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Biomedical subjects

Y J Pouliquen

Publications and source records attributed to Y J Pouliquen.

12 recordsLinked to original sources
PubMed1998

A prospective randomized trial of topical soluble 0.1% indomethacin versus 0.1% diclofenac versus placebo for the control of pain following excimer laser photorefractive keratectomy.

BACKGROUND AND OBJECTIVE: To compare the safety and efficacy of topical nonsteroidal antiinflammatory drugs (NSAIDs) for the control of pain after excimer laser photorefractive keratectomy (PRK). PATIENTS AND METHODS: One hundred twenty informed patients were enrolled in a double-masked, randomized, comparative study and assigned to either 0.1% indomethacin, 0.1% diclofenac, or placebo treatment. Subjective postoperative pain, symptoms, re-epithelialization rate, and systemic medications were monitored for 2 days following photoablation. RESULTS: Compared with the placebo, 0.1% indomethacin solution significantly reduced pain on the day of surgery (D0) (P < .05), whereas 0.1% diclofenac did not reach a significant level (P = .46). At D0, analgesic intake by the oral route was significantly greater in the placebo group (P < .05). Severe photophobia was significantly less frequent in the group treated with 0.1% indomethacin (P < .05). Corneal wound healing was significantly delayed in the patients treated with 0.1% diclofenac at D2 as compared with other groups (P = .04). CONCLUSION: Topical 0.1% indomethacin solution helps control the pain induced by excimer laser photoablation of the cornea without any detrimental effect to the corneal epithelial wound healing.

Administration, Topical↗
PubMed1996

Full panretinal photocoagulation and early vitrectomy improve prognosis of florid diabetic retinopathy.

BACKGROUND: Florid diabetic retinopathy (FDR) is a rare form of proliferative diabetic retinopathy (PDR) that is characterized by a bilateral rapidly progressive, very severe ischemic retinopathy. Florid diabetic retinopathy was reported to carry a high risk of blindness. This study was conducted to determine whether visual prognosis of FDR can be improved by appropriate photocoagulation and surgical management. METHODS: The authors retrospectively studied 20 patients (40 eyes) who were treated from October 1978 to February 1994. Systemic risk factors, visual acuity, complete ocular examination, and fundus findings, as well as fluorescein angiography, were analyzed with respect to photocoagulation and surgical management. Mean follow-up was 3.6 years. RESULTS: All patients had poorly controlled type I diabetes (mean duration, 13.5 years), which often was associated with systemic complications. Mean initial visual acuity was equal to or better than 20/40 in 32 eyes (80%). During the course of the study, high-risk PDR was observed in 38 eyes (95%) and vitreous hemorrhage occurred in 26 eyes (65%). Extensive full subconfluent panretinal photocoagulation was performed completely in 37 eyes (92.5%). Vitrectomy was necessary in 15 eyes (37.5%). Macular edema was present in 30 eyes (75%). Major complications included retinal detachment that required surgery (2 eyes, 5%) and neovascular glaucoma (2 eyes, 5%). However, final visual acuity was equal to or better than 20/40 in 23 eyes (57.5%) and less than 5/200 in only 4 eyes (10%). CONCLUSION: These results suggest that aggressive treatment of FDR with extensive panretinal photocoagulation and early vitrectomy, when necessary, may result in a much better prognosis than has been reported previously.

Adolescent↗
PubMed1992

A new fluorocarbon for keratoprosthesis.

Previous studies have demonstrated the potential use of microporous, biocompatible materials to improve the long-term stability of keratoprosthesis. To determine the factors that will influence corneal tissue ingrowth into biocompatible, microporous materials, we have compared three types of fluorocarbon polymers--Impra, Gore-Tex, and Proplast--after intrastromal implantation in rabbit corneas. Despite similar physicochemical structures, a great difference was observed in histologic and ultrastructural cross sections after 4- and 8-month follow-ups. For Gore-Tex, we observed extrusion of the implant and infiltration of necrotic and inflammatory cells. All implants of Proplast also led to significant corneal damage resulting in extrusion of the material. Through the use of electron and light microscopy and image analysis, this study demonstrates the presence of cell differentiation and collagen synthesis in the pores of the Impra implant. Apart from biocompatibility, this experiment demonstrates the influence of pore size, porous microorganization, and biomechanical factors on prosthetic corneal material. Only Impra offers satisfactory interface, allowing fibroblastic cells and neocollagen synthesis into its pores, and it can become transparent.

Animals↗
PubMed1991

Computerized method for rotational autokeratoplasty.

The aim of our study was to formulate the procedure of rotational autokeratoplasty; that is, design the computer system and software necessary to automatically define the parameters of the problem. To achieve this, we used a CCD camera (Nikon) and a microcomputer with an integrated IMAGENIA (Biocom) interface software card (512 x 512 pixels and 100 gray levels), which permitted acquisition and digitalization of photographs of the lesioned cornea. Digitization of the image allowed us to determine the coordinates (x,y) of the points that lay on the lesion periphery as well as the coordinates of the corneal center; i.e., the geometric center of the cornea. The center of trephination and the optimal diameter of trephination can then be calculated as a function of a point situated on the lesion edge.

Corneal Transplantation↗
PubMedDate not supplied

Ultrasound biomicroscopy of Baikoff anterior chamber phakic intraocular lenses.

BACKGROUND: The purpose of the study was to analyze qualitatively and quantitatively anatomic relationships of anterior chamber Baikoff phakic intraocular lenses (IOL) to the cornea, angle, iris, and lens in myopic eyes. METHODS: Thirteen phakic myopic eyes (-9.00 to -15.00 diopters) corrected by minus power, angle-supported, anterior chamber intraocular lenses of the ZB5M style (Chiron-Domilens), with a mean follow-up of 25 months (range 18 to 36 months), were examined clinically and by ultrasound biomicroscopy. RESULTS: The mean distance (+/- SD) between the central cornea and the IOL was 2.05 +/- 0.18 mm (range 1.8 to 2.47 mm); mean distance between the corneal periphery and the IOL was 1.56 +/- 0.17 mm (range 1.33 to 1.95 mm); and the mean distance between the IOL and the lens was 0.58 +/- 0.12 mm (range 0.48 to 0.81 mm). IOL footplates seemed to be correctly positioned in the angle in all eyes. We observed no goniosynechiae. In six eyes, we found localized posterior indentation of the iris caused by the haptics. Four of these six eyes exhibited oval pupils associated with an oversized IOL. CONCLUSIONS: High frequency ultrasound biomicroscopy can define anatomic relationships of anterior chamber phakic IOLs, and help analyze the mechanisms of corneal and iris complications.

Adult↗
PubMedDate not supplied

Results of transverse keratotomies for astigmatism after penetrating keratoplasty: a retrospective study of 48 consecutive cases.

BACKGROUND: High astigmatism is still a common complication of penetrating keratoplasty which often limits the final corrected visual acuity. Surgical correction of high astigmatism persistent after suture removal remains rather controversial. In our present study, we used the technique of transverse keratotomies for the surgical correction of high astigmatism following penetrating keratoplasty because of its simplicity and corrective potential. METHODS: We present a retrospective clinical study based on the results of 48 consecutive transverse keratotomy procedures performed on the graft. Three eyes were operated on twice, for a total of 51 procedures. The astigmatism had to be stable for at least 6 months after suture removal, with poor corrected visual acuity with spectacles or contact lenses. The operative protocol (number of incisions, optical zone size) was decided based on the degree of astigmatism. The mean post-operative observation period was 5.11 +/- 3.93 months (range, 1 to 24 months). RESULTS: The mean preoperative cylinder was 8.96 +/- 2.22 diopters and 4.91 +/- 1.79 D postoperatively. The mean cylindrical change was 4.51 +/- 2.77 D. The spherical equivalent remained unchanged in most cases. In a majority of cases, the corrected visual acuity for distance and near vision was improved. No cases of persistent graft edema caused by immunologic rejection or endothelial failure were observed. Moreover, in no case was there worsening of the best corrected visual acuity. CONCLUSIONS: The technique of transverse incisions in the graft to correct or reduce high postkeratoplasty astigmatism is simple, efficient, and relatively safe. The main problem was poor predictability.

Adult↗
PubMedDate not supplied

Does the progressive increasing effect of radial keratotomy (hyperopic shift) correlate with undetected early keratoconus?

Keratoconus suspect is a new clinical entity revealed by videokeratography. We perform systematic videokeratography on all candidates for refractive surgery, and have identified a keratoconus suspect in more than 10% of eyes. A lot of patients with undetected early keratoconus have been operated on since 1980. We suggest a possible correlation between early keratoconus suspect and the hyperopic shift following radial keratotomy. Our arguments are based on clinical observations, knowledge about pathogenesis of keratoconus and the mechanism of action of radial keratotomy, and epidemiological considerations.

Cornea↗
PubMedDate not supplied

Ocular damage after implantation of oversized minus power anterior chamber intraocular lenses in myopic phakic eyes: case reports.

BACKGROUND: Positioning in the iridocorneal angle is one of the factors determining long-term tolerance of anterior chamber intraocular lenses (IOLs). This problem has again become topical with the use of myopic IOLs with angular supports. METHODS: The authors describe three eyes illustrating the possible complications resulting from the insertion of oversized minus power anterior chamber implants in myopic phakic eyes. RESULTS: The complications developed early or late after surgery. They consisted mainly of inflammatory reactions, stable or progressive pupillary deformation, and adherence of the iris to the implant. CONCLUSIONS: In myopic phakic eyes, the insertion of incorrectly sized IOLs with angular supports may cause complications which have already been reported for anterior chamber implants in aphakic eyes. Haptic flexibility does not always make up for incorrect sizing due to imprecise preoperative evaluation of iridocorneal angle diameter.

Adult↗