1
|
Abstract
La clinique générale de l’autisme est bien connue mais le triptyque troubles des interactions sociales, de la communication verbale et non verbale, et intérêts restreints est peu spécifique. La connaissance de particularités sensorielles, sensori-motrices et cognitives est insuffisamment répandue. Pourtant, les arborescences de symptômes singulières pour chaque personne autiste deviennent familières à ses accompagnants proches (parents et professionnels).Mais tous se trouvent conjoncturellement démunis par des troubles du comportement :– soit parce que les symptômes de l’autisme sont amplifiés ou modifiés ;– soit parce que des syndromes psychiatriques s’ajoutent à l’autisme ;– soit parce que des maladies du corps sont associées à l’autisme (génétiques ou neurologiques) et ont aussi une expression psychique et comportementale.Ces différentes causes sont souvent confondues dans les services, d’autant plus qu’elles peuvent interférer.Or les traitements ne sont pas les mêmes, qu’ils soient éducatifs, institutionnels ou médicamenteux. Une approche psychiatrique exclusive sera erronée. Notamment les traitements médicamenteux sont souvent inappropriés, source de conflits entre les professionnels, avec les familles, et aussi, parfois, avec la justice. Inversement, tout rapporter à l’autisme peut nous égarer.Seront présentés des éléments pour le diagnostic différentiel avec des exemples qui relèvent de ces trois causes :– ce qui est dû à l’accentuation des troubles autistiques : ici, la poussée de l’adolescence et la sexualité seront des facteurs importants ;– des maladies psychiatriques que l’on peut reconnaître malgré le mélange avec la pathologie autistique : la comorbidité psychiatrique proprement dite ;– ce qui relève de la comorbidité somatique d’expression psychiatrique (des maladies organiques : génétiques, neurologiques dont l’épilepsie, et des algies diverses).
Collapse
|
2
|
Assouline M, Girard C, Guedj T, Denis C. 245 Résultats de la compensation chirurgicale de la presbytie par PresbyLasik ou implants pseudophakes multifocaux. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73372-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
3
|
Abstract
An endonasal dacryocystorhinostomy (DCR) was followed by cerebrospinal fluid leakage and pneumoencephalocele in an 80-year-old female patient presenting four independent risk factors for an ethmoidal breach: severe septal deviation requiring forced reclining, a cranial insertion of the perpendicular plate of the ethmoid directly onto the cribriform plate, meningeal prolapse, and extensive osteoporosis of the skull base. The use of a Killian valve speculum to recline the nasal septum was probably the main cause of the anterior skull base fracture. The defect was repaired by a composite patch of septal cartilage, abdominal fat grafts, Surgicel, and inferior turbinate mucosa. Thirty-four months after surgery, there was no residual symptom. A narrow nasal fossa makes endoscopic DCR more difficult to perform. The use of a Killian valve speculum to enlarge the nasal fossa may carry a risk for structural damage to the skull base. A narrow nasal fossa may require an external DCR or a prior endoscopic septoplasty to facilitate an endonasal approach. Closing an ethmoidal defect causing cerebrospinal fluid leakage can be successfully achieved by an endonasal approach rather than by a more conventional neurosurgical method.
Collapse
Affiliation(s)
- B Fayet
- Service d'Ophtalmologie, Hôpital de l'Hôtel Dieu de Paris, Paris, France
| | | | | |
Collapse
|
4
|
Favard C, Machado L, Krivosic V, Assouline M, Francais C, Caputo G. 315 Intérêt et limites du traitement combiné IVT Triamcinolone et PDT pour 3 types de néovaisseaux maculaires échappant au traitement PDT seul : résultats à 1-2 ans, apport du traitement par les anti VEGF. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80127-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Girard C, Assouline M, Guedj T. 194 Evaluation clinique de l’Ocular Response Analyzer (ORA). J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80006-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
6
|
Assouline M, Guedj T, Girard C. 186 Modulation des aberrations optiques d’ordre inférieur et supérieur pour la compensation chirurgicale de la presbytie : l’exemple du presbylasik. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)79998-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
7
|
Guedj T, Assouline M, Girard C. 221 Analyse de la qualité optique de l’œil par technique oqas « dual-pass ». J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Assouline M, Guedj T. 119 Technique chirurgicale de l’autogreffe limbo-conjonctivale : les clés du succès. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)79931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
9
|
Lebuisson DA, Arson B, Abenhaïm A, Albou-Ganem C, Assouline M, Chong Sit D, Danan A, Montefiore G, Montin JF, Nguyen-Khoa JL, Pietrini D, Saragoussi JJ, Trong T, Amar R. Certification ISO 9001-2000 des traitements réfractifs par laser cornéen. J Fr Ophtalmol 2005; 28:562-70. [PMID: 15976727 DOI: 10.1016/s0181-5512(05)81097-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To obtain ISO 9001-2000 certification for laser corneal refractive treatment, never before sought in Europe. MATERIAL AND METHODS The consulting firm Veritas led the certification process with the clinic's staff manager. This ISO norm is dedicated to the implementation of a quality management system. We assessed and optimized all necessary resources, evaluating customer satisfaction using patient and referring-physician surveys. We started quality rounds including surgeons, nurses, and technicians. Based on this preparation, we redefined and explained all processes including staff responsibilities and necessary resources in the quality manual. The procedure lasted 14 months with substantial involvement on the part of the management. RESULTS Unconditional ISO 9001-2000 certification was granted by the independent audit firm, BVQI, in december 2003 for refractive laser treatment. CONCLUSION The 2000 version of the new ISO 9001-2000 seeks to meet the demand for improving health care delivery in this field, most particularly by establishing a clear procedural orientation. Such certification enhances team work, stabilizes methodologies, and reinforces cohesion and self-audit. Patients notice that the center follows a consistent quality policy and are assured that the clinic respects rules and regulations. Certification is an advantageous alternative when accreditation cannot be considered. Our article discusses the steps taken in upper management, quality management, procedural guidance, as well as customer and staff counselling. It also discusses the project's cost/benefit ratio for the organization.
Collapse
Affiliation(s)
- D A Lebuisson
- Clinique de la Vision, 55, avenue Hoche, 75008 Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Favard C, El maftouhi A, Assouline M, Francais C, Caputo G, Laroche L, Coscas G. 342 Corrélation OCT-angiographie des néovaisseaux juxtafovéolaires visibles de la DMLA traités au Laser Krypton : facteurs prédictifs de récidive. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74739-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
11
|
Assouline M, Tetard J. 193 Qualité de la vision en chirurgie réfractive. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74589-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
12
|
Angot H, Assouline M. 208 Détection automatisée du kératocône au moyen de l’analyse quantitative de la topographie cornéenne d’élévation (Orbscan II data recorder). J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74604-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
13
|
Abenhaïm A, Assouline M. [Cataract: etiology, diagnosis, principles of treatment]. Rev Prat 2001; 51:1819-22. [PMID: 11795129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- A Abenhaïm
- Service d'ophtalmologie, Hôtel-Dieu de Paris, 75181 Paris
| | | |
Collapse
|
14
|
Fayet B, Assouline M, Hanush S, Bernard J, D'Hermies F, Renard G. Silicone punctal plug extrusion resulting from spontaneous dissection of canalicular mucosa: A clinical and histopathologic report. Ophthalmology 2001; 108:405-9. [PMID: 11158821 DOI: 10.1016/s0161-6420(00)00534-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To report on an uncommon, previously unidentified, progressive silicone punctal plug extrusion. DESIGN Small, retrospective case series. PARTICIPANTS Five cases of punctal plug extrusion were identified among a series of 424 consecutive implantations. Histopathologic analysis was obtained in one case. One additional referred case was included in this report. RESULTS The plugs were completely extruded from the punctal lumen 6 to 14 months after insertion after an otherwise uncomplicated postoperative course. All plugs were retained at the punctal margin by an encircling band of vascularized mucosal tissue originating from the canalicular lumen. The band consisted of connective tissue of canalicular mucosal origin, attached just below the junction of the punctal and canalicular epithelium. Mild mononuclear infiltration was present in the connective tissue component of the punctal region. There was no cytologic or architectural evidence of abnormal epithelium or connective tissue or of pyogenic granuloma. CONCLUSIONS These observations suggest that progressive lacrimal punctal plug extrusion may relate to mucosal dissection by the plug edges. We speculate that mechanical stress induced by eyelid closure on an improperly sized or placed implant may result in plug tilt. Subsequent epithelial hyperplasia further enhances the tilt, and the sharper edge of the conical bulb promotes separation of the canalicular mucosa from its distal luminal aspect. At the completion of the extrusion, the mucosal surface is separated from its connective tissue base, at a proximal subpunctal level, causing formation of an encircling tissue band.
Collapse
Affiliation(s)
- B Fayet
- Department of Ophthalmology, Hôtel-Dieu de Paris, University of Paris VI, School of Medicine, Paris, France
| | | | | | | | | | | |
Collapse
|
15
|
Garrana RM, Zieske JD, Assouline M, Gipson IK. Matrix metalloproteinases in epithelia from human recurrent corneal erosion. Invest Ophthalmol Vis Sci 1999; 40:1266-70. [PMID: 10235563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
PURPOSE To assay for the presence of matrix metalloproteinases (MMPs) in human corneal epithelium affected by recurrent erosion compared with that in normal corneal epithelium. METHODS Corneal epithelial debridement samples were obtained from 13 patients with recurrent epithelial erosion. For control specimens, epithelia were obtained from healthy patients undergoing photorefractive keratectomy. Zymography was performed on all samples to identify MMPs. Immunolocalization of MMP-2, laminin, and collagen type VII was determined in two samples with human recurrent epithelial erosion and compared with that in control epithelium. RESULTS Twelve of 13 erosion samples showed MMP-2 enzymatic activity; one of the 12 also showed MMP-9 activity. Only one erosion sample showed no MMP enzymatic activity. All normal control specimens were negative for MMP. Immunohistochemical analysis of two recurrent erosion samples showed MMP-2 presence in basal cells, whereas, in normal epithelium it was not detected. One sample with epithelial erosion showed laminin localization in basal epithelial cells and basal lamina. Type VII collagen localized in basal epithelial cells only in this sample. A second erosion sample showed localization of laminin and type VII collagen in basal epithelial cells only. Normal corneal epithelium showed presence of laminin and type VII collagen in basal epithelium and basal lamina. CONCLUSIONS Matrix metalloproteinase-2 expression is upregulated in human epithelia affected by recurrent erosion compared with that in normal control samples. Immunolocalization studies suggest that this enzyme is concentrated in basal epithelial cells where it may play an important role in degradation of the epithelial anchoring system and the recurrent epithelial slippage and erosion observed in these patients.
Collapse
Affiliation(s)
- R M Garrana
- Schepens Eye Research Institute and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA
| | | | | | | |
Collapse
|
16
|
Dighiero P, Ellies P, Legeais JM, Briat B, Mayer F, David T, Saragoussi JJ, Abenhaïm A, Assouline M, D'Hermies F, Pouliquen Y, Renard G. [Phototherapeutic keratectomy in the treatment of Groenouw's type I corneal dystrophy]. J Fr Ophtalmol 1999; 22:176-9. [PMID: 10327347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
PURPOSE This study was designed to investigate the therapeutic potential of phototherapeutic keratectomy (PTK) for the treatment of corneal granular dystrophy. PATIENTS AND METHODS PTK was performed with the Excimed UV 200, (Summit Technology, Inc) on a series of 27 eyes of 22 patients with corneal granular dystrophy. Mean patients' age was 34.6 years. The mean follow-up period was 31 months (ranged from 6 to 52 months). The changes in best corrected visual acuity and spherical equivalent were evaluated at 6, 12, 18 and 24 months. RESULTS All of patients achieved visual improvement. Mean preoperative best corrected visual acuity (BCVA) was 20/100 and mean postoperative BCVA was 20/30 at one year. The mean hyperopic shift caused by tissue ablation was +/- 2.8 D after one year. CONCLUSION Corneal grafting was the standard treatment for visually disabling granular dystrophy, but PTK has significant advantages over this procedure and must now be the standard method of managing corneal granular dystrophy when intervention is required.
Collapse
Affiliation(s)
- P Dighiero
- Service d'Ophtalmologie, Hôpital de l'Hôtel-Dieu de Paris
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Assouline M, Lebuisson D. [Videokeratoscopy]. J Fr Ophtalmol 1999; 22:241-54. [PMID: 10327358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- M Assouline
- Service d'Ophtalmologie, Fondation Ophtalmologique Rothschild, Paris.
| | | |
Collapse
|
18
|
Benaoudia F, Assouline M, Pouliquen Y, Bouvet A, Guého E. Exophiala (Wangiella) dermatitidis keratitis after keratoplasty. Med Mycol 1999; 37:53-6. [PMID: 10200934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
We report the first French case of an intraocular infection due to Exophiala (Wangiella) dermatitidis. Two months after a second corneal transplant for congenital hereditary endothelial dystrophy, the patient presented with ocular pain and corneal infiltrates leading to the graft rejection. Diagnosis was established by positive direct examination and cultures of the same fungus from corneal buttons, iris biopsies and ablated sutures.
Collapse
Affiliation(s)
- F Benaoudia
- Laboratoire de Microbiologie, Hôpital Hôtel Dieu, Institut Pasteur, Paris, France
| | | | | | | | | |
Collapse
|
19
|
|
20
|
|
21
|
Abenhaïm A, Assouline M. [Cataract. Etiology, diagnosis, treatment principles]. Rev Prat 1998; 48:1367-72. [PMID: 9781199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- A Abenhaïm
- Service d'ophtalmologie, Hôtel-Dieu de Paris
| | | |
Collapse
|
22
|
Assouline M, Renard G, Arne JL, David T, Lasmolles C, Malecaze F, Pouliquen YJ. 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. Ophthalmic Surg Lasers 1998; 29:365-74. [PMID: 9599360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
Collapse
Affiliation(s)
- M Assouline
- Department of Ophthalmology, Hôtel-Dieu de Paris, INSERM U86, University of Paris VI, Medical School, France
| | | | | | | | | | | | | |
Collapse
|
23
|
Assouline M, Kaplan-Messas A, David T, Saragoussi J, Abenhaim A, Othenin-Girard P, Moossavi J, Pouliquen Y. [Excimer laser phototherapeutic keratectomy]. Bull Soc Belge Ophtalmol 1998; 266:93-100. [PMID: 9554139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M Assouline
- Department of Ophthalmology, INSERM U86, University of Paris VI-School of Medecine, Hôtel-Dieu de Paris, France
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Bergès O, Puech M, Assouline M, Letenneur L, Gastellu-Etchegorry M. B-mode-guided vector-A-mode versus A-mode biometry to determine axial length and intraocular lens power. J Cataract Refract Surg 1998; 24:529-35. [PMID: 9584251 DOI: 10.1016/s0886-3350(98)80297-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare prospectively the reproducibility and accuracy of B-mode-guided biometry with those of A-scan biometry using a conventional A-mode probe to calculate intraocular lens (IOL) power. SETTING Department of Ophthalmology, Hôtel-Dieu de Paris, France. METHODS The axial length (AL) in 87 eyes of 72 candidates for cataract surgery was determined by B-mode-guided vector-A-mode and A-mode biometry using an Ophthascan S Ultrasound imager. Patients were assigned to one of two groups based on the B-mode biometry: nonmyopic (AL < 24.5 mm; n = 54) or myopic (AL > 24.5 mm; n = 33). Postoperative refractive results were compared with attempted values. RESULTS Mean AL variance was significantly greater when using the A-mode than the B-mode: 0.157 mm +/- 0.260 (SD) versus 0.015 +/- 0.018 mm in the myopic group (P < .001) and 0.024 +/- 0.024 +/- 0.045 versus 0.009 +/- 0.011 mm in the nonmyopic group (P < .001). More eyes having B-mode biometry achieved a final refraction within +/- 0.50 diopter (D) of the attempted refraction (63 and 43%, respectively; P < .05). No deviation greater than 1.60 D was observed with the B-mode in the myopic or nonmyopic group. Three cases with a such a deviation (up to 2.24 D) would have been observed had A-mode-based biometry been chosen for the IOL power calculation. In the myopic group, attempted postoperative refraction was within +/- 0.50 D in 78% of eyes having B-mode biometry compared with 65% having A-mode. This difference was not statistically significant. CONCLUSION> These results suggest that the reproducibility and accuracy of AL measurements are significantly better with B-mode-guided A-mode biometry than with A-mode biometry in myopic and nonmyopic eyes.
Collapse
Affiliation(s)
- O Bergès
- Department of Medical Imaging, Fondation Ophthalmologique A. de Rothshild, Paris, France
| | | | | | | | | |
Collapse
|
25
|
Pouliquen Y, Bureau J, Mirshahi M, Mirshahi SS, Assouline M, Lorens G. [Keratoconus and inflammatory processes]. Bull Soc Belge Ophtalmol 1998; 262:25-8. [PMID: 9376921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
26
|
el Aouni A, Briat B, Mayer F, Saragoussi JJ, Abenhaim A, Assouline M, David T, Pouliquen Y, Renard G. [Reis-Buckler dystrophy: therapeutic photo-ablation with the excimer laser]. J Fr Ophtalmol 1998; 21:23-7. [PMID: 9834896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE Reis-Buckler's corneal dystrophy consist of superficial reticulated opacities with recurring attacks of corneal erosion. Lamellar and penetrating keratoplasties were the traditional surgical means of improving recurrent erosions and vision but the dystrophy recurs following surgery. Phototherapeutic keratectomy (PTK) is now the standard method of managing this anterior corneal disease when intervention is required. MATERIAL AND METHODS We have treated ten eyes with Reis-Buckler's dystrophy using Excimer laser PTK. RESULTS All of patients achieved visual improvement (preoperative corrected visual acuity: average 0.3 +/- 0.2 SD, postoperative at one month 0.6 +/- 0.3 SD and 0.7 +/- 0.2 SD at one year. The refractive shift changed from a spherical equivalent of -0.92 D to a postoperative refraction of +1.80 D at one month and +1.65 D at one year.
Collapse
Affiliation(s)
- A el Aouni
- Service d'Ophtalmologie, Hôtel-Dieu, Paris
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Assouline M, Moossavi J, Müller-Steinwachs M, Cohen-Sabban J, Thompson HW, Pouliquen Y. PMMA model of steep central islands induced by excimer laser photorefractive keratectomy. Surv Ophthalmol 1997; 42 Suppl 1:S35-51. [PMID: 9603289 DOI: 10.1016/s0039-6257(97)80026-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We designed a polymethyl methacrylate (PMMA) model of refractive steep central islands (CIs) induced by PRK. A standardized photorefractive ablation procedure was performed using seven different excimer lasers on test PMMA specimens including 70 flat plates and 98 convex contact lenses. The resulting surface was analyzed by high-resolution confocal microscopy and computerized videokeratoscopy using both TMS-1 and CAS-2000 systems. A total of 50 (54.9%) CIs were observed using computerized videokeratoscopy. The rate of occurrence of CIs was significantly reduced by shock wave absorption (P = 0.0001), aspiration of fumes (P = 0.0044), and smaller diameter ablation (P = 0.0296). The diameter of the CIIs was significantly increased for broad-beam mode ablation (P = 0.016) and for larger ablation zones, (P = 0.042). The refractive power of CIs was significantly increased in the absence of a shock wave absorption system (P = 0.001). Only 20 (40%) of the CIs detected by the TMS-1 device were identified on CAS-2000 at a 0.5 diopter (D) scale resolution level. Shock wave induced deformation and subsequent dynamic alteration of convection forces applied to emitted particles may be the primary mechanism underlying the formation of CIs after PRK, regardless of any biological response of the ablated tissue. Reported rates and characteristics of CIs may largely depend upon the specific design of videokeratoscopes.
Collapse
Affiliation(s)
- M Assouline
- Department of Ophthalmology, Fondation Ophthalmologique A de Rothschild, Paris, France.
| | | | | | | | | | | |
Collapse
|
28
|
Assouline M, Briat B, Kaplan-Messas A, Renard G, Pouliquen Y. [Computerized video-keratoscopic analysis and cataract surgery by phacoemulsification. Predictive calculation of the power of the intraocular implant]. J Fr Ophtalmol 1997; 20:411-7. [PMID: 9296036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE The authors present the results of a prospective study of 125 consecutive cases of phacoemulsification, performed by a single surgeon, to assess the benefit of computerised videokeratoscopy for the improvement of the predictive calculation of the power of intraocular lenses (IOL). METHODS Preoperative keratometry was determined by means of 3 concurrent techniques, including automated kerato-refractometry (AKR 2000, Nidek) and videokeratoscopy by TMS-1 (Tomey) and CAS-1 (EyeSys). The results of the IOL calculation by these 3 methods was compared postoperatively to the power of the actual IOL yielding emmetropia as calculated by the optical method based on the postop, refraction at the various time-points. RESULTS Simulated values obtained with videokeratoscopy significantly reduced the refractive error at 1 postop, week (p = 0.001), one month (p = 0.002) and 3 months (p = 0.002) for the CAS1 and at 3 months (p = 0.002) for the TMS1, as compared to values obtained with conventional automated keratometry. The refractive error was significantly reduced with the CAS1 at one month (p = 0.001) and 3 months (p = 0.019) as compared to TMS1. CONCLUSION The determination of the anterior curvature of the entrance pupil by videokeratoscopy significantly improves the predictive calculation of the IOL power.
Collapse
Affiliation(s)
- M Assouline
- Département d'Ophtalmologie, Hôtel-Dieu, Paris
| | | | | | | | | |
Collapse
|
29
|
Saragoussi JJ, Puech M, Assouline M, Berges O, Renard G, Pouliquen YJ. Ultrasound Biomicroscopy of Baikoff Anterior Chamber Phakic Intraocular Lenses. J Refract Surg 1997; 13:135-41. [PMID: 9109069 DOI: 10.3928/1081-597x-19970301-09] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
Collapse
Affiliation(s)
- J J Saragoussi
- Department of Ophthalmology, Hotel-Dieu Hospital of Paris, France
| | | | | | | | | | | |
Collapse
|
30
|
Chauvaud D, Assouline M, Perrenoud F. [Posterior scleral reinforcement surgery]. J Fr Ophtalmol 1997; 20:374-82. [PMID: 9238475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
UNLABELLED Scleral reinforcement is proposed to stabilize the visual acuity in patients with macular myopic staphyloma. Although many patients have been treated, this procedure is still debated. PURPOSE Evaluation of the feasibility of scleral reinforcement and the operative risk of this procedure. PATIENTS AND METHODS Patients were eligible for this prospective study patients with a clinical history of visual loss, staphyloma concerning the macular area associated with atrophic lesion and or lacquer cracks. Sixteen eyes in 13 successive patients have been operated on with a single band of PTFE. RESULTS At the last examination, visual acuity was unchanged for 14 cases. In one case, an improvement of the vision was related to the disappearing of a macular detachment by shortening of the axial length. In one case, vision decline was associated with inadequate band position. Diplopia occurred in 2 cases. A choroidal detachment, and a vitreous haemorrhage disappeared without sequelae. CONCLUSION An accurate technique is necessary to avoid operative risk. Further long term studies are needed to assess the benefit of scleral reinforcement.
Collapse
Affiliation(s)
- D Chauvaud
- Service d'Ophtalmologie, Hôtel-Dieu, Paris
| | | | | |
Collapse
|
31
|
Favard C, Guyot-Argenton C, Assouline M, Marie-Lescure C, Pouliquen YJ. Full panretinal photocoagulation and early vitrectomy improve prognosis of florid diabetic retinopathy. Ophthalmology 1996; 103:561-74. [PMID: 8618753 DOI: 10.1016/s0161-6420(96)30652-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- C Favard
- Department of Ophthalmology, Diabetes Eye Center, Hôtel Dieu de Paris, France
| | | | | | | | | |
Collapse
|
32
|
Assouline M. In vitro modelling of central island following PRK. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98687-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
33
|
Assouline M, Kaplan A, Saragoussi J, David T, Abenhaim A, Pouliquen Y. P 168 Excimer laser phototherapeutic keratectomy. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
34
|
Assouline M, Moossavi J, Muller-Steinwachs M, Hartman C, Pouliquen Y. P 161 In vitro evaluation of surface regularity following ablation with seven different excimer lasers. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90477-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
35
|
Assouline M, Muller-Steinwachs M, Hartmann C, Renard G, Pouliquen Y. P 169 Comparison of various masking agents for phototherapeutic keratectomy: An experimental in vitro study. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Assouline M. In vitro evaluation of surface regularity following ablation with seven different excimer lasers. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
37
|
David T, Saragoussi J, Abenhaïm A, Othenin-Girard P, Assouline M, Renard G, Pouliquen Y. 1114 Long term refractive results of a 3 month treatment with dexamethasone after photorefractive keratectomy (PRK) for myopia: A randomized prospective study. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90014-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
38
|
Assouline M. Excimer laser phototherapeutic keratectomy. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98692-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
39
|
Mayer F, David T, Assouline M, Saragoussi J, Abenhaim A, Pouliquen Y. P 159 Comparison of 5 vs 6 mm ablation zone for PRK. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
40
|
Mashhour B, Sabatier P, Assouline M, Perricaudet M, Pouliquen Y. 4113 Adenoviral gene transfer into human endothelial corneal cells of corneal grafts ex vivo. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
41
|
Assouline M, Delbose B, Rigal D, Adenis J, Bechetoille A, Sabatier P, Golmard J, Pouliquen Y. 2112 Survival of high risk HLA matched penetrating keratoplasty. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
42
|
Assouline M. Survival of high risk HLA matched penetrating keratoplasty. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
43
|
Assouline M. Risk factor analysis for poor visual outcome following PRK. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98222-u] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
44
|
David T, Saragoussi J, Abenhaïm A, Othenin-Girard P, Assouline M, Renard G, Pouliquen Y. 1112 Photorefractive keratectomy (PRK) for low to moderate myopia with a 5MM optical zone: Two years follow-up. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Santiago P, Assouline M, Ducoussau F, Bazin S, Ballion J, Mezraoui A, Pouliquen Y. 2311 Prevalence of keratoconus. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90188-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
46
|
Mashhour B, Goes F, Assouline M, Pouliquen Y. 3437 Comparative analysis of topographic abnormalities induced by sclerotomies sutures in vitrectomies. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90347-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
47
|
Kaplan-Messas A, Assouline M, Djada D, Renard G, Pouliquen Y. 1413 Comparison of mitomycin C and 5 fluorouracil in 100 cases of high risk trabeculectomies. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
48
|
Assouline M, Zawha A, Goldstein A, Legras J, Renard G, Pouliquen Y. P 307 The effect of peribulbar anaesthesia on intraocular pressure. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90567-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
49
|
Stern ME, Waltz KM, Beurerman RW, Ghosn CR, Mantras CE, Nicolson M, Assouline M, Stern KL, Wheeler LA. Effect of platelet-derived growth factor on rabbit corneal wound healing. Wound Repair Regen 1995; 3:59-65. [PMID: 17168863 DOI: 10.1046/j.1524-475x.1995.30111.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Human recombinant platelet-derived growth factor was evaluated with the use of wound healing models in New Zealand albino rabbits. The efficacy of the platelet-derived growth factor dimers, AA, AB, and BB, was determined in corneal reepithelialization and anterior keratectomy models which examined the healing response in the presence or absence of the basement membrane. All dimers increased the rate of wound healing in both models at 100 microg/ml when compared with control; however, the platelet-derived growth factor-BB isoform showed the most dramatic increase in both studies. The strength of the healing stroma after incision was evaluated by means of a tensile strength model. Histologic evaluation of the stromal wound area after 9 days of healing showed a marked increase in the number of keratocytes within the wound bed of the corneas treated with platelet-derived growth factor-BB when compared with control corneas. In addition, at 9 days, the epithelial plug was still present in the control corneas but had been extruded to the surface by the granulation tissue in the platelet-derived growth factor-BB-treated corneas. These results are indicative of a more advanced stage of healing in treated versus control wounds at 9 days after the operation. A 30% increase in corneal tensile strength versus control was noted after 21 days of healing. Finally, in an in vitro gel contraction assay, platelet-derived growth factor exhibited a dose-dependent effect on the contraction of fibroblasts for doses ranging from 0.01 to 10 ng/ml. These results indicate that platelet-derived growth factor is active in the corneal wound healing process.
Collapse
Affiliation(s)
- M E Stern
- Department of Biological Sciences, Allergan Incorporated, Irvine, California, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Jacob-LaBarre JT, Assouline M, Byrd T, McDonald M. Synthetic scleral reinforcement materials: I. Development and in vivo tissue biocompatibility response. J Biomed Mater Res 1994; 28:699-712. [PMID: 8071381 DOI: 10.1002/jbm.820280607] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The surgical treatment of pathological myopia involves the placement of a band cut from donor sclera around the back of the globe to provide support and to prevent elongation that leads to retinal detachment and blindness. In the search for a synthetic material that would overcome the disadvantages of the donor tissue band, we tested 11 types of bands made from 14 polymers in rabbit eyes. Bands were cut from porous and solid materials, as well as porous materials coated with solids and solid materials with porous patches affixed to the posterior surface. Criteria for suitability and biocompatibility included ease of placement and suturing, stable positioning, and absence of long-term tissue response on a cellular level. Testing included evaluation by the surgeons performing the implantations, measurement of the distance between the band and the globe, determination of fibrous capsule thickness and amount of collagen deposition, and enumeration of macrophages accumulated at the band/capsule interface. Based on the results of these studies, two of the porous materials (expanded polytetrafluoroethylene and porous polyurethane fabric) and two of the composite materials (porous polyurethane fabric coated with polyacrylonitrile and silicone with microvilli cut into the posterior surface) were selected for further study.
Collapse
Affiliation(s)
- J T Jacob-LaBarre
- Department of Ophthalmology, Louisiana State University Medical Center School of Medicine, New Orleans 70112
| | | | | | | |
Collapse
|