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Biomedical subjects

Y Le Mer

Publications and source records attributed to Y Le Mer.

47 records · Page 3Linked to original sources
PubMed1987

A new method for the evacuation of aqueous humor in uncontrolled glaucoma. The vitreo-tenonian tube.

The vitreo-tenonian tube is a new procedure, used in uncontrolled glaucoma, for the drainage of aqueous humor. It presents three original characteristics: it is made of a stainless metal, it is implanted in the posterior segment after vitrectomy and it drains the aqueous humor in the subtenonian space. We will describe first the surgical technique for the implantation of the tube, and then we will present the results of the first eight cases treated by this method. The advantages and drawbacks of this type of drainage are discussed: they are compared with the other surgical techniques used in cases of glaucoma which is uncontrolled by the classical methods.

Aqueous Humor↗
PubMed1987

[Treatment by internal tamponade of retinal detachment with a macular hole].

The authors analyse the operative results of 92 cases of retinal detachment with macular hole, treated by internal tamponade, since 1976. Three technics were used: vitrectomy + silicone oil injection (75 cases), vitrectomy + SF6 gas injection (9 cases), intra-ocular liquid suction + SF6 gas injection (8 cases). Silicone vitrectomy is particularly advisable in the case of large, old retinal detachment with proliferative vitreoretinopathy. This form of treatment is imperative when there is no hope of a satisfactory postoperative positioning, or after an unsuccessful gas treatment due to epiretinal macular membrane. Suction gas is a new and simple technique which is recommended when the macular hole is isolated and without epiretinal membranes. A lattice pattern argon-laser retinopexy is performed, by means of a series of laser impacts at the posterior pole, up to the edge of the macular hole. Treatment of isolated macular holes in a flexible retina by silicone vitrectomy achieved a 78.5% success rate; suction + gas achieved a similar success rate; this last method appears to be the ideal first choice for most of the cases, i-c the two failures which were subsequently turned into successes by silicone vitrectomy.

Evaluation Studies as Topic↗
PubMed1987

[Adverse effects and complications of argon laser trabecular retraction: practical results].

Argon laser trabeculoplasty is learned and used much more easily than filtration surgery. This explains the danger of its being abusively employed, as well as the existence of complications such as an aggravated glaucoma condition (1 to 3% of the cases). In 253 eyes afflicted with various forms of chronic open angle glaucoma with follow-ups ranging from at least 6 months to 4 years, the following complications were disclosed: 3% of the cases required treatment for severe anterior uveitis; anterior synechiae occurred in 23%, including one case of circular anterior synechiae and 4 other cases in which acute angle closure glaucoma developed several months later; trabecular hemorrhage in 6%; post operative intra ocular pressure elevation in 13%. This last complication is the most dangerous especially in advanced glaucoma: it very frequently happens during the first post operative hours in the absence of preventive treatment and it can arise up to three weeks after the procedure. In 33 cases upon 253 (13%), the pressure increase, despite a systematic preventive treatment, ranged from +3 mmHg to +16 mmHg above the baseline level in more than two thirds of these particular cases (+5 mmHg in only 7.5% of the cases and +9 in only 3.5%). In 59 eyes treated by less intensive trabeculoplasty (50 burns upon 180 degrees trabeculoplasty ring), the pressure increased in only 3.4% of the cases but the long term efficacy was reduced. Argon laser trabeculoplasty complications are less numerous than those of surgery, but some of them, i.e. intra ocular pressure elevation, can be very serious and must lead to a study of the risk-benefit ratio corresponding to the glaucoma stage which is to be treated.

Follow-Up Studies↗
PubMedDate not supplied

[Principles and histologic effects of the treatment of hypertension with focused high-intensity ultrasound].

Focused high-intensity ultra-sound is used to treat glaucoma. Histopathologic examinations of rabbit and pig eyes following therapeutic ultrasound demonstrated highly localized lesions including destruction of the ciliary epithelium and thinning of the sclera. The bond between the sclera and the ciliary epithelium is weakened. The conjunctiva remains intact. The histologic findings in human eye enucleated after ultra-sound therapy are identical. Three mechanisms for pressure reduction are proposed: transscleral outflow of aqueous humor can occur under the overlying conjunctiva; focal destruction of the ciliary epithelium can reduce aqueous production; scleral scarring produces the potential for separation of the ciliary body and the sclera.

Animals↗
PubMedDate not supplied

[An anterior chamber-subtenonian drainage tube. A long-term study].

A drainage of aqueous humor from the anterior chamber to the subtenonian space using a tube and a scleral implant was performed in 22 eyes, previously unsuccessfully operated on for glaucoma. The results after a follow up of 12 to 36 months were good, specially in cases with undissectable conjunctiva (a 73% rate of success). The small incidence of serious complications incites us to use this technique earlier in the surgical treatment of uncontrolled ocular hypertension.

Adolescent↗
PubMedDate not supplied

[Non-traumatic retinal detachment in children under 15 years of age].

In less than fifteen years old children, thirty nine non traumatic retinal detachments are reported. Their poor prognosis is attributed to the late diagnosis, the early age occurrence, the combination with an ocular pathology (congenital aphakia--myopia--hereditary vitreoretinal degeneration) present on the first examination. Prophylaxis of the fellow eye is recommended in order to avoid the alarming occurrence of bilateral detachment.

Adolescent↗
PubMedDate not supplied

[Retinal detachment following YAG laser section of vitreous strands. Apropos of 3 cases].

PURPOSE: Retinal detachment after Nd: YAG laser vitreolysis is rarely reported. The pathogenic role of Nd: YAG laser is analyzed from 3 cases of severe retinal detachment. METHODS: Three men aged (40 to 59 years old) had one or more risk factors for retinal detachment: myopia, complicated cataract surgery, personal or family history of retinal detachment. Nd: YAG laser treatment onto vitreous strand was performed because of: retinal traction, repeated vitreous hemorrhage, anterior vitreous strand in a aphakic patient with cystoid macular edema. Within six weeks following Nd: YAG laser vitreolysis, severe retinal detachment with several tears occurred, complicated with proliferative vitreoretinopathy in two patients, and with choroidal hemorrhage in one. In two cases, several surgical procedures with silicon oil were required and visual acuity remained under 20/1000. In the last case retinal reattachment was obtained with scleral buckling and cryopexy, the patient recovered a visual acuity of 20/100 with a macular pucker. DISCUSSION: Retinal detachment occurred shortly after laser YAG vitreolysis. We assumed Nd: YAG laser was possibly responsible and investigated the possible mechanisms: direct retinal tear, vitreous strand traction, side effect of intraocular shock wave. CONCLUSION: Nd: YAG laser vitreolysis seems to be able to cause retinal detachment. Its use is therefore not recommended, particularly in patients at risk, especially since the efficacy of this treatment has not been proved.

Adult↗