatment. MATERIAL AND METHODS: The study involved 33 keratitis corneal graft recipients, 21 of whom had documented herpes keratitis. A control group was made with 11 cataract patients. An anterior chamber puncture was performed just before surgery. The micro-ELISA test was done on both aqueous humor and serum, and local anti-HSV or VZV antibody synthesis was acknowledged if the ratio of antibody concentrations was above 4. RESULTS: Local antibody synthesis to HSV was detected in 22 cases, to VZV in 9 cases, to both HSV and VZV in 6 cases, and no synthesis in 8 cases. The sensitivity of the test was 65% in patients with a documented history of herpes (14 cases out of 21). Among non-herpetic patients, the test was positive in 9 patients, who thus benefited from postoperative antiviral therapy. No viral reactivation was encountered after a minimum follow-up of 1 year. CONCLUSIONS: Antibody testing in the aqueous humor at the time of keratoplasty is a convenient, inexpensive diagnostic tool in corneal recipients. It provides useful information before prescribing a long and expensive postoperative antiviral therapy.

Acyclovir↗

[Lymphoma revealed by isolated obliquus inferior muscle involvement in exophthalmia].

Orbital lymphomas account for 4% of nontraumatic orbital disorders. We report the case of a 54-year-old patient who presented with binocular diplopia associated with right exophthalmia with an isolated obliquus inferior localization. This lymphomatous localization was unexpected, as lymphomas are described more often in the rectus superior and inferior muscles. Pathological examination found a low-grade non-Hodgkin's MALT lymphoma. This case is the basis of a review of the various diagnoses and the necessity of a biopsy prior to surgical tumor ablation that may damage an oculomotor muscle. Treatment should be medical: first-intention surgery would have abolished obliquus inferior function.

Biopsy↗