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Biomedical subjects

Y M Ruellan

Publications and source records attributed to Y M Ruellan.

At least 19 recordsLinked to original sources
PubMed1998

[Phacoemulsification for visual refraction on the clear lens. Apropos of 33 severely myopic eyes].

PURPOSE: To evaluate visual benefit, predictability and complications after clear lens phakoemulsification and posterior chamber implantation in highly myopic eyes. METHODS: Thirty-three highly myopic eyes were reviewed at a mean postoperative follow-up of 27 months. The mean age of the 19 patients was 31.04 +/- 5.51 years. The mean preoperative spherical equivalent was -19.50 +/- 7.0 D (-12 to -40 D). Preoperative best spectacle corrected visual acuity was compared with the last postoperative one. Postoperative spherical equivalent was compared with the desired value. All complications were reviewed. RESULTS: A mean visual benefit of 0.24 +/- 0.18 (decimal notation) was noted (p < 0.05). The mean postoperative spherical equivalent (-2.57 +/- 1.84 D) was not significantly different from the mean previous value (p = 0.75). Retinal detachment arose in the two eyes of the same patient (incidence of 6.1%). BSCVA decreased slightly in only one of the two eyes (0.1). The incidence of Nd-YAG capsulotomy was 30%. CONCLUSION: Clear lens phakoemulsification is an effective and predictable method for the correction of high myopia. Retinal detachment is the major complication of this technique, even if a severe decrease of the visual acuity is not usual.

Adult↗
PubMed1996

[Radial keratotomy for the treatment of Excimer laser undercorrections].

BACKGROUND: Effectiveness of radial keratotomy for undercorrections following photorefractive keratectomy. METHODS: Twenty myopic eyes from minus 4.75 to minus 8.25 were treated by Excimer laser photorefractive keratectomy and regressed to a mean myopic refraction of minus 2.20 +/- 0.81 after a follow-up of 10 to 22 months (mean: 16.25). Radial keratotomy was performed using Hoffmann Fyodorov Thornton nomogram. Blade depth was set according to pachymetry performed before surgery under microscopic examination, paracentrally on the meridian of each incision. RESULTS: Postoperative results were evaluated after 6 to 20 months follow-up. After radial keratotomy mean refractive error was minus 0.30 +/- 0.43 and minus 0.32 +/- 0.25 at 3-6 and 6-12 months respectively. Visual acuity, without correction, was prior to radial keratotomy: 2.18 +/- 0.99; 8.125 +/- 0.6 at 3-6 months and 8.43 +/- 1.57 at 6-12 months after radial keratotomy. CONCLUSION: Radial keratotomy appears to be a safe, simple and predictible technique to treat undercorrections following Excimer laser photokeratectomy.

Adult↗
PubMed1995

[Asymmetric radial keratotomy for low-grade myopia].

Thirty patients (47 eyes) underwent a radial keratotomy for low myopia (from -0.75 to -2.5 D). Surgical technique was as follows: optical zone between 3.0 and 4.5 mm according to the degree of the myopia; two radial incisions in vertical superior and nasal horizontal meridian. The incisions were full thickness, obtained either with the "Russian" (centripetal) technique or with a centrifugal technique, but using a special designed knife. Mean refractive result was 1.73 D. For low myopia, our technique seems less traumatic and the refractive effect more rapidly steady.

Adolescent↗
PubMed1994

[Prevention of postoperative inverse astigmatism during radial keratotomy].

Seventy eight patients (156 eyes) were treated by radial keratotomy. Patients with spherical axial myopia were selected (including 39% of physiological astigmatism cases). After radial conventional technique the against-the-rule astigmatism > 1.0 D is 31.6% and between 1.0 and 2.0 D is 3.4% versus 0.6% (< 1.0 D) and 0.1% (1.0-2.0 D) with the modified technique. To decrease the frequency of the against-the-rule postoperative astigmatism after RK procedure we performed 1 or 2 vertical additional flag-incisions on the horizontal meridian to counteract the effect of the corneal oedema on the superior incisions.

Astigmatism↗
PubMed1993

[Cataract and implantation in the vitrectomized eyes].

Cataract is a frequent complication of vitreous surgery after some months or years. In these cases cataract extraction is somewhat difficult. We performed cataract surgery with implantation in 38 eyes from 37 patients between 1986 and 1991. Twenty patients underwent vitreous or vitreoretinal surgery with or without internal tamponade by gas, 17 underwent silicone oil tamponade and silicone oil removal, prior to cataract surgery. Timing of surgery, number of surgical procedures and complications previous to cataract surgery are detailed in the paper. Cataract extraction was extracapsular in 7 cases, intracapsular in 6 cases; phako was performed in 24 cases and phacophagy in one case. A posterior IOL was inserted in 31 cases, an anterior chamber IOL in 7 cases. Anatomical and visual results were satisfying. Visual acuity improved postoperatively in 29 cases (up to 20/20 in 4 cases), was unchanged in 6 cases, decreased in 3 cases. Among these, loss of vision occurred in 5 cases due to retinal detachment or redetachment. For anatomical reasons, lack of vitreous support and the frequent zonular weakness of these eyes, account for surgical difficulties. Thus, phakoemulsification appears the best way to manage cataract in vitrectomized eyes.

Adult↗
PubMed1993

[Phacoemulsification by the anterior approach combined with vitreoretinal surgery].

Phacoemulsification was combined with vitreoretinal surgery in 22 cases in which lens opacity prevented good visualisation of the fundus. The main indications were proliferative diabetic retinopathy and retinal detachment complicated by proliferative vitreoretinopathy. Phacoemulsification was achieved by a limbal approach. The technique was adapted to the hardness of the lens nucleus. The incision was temporarily or definitely closed. The visualisation system was set up and the endocular surgery performed. In 5 cases an implantation in the bag was realised at the end of surgery. This type of combined procedure offers both the benefits of extra capsular surgery: avoids neovascular glaucoma in diabetic patients, keeps silicone oil in good position, possible implantation in the capsular bag, and those of a small incision: absence of leakage, of myosis, of corneal clouding, rapid rehabilitation.

Aged↗
PubMed1991

[Surgical treatment of non-traumatic retinal detachment in children under 15 years of age].

Etiological and clinical features of 151 retinal detachments in childhood are studied and discussed. Results of surgical management of 92 of them, after at least a 6 month follow-up, especially after ablation of silicon oil when used temporarily, are described. Clinical aspects of the contralateral eyes and their prophylactic treatment is also studied. Though surgical techniques have done great strides, prognosis of retinal detachment in childhood is still desperately poor. Proliferative vitreo-retinopathy, frequent, early and very progressive, is the leading complication and cause of failure in surgical of these retinal detachment. In this series of 151 retinal detachments, only 38% have achieved long term retinal reattachment because of it. If high grade (C-D) proliferative vitreo-retinopathy is associated 14.5% only achieved long term reattachment though 86% it when proliferative vitreo-retinopathy was moderate or absent. It is for this reason that we wish to emphasize the need to inform practitioners and "at risk" families. Strict and systematic follow-up of the "at risk eye" is essential. The most complete surgery at the outset seems to be the best way of managing high-grade proliferative vitreo-retinopathy associated with retinal detachments.

Age Factors↗
PubMed1991

[Surgical treatment of traumatic retinal detachment in children under 15 years of age].

The clinical features and results of surgical management of 68 out of a series of 101 cases of traumatic retinal detachment in childhood are described and analysed. Follow-up, in particular after the removal of silicon oil used temporarily, was always been longer than six months. Cases were divided into three groups: contusions, ocular injuries without foreign body and with foreign body. Cases of retinal detachment related to traumatic aphakia, severe myopia and associated with proliferative vitreo-retinopathy were also studied. The prognosis of retinal detachment in childhood, the main characteristics of which are late diagnosis and the early and rapid growth of proliferative vitreo-retinopathy appears to be worse in this series than usually published figures. Proliferative vitreo-retinopathy is the leading cause of surgical failure. The long term retinal reattachment rate did not exceed fifty per cent and the functional success rate was only thirty-three per cent. It is for this reason that the authors wish to emphasize the need for the provision of information to families and to ophthalmologists responsible for the management of these "high risk eyes". It is felt that the most complete surgery possible should be performed at the outset when proliferative vitreo-retinopathy exists.

Adolescent↗
PubMed1990

[Cyclodiathermy: is it effective in the treatment of glaucoma?].

The authors describe the non penetrating technique of cyclodiathermy in the treatment of different types of glaucoma and publish the results and the complications of the application of this technique on thirty three eyes among their patients. These eyes included congenital glaucoma (8 eyes), aphakic glaucoma (5 eyes), after silicone surgery (5 eyes), neovascular glaucoma (4 eyes), traumatic glaucoma (4 eyes), secondary glaucoma (3 eyes), Sturge-Weber-Krabbe (2 eyes) and open angle glaucoma (2 eyes). Their study with a mean follow up of 2.5 years shows an overall success rate of 60%. The success is defined as an ocular tension less than or equal to 22 mmHg in the absence of serious complications. All the encountered complications are mentioned. Phtysis occurred in not more than 3% of cases (1 eye). They establish a comparison with the published results and complications of the other cyclodestructive procedures: Sonocare, transcleral laser Yag, transcleral laser Ruby and cyclocryotherapy. This comparison does not prove the superiority of these other procedures with regard to the non penetrating cyclodiathermy. They conclude that this non penetrating cyclodiathermy is a non expensive procedure which still have its good therapeutic value.

Electrocoagulation↗
PubMed1990

[Effects and complications of Nd YAG laser posterior capsulotomy after ECA + PCI (extracapsular extraction and posterior chamber implantation)].

264 consecutive cases of ECCE are reviewed. In this series 28 cases of Nd YAG laser capsulotomy have been performed. Visual results are excellent: visual acuity is improved in 90% of cases. The rate of complications is low: 1 case of retinal detachment, 2 cases of IOP raise, no clinical CME. Laser therapy is performed when visual acuity decreases, prior to other extra clinical examination.

Aged↗
PubMed1985

[Retinal detachment: temporary internal tamponade with silicone oil after vitrectomy. Anatomic and functional results].

Forty-seven patients with retinal detachment treated by vitrectomy and silicone oil injection benefited from semi-premature ablation of the oil: after a mean of 5 months for supple retinal detachments and 6 1/2 months for those associated with vitreoretinal proliferation. Ablation was performed after obtaining a solid chorioretinal scar by cryopexy or endodiathermy, usually combined with laser panphotocoagulation. The technique used for ablation is described. After follow up for from 9 months to 3 1/2 years (mean 18 months) two-thirds of the patients had flat retinas. Recurrences developed usually during the first month. An explanation for these relapses is proposed.

Adolescent↗
PubMed1984

[Treatment of retinal detachment by vitrectomy and injection of silicone oil. Long-term results and complications in 105 cases].

The present study is a two year-follow up of 105 eyes (including 27 aphakic eyes), operated on retinal detachment by silicone oil injection after pars plana vitrectomy. This procedure was chosen either as an initial treatment (37 eyes) or after a classical treatment by external indentation had failed (68 eyes). All cases of retinal detachment were of bad prognosis: macular hole, massive periretinal proliferation, isolated or associated with a tear. Cases of vitrectomy with silicone injection for proliferative retinopathy due to diabetes or hemoglobinopathy were excluded. Operations were performed under a surgical microscope with the help of a corneal contact lens (Goldmann, Kl oti or O' Malley ). Functional and anatomical results, as well as complications, were evaluated at least 2 years after treatment. In 24,7% of cases, vision was improved as compared to preoperative visual acuity. Cataract was a constant complication in all phakic eyes, as silicone oil had not been removed within the first 6 months. Intraocular hypertension developed frequently both in phakic and in aphakic eyes (29,5 and 33% of cases, respectively) and responded poorly to medical or surgical treatment. Other complications occurred less frequently. They were corneal edema, conjunctival hyperemia and uveitis. Pain imposed the evisceration of 2 eyes. These complications were the consequence of silicone oil toxicity and/or the mechanical effects of intraocular oil. Besides treatment-associated complications, early (36 during the first 6 months) as well as late (2 between the 12th and 18th months) recurrences of retinal detachment were observed. In contrast to these fair functional results, anatomical results were good in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Obliteration of the posterior holes and tears of the retina by endodiathermy after vitrectomy].

The authors report 19 cases of posterior retinal and tears treated by endodiathermy after vitrectomy. Nine cases were iatrogenic with a retinal break occurring during an intravitreal procedure. The remaining 10 cases were non-iatrogenic. A flat or reapplied retina is a prerequisite for achieving an adequate chorioretinal adhesion by endodiathermy. Short-term internal tamponade by intravitreal gas is recommended in cases with tears and no detachment, whereas, longer term tamponade with intravitreal silicone is preferable when the retina is detached. This method can be used when external retinopexy becomes impractical for lesions too far posterior, or when endophotocoagulation cannot be performed.

Adolescent↗
PubMed1983

[Indications for vitrectomy in the extraction of intraocular foreign bodies].

Vitrectomy represents an important advance for the extraction of intra-ocular foreign bodies, a study of 20 cases emphasizing the advantages of the method. Pars plana vitrectomy was performed using Klöti's vitreous stripper; intra-ocular foreign bodies were extracted through the pars plana incision by a magnet or with forceps. The main indications of the technique are: posterior pole foreign bodies; old embedded metallic foreign bodies; foreign bodies with complications (traumatic cataract, vitreous hemorrhage, retinal detachment); non-magnetic oxidizable foreign bodies: these must be extracted under visual control with vitrectomy techniques, but complications and failure remain common. This technique also has its limits: extraction of non-oxidizable non-magnetic foreign bodies; foreign bodies attached to the ocular globe wall. These are preferably left in place. Vitreoretinal complications were the main reasons for failure in this study. Nevertheless, vitrectomy allows clearing of cloudy media, visualization, localization and extraction of foreign bodies under visual control through the pars plana, and reduction of complications.

Adult↗