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Biomedical subjects

L Durand

Publications and source records attributed to L Durand.

At least 19 recordsLinked to original sources
PubMed1992

[Band keratopathy. Symptomatological value based on 23 cases].

This study attempts to better define band keratopathy. A total of 23 eyes were reviewed, the largest sample ever published. The histopathology of this condition, characterized by lesions situated beneath the corneal epithelium, as well as its various clinical forms, are described. A distinction is drawn between band keratopathy and brown band keratopathy from an etiological and histological standpoint. The various available treatments are reviewed, emphasising lamellar keratoplasty as the safest and most effective technique.

Adolescent↗
PubMed1991

[A severe epidemic of Streptococcus group G infection in hemodialysis: epidemiologic survey by molecular biology and preventive measures].

An outbreak of group G streptococci infection affected 6 patients of an hemodialysis unit. Group G streptococci were isolated from patients and from numerous atmospheric specimens, different parts of two dialysis machines, and two blankets, but from only one nurse on the hospital staff. Typing of group G streptococci by an improved method of DNA fingerprinting showed that the isolates from one patient, the nurse and the two blankets differed from one another. The group G streptococci were probably transmitted to patients by dialysis machines with defective microporous filters. No further case of group G streptococci infection was reported three years later since microporous guard filters were systematically doubled.

Adult↗
PubMed1991

[Correction of severe myopia by refractive lamellar keratoplasty without freezing].

The analysis of 56 successive procedures for correction of severe myopia enables us to determine the indications of the two surgical techniques we use: Myopic keratomileusis or Myopic Epikeratophakia. The results are very different. They are reliable and steady throughout one year for certain myopias, but more uncertain for more severe ones. This led us to distinguish two subgroups: the first includes the initial myopia equal to or less than -15 dioptres, the second includes the more severe myopia. Epikeratophakia, always implemented using fresh lenticules corrects more severe myopias than keratomileusis (from -15 to -30 dioptres). So, the indication for epikeratophakia depends on the initial ametropia, as well as on refractive parameters such as keratometry. With the same myopia, an anterior curvature radius over 8.2 mm will render a myopic keratomileusis less efficient then a myopic epikeratophakia. The results with one year follow up are more predictable and stable for the first subgroup. The second group and those cases corrected by epikeratophakia had less predictable results.

Corneal Transplantation↗
PubMed1991

[Radial keratotomy: analysis of undercorrected patients, based on 200 successive operations].

The authors present the results of a series of 200 radial keratotomies. there were two anatomical complications, neither of which caused any clinical damage. 83% of patients obtained 5/10 distant visual acuity or more without correction. The overcorrection rate was 1.5%. The incidence of induced astigmatism was 3.0%. The real failure of the method lay in an undercorrection rate of 13%. These cases are analysed here. Correction proved easier as patients were older: 0.64 diopters per decade. There was a 0.30 diopter gain in men over women. With corneal curvature of more than 43.5 diopters, the benefit was 0.15 diopters per diopter of keratotomy. Limbus to optical zone incisions provided 1.60 diopters as compared with optical zone to limbus incisions, while redeepening incisions provided only 0.27 diopters. Emphasis is placed upon practical matters, such as quality of measurement, instruments and the dexterity of the surgeon. We limit surgical indications to within the range of -1.50 diopters to -4.50 diopters of myopia. The undercorrection rate within this myopia range was 6.3%, increasing to 39.0% over the range.

Adult↗
PubMed1990

[Cornea farinata. Report of a case: clinical, histologic and ultrastructural study].

A woman-aged 44-had corneal dystrophy anterior to Descemet's membrane. This corneal abnormality resembles Cornea Farinata with tiny, punctate, grey opacities localized in the entire thickness of the corneal stroma. We used light and electron microscopic to study this case. The corneal opacities were due to abnormal stromal keratocyte enlarged by intra-cytoplasmic vacuole containing lipid-like inclusions.

Adult↗
PubMed1990

[Refractive surgery and the non-freeze BKS set. Reliability of our Lyon methods. Value of our results].

The authors analysed the results of 24 patients who underwent non-freeze refractive surgery with the BKS set. 22 myopic and 6 hypermetropic keratomileusis, and 6 epikeratoplasty are evaluated. The majority of patients had no astigmatism (or some irregular one) on corneoscopy. The final refraction may take up to 6 months to stabilize. The technique is difficult but may have application in the visual rehabilitation of these patients.

Adolescent↗
PubMed1990

[Inlay corneo-conjunctival lamellar graft, preliminary step in surgical treatment of the sequelae of corneal burns].

Surgical rehabilitation of the eye following severe burns is difficult and frequently leads to failure. Penetrating keratoplasty gives functional improvement which is often of short duration because of recurrence of the epithelial defect or because of the gravity of the initial injury. A method which includes a first step before corneal transplantation is described: a lamellar corneo-conjunctival autotransplantation, from the uninjured fellow eye is performed in order to improve the epithelial condition of the injured eye prior to later penetrating keratoplasty. This lamellar graft was performed on 25 patients between 1984 and 1988. Analysis of the results demonstrates the efficacy of the method: no complications were noticed on the grafted or the uninjured eye; visual acuity was improved in 76% of cases; the following penetrating keratoplasty led to a good result (clear graft at one year) in 88% of cases; and in 16% of cases, functional improvement gained with this first surgical step was sufficient to avoid having to carry out the penetrating keratoplasty.

Adolescent↗
PubMed1989

[Corneal graft].

As an architectonic, transparent and dioptric structure, the cornea plays an important role in the anatomy and physiology of the eye. Corneal grafting consists of replacing an irreversibly damaged cornea by a healthy cornea taken from a donor. Lamellar and transfixiant keratoplasty techniques are now well codified in their modus operandi and their indications. The marvellous and dramatic results achieved in some types of corneal lesions, such as keratoconus, stand in sharp contrast with the still mediocre results obtained in other lesions. Technical, surgical and above all biological research is therefore needed to improve our knowledge of rejection mechanisms and surgical failures.

Corneal Dystrophies, Hereditary↗
PubMed1989

Natural history of acquired immunodeficiency syndrome in women in Rhode Island.

PURPOSE: Current recommendations for treatment of human immunodeficiency virus (HIV) infection and for prophylaxis against associated opportunistic infections in North America are largely based on observations of HIV infection in males. In an effort to determine whether the natural history and clinical course may be different, with implications relevant to prophylaxis against opportunistic infections, we have documented the clinical courses of the first 24 known cases of acquired immunodeficiency syndrome (AIDS) in women in Rhode Island, most of whom developed Centers for Disease Control-defined AIDS before the availability of an effective antiviral agent (i.e., zidovudine) or a well-defined approach to prophylaxis against opportunistic infections (e.g., oral trimethoprimsulfa). PATIENTS AND METHODS: The subjects in this study are 24 women with AIDS who were treated by members of the Brown University medical faculty from June 1982 through June 1988. All patients had thorough clinical evaluations and appropriate laboratory studies as they became available. All were followed at intervals no greater than two months. All opportunistic infections were treated by appropriate, specific antimicrobial therapy. When zidovudine became available, it was administered to all remaining patients in the study. All subjects were counseled about HIV infection, its modes of transmission, and the early symptoms of opportunistic infections. RESULTS: These observations yielded the following three major findings: (1) Candida esophagitis was the most common (38%) AIDS-defining event; (2) Pneumocystis carinii pneumonia was less frequently the AIDS-defining event (13%) and occurred less commonly during the illness (29%) than in North American males with AIDS; (3) Of 14 women in whom the diagnosis of AIDS was established before January 1, 1987, the mean survival time after diagnosis was greater than 20 months. CONCLUSION: More information on the natural history of HIV infection in North American women is urgently needed. If more extensive data from other geographic regions confirm the observations in this study, the optimal approach to prophylaxis against opportunistic infections in women with AIDS may be substantially different from that which is most appropriate for males.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Wedge resection, corrective treatment of giant corneal astigmatism].

This study divides major astigmatism into 2 groups for which the authors advocate a new type of wedge resection. Group I includes 18 patients with astigmatism occurring as a complication of penetrating keratoplasty. Group II includes 10 patients with astigmatism due to circumscribed peripheral limbal corneal dystrophy. Wedge resection over a 180 degrees corneal arc resulted in a significant reduction of preoperative astigmatism and an improvement of visual acuity. Use of a photokeratoanalysor could permit better prediction of the expected effect of wedge resection. This instrument provides measurements of all corneal parameters necessary for determining whether surgery should be performed and which technique to use.

Astigmatism↗
PubMed1987

[An obstetrical injury as the etiology of chronic corneal edema. Clinical study with scanning microscopy].

The case of a young woman with an unilateral corneal edema with regular folds of the descemet's membrane is reported. These lesions originate from an obstetrical traumatism by forceps and are associated with cutaneous scars of the temples. Scanning electron microscopy of the cornea shows multiple endothelial fissures; they are responsible for the late corneal decompensation.

Adult↗