[A new concept in the treatment of retinal detachment with massive periretinal proliferation].
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Biomedical subjects
Publications and source records attributed to M Gonvers.
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I have designed an asymmetrical 50/70 beam splitter that allows a television camera to be coupled directly to the Zeiss operating microscope. This device provides more light for the surgeon.
We have developed a weight-and-pulley armrest for surgeons to use during ocular microsurgery. The armrest is mobile, sterilizable, and allows the weight stress on the forearm to be regulated.
Over the last few years there has been a further increase in the surgical treatment of the retinal detachment. Reapplication of the retina is now very often achieved immediately. Repeated intervention has become less common and operative methods less aggressive. This communication aims to give an idea of present concepts in the treatment of retinal detachment and to explain some surgical attitudes. It also recalls the importance of early diagnosis, as well as the examination methods and the prophylactic measures generally used. Some new ideas on the etiology of retinal detachment are also discussed.
The authors illustrate by means of a film the surgical difficulties and dangers involved in a vitrectomy procedure completed by a peeling of preretinal membranes. Taking a case of proliferative diabetic retinopathy, they demonstrate and justify their surgical indications for vitrectomy in diabetics.
This paper describes situations in which a circular or semicircular episcleral compression using a silicon sponge, with evacuation of the subretinal fluid, is preferable to a silastic cerclage without drainage. Results obtained in 46 cases are presented. This is the second part of a report presented at the French Society of Ophthalmology in May 1979, devoted to results obtained with the technique of silastic cerclage without drainage.
Vitrectomy instruments are very helpful for anterior ocular reconstruction following trauma. Pars plana approach seems better than limbal approach. This latter is reserved for cases where micro-surgical scissors must be used in addition to the vitreous instrument. When pars plana approach is chosen, a phakofragmentation unit is needed for the removal of adult cataract with marked nucleus sclerosis.
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The echography of ocular tumours (7 malignant melanomas and 2 metastatic tumours) is presented in correlation with their microscopic architecture. A metastatic tumour presenting echographic characteristics typical of malignant melanoma was considered as such at the ultrasound test. All 7 malignant tumours were diagnosed through the ultrasound test, but it was impossible to foretell a predominant type of cell.
Persistent hyperplastic primary vitreous is a disease whose spectrum has continued to widen throughout the years; in fact, it probably comprises a number of nosological entities considered as isolated symptoms until today. Our study has shown that the disease can be congenital and affect both eyes in the same individual. The possibility of an etiopathogenic connection with retrolental fibroplasia cannot be excluded.
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BACKGROUND: A retrospective study was conducted to evaluate the risk of increased intraocular pressure (IOP) following a temporary silicone oil (SO) tamponade and to study some parameters possibly involved in this hypertension. METHODS: Forty-four patients with retinal detachment complicated by proliferative vitreoretinopathy (PVR) were treated by vitreoretinal surgery and SO tamponade. One to 11 years after SO removal, they underwent full ophthalmic examination. All these patients had a healthy, non-operated, normotensive fellow eye. RESULTS: Six (14%) of 44 eyes had IOP higher than 20 mmHg. Five other eyes (11%) had their IOP controlled by beta blockers. Phakic and pseudophakic eyes had a very limited tendency to develop ocular hypertension and anyway responded well to beta blockers. Residual SO droplets in the eye after removal of the big bubble of SO disappeared exponentially with a mean disappearance time of three years. Eyes with residual SO were no more prone to ocular hypertension than those without (p > 0.50). No association was found between IOP and duration of SO tamponade (r = 0.13) or between IOP and flare (r = 0.14). CONCLUSION: This study suggests that the risk of developing ocular hypertension after a temporary SO tamponade is moderate. No satisfactory explanation could be found for this increase of IOP.
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