[Madame G.' biliary calculi].
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Biomedical subjects
Publications and source records attributed to M Marsault.
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Authors report polyglactin suture's experience in anterior segment surgery. Absorbable sutures have good tolerance, their disappearing delay is slow enough to allow good scar. Experiment shows that absorption is secondary to hydrolysis without inflammatory or necrotic reaction.
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This communication is a survey of 53 cataract operations followed up during a period of 1-6 years, with an average of 4 years, and performed on patients who had a high risk of subsequent retinal detachment because of a preceding detachment on the fellow eye or on the cataractous eye, because of peripheral retinal degenerations, or a history of hereditary retinal detachment. Most of the operations were performed under general anesthesia and ocular hypotony. In all the cases, a limbal-based conjonctival flap with a double line of sutures (scleral and conjonctival), an iridectomy in segment, a zonulolysis and a cryoextraction, were done. As for the retina, 18 eyes received a coagulation before the cataract extraction by galvano- or cryocoagulation or even by xenon photocoagulation. Among them 3 had a detachment after the cataract extraction, but 2 of them were cured by a new operation. 15 eyes had peripheral retinal lesions which were coagulated after the cataract extraction by cryo-, laser or xenon coagulation. Nevertheless 2 had a detachment. 13 patients with a detachment on the fellow eye or in the family, had no peripheral lesion and were not coagulated. None of them had a retinal detachment after the cataract extraction. Finally the eyes operated upon a short time after the cataract extraction suffered severe complications: reopening of the cataract incision, loss of vitreous and finally loss of 2 eyes out of 3.
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This survey has been carried out over 186 operations for retinal detachment during which a voluntary or accidental drainage took place in 2/3 of the cases. Its frequency is studied according to the type of the detachment, its age, the duration of the preperatory rest, the number of operations and the surgical technique. The postsurgical evolution of detachments with drainage shows that the vitreous is more frequently clouded, later cleared up, and that there are more choroidal detachments and more retinal hemorrhages. The frequency of the early retinal flattening, the only one which has been studied, is not increased by drainage. It is no use debating the opportunity of drainage because indeed it is often imposed on the surgeon a as a last resort by the type of the detachment. The means for limiting its frequency are reviewed.
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