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A 67-year-old woman had three different tumors of the eyelids. The most prominent one was a nevus of the free margin of the inferior left eyelid. The nevus was followed for 18 months without change while two epidermal papillomatous tumors grew and were surgically removed. Histopathology disclosed that one tumor was a seborrheic keratosis and the other was a pre-epitheliomatous keratosis. Histologic evaluation of the margins showed that surgical removal was complete. A regular examination of the scars was recommended to the patient.

Due to a long-term alteration in their chemical composition, resulting in excessive swelling, Miragel scleral buckles are now commonly removed. The aim of this study was to determine the characteristics and the outcome of patients needing Miragel buckling removal.Retrospective analysis between 1997 and 1999 of the charts of patients successfully treated for retinal detachment and in whom a Miragelepiscleral buckle was removed after surgery with a minimal follow-up of 6 months after removal.The study group consisted of 24 eyes of 13 women and 11 men. Their mean age at removal was 47.1+/-18.4 years. The removed buckle was encircling in nine cases (37.5%), circumferential (180 degrees ) in 11 cases (45.8%) and radial in four cases (16.7%). An exposed buckle was observed in two cases (8.3%). Reasons for removal were excessive swelling of the buckle inducing ocular motility disturbance in 23 cases and infection of an extruded buckle in only one case. The mean time between implantation and removal was 91.9+/-28.7 months (range 20-120). One case of scleral perforation during removal and one case of retinal redetachment were observed. Three cases of persistent ocular motility disturbance after removal were also noted.Late swelling of the buckle was the main reason for removal. Patients undergoing Miragel buckling removal should be informed of scleral perforation during removal, retinal redetachment and persistence of ocular motility disturbance as possible complications.

An 80-year-old male patient experienced recently diagnosed swelling of the limbal conjunctiva. In his clinical history were found cataract surgery on the right eye 3 months before, chronic open angle glaucoma effectively treated by local eye drops, treated systemic hypertension and hypercholesterolemia. On ophthalmic examination, a conjunctival mass was present in the inferior lateral conjunctival quadrant next to the limbus, with numerous vessels visible at its top. Treatment with topical corticosteroids failed to obtain regression, but decreased the local inflammatory signs. The persistence of the mass led to its surgical excision under local anesthesia. Histopathology found a subepithelial accumulation of modified collagen bundles typical of elastotic degeneration. Capillary vessels were seen in the superficial subepithelial area, attesting to the high degree of vascularization observed clinically. The final diagnosis was a pinguecula, which was not exactly located on the horizontal meridian area as it is usual.

Chicken pox is a very common infectious disease in children. Its corneal involvement is less serious than with measles, which may lead to blindness in numerous developing countries. However, with occasional cases occur. A case of a 59-year-old male patient whose left cornea was involved during a chicken pox infection at the age of 7 is reported. More recently, the vision of the right eye was normal at 20/20 and reduced to visual perception in the affected left eye. Corneal sensitivity was maintained in the left eye, which, however exhibited a central epithelial defect. A central round opacity of the left corneal stroma was believed to be the scar resulting from a previous disciform keratitis. The left central cornea was thinned and there was neither an anterior chamber flare nor new corneal vessels. This corneal condition required a corneal allograft, performed quickly because of the potential risk of perforation. Histopathological study of the corneal button showed a central corneal thinning with an increase in epithelial thickness. The corneal stroma was disorganized, with irregular collagen bundles. No inflammatory cells could be observed, however. All the histopathological changes observed were those of a corneal scar.

Abstract Formation damage in horizontal wells, often open hole completed, is a critical point for oil fields developed in deep offshore, where acceptable development costs are based upon a limited number of highly productive wells. This paper describes a simplified numerical approach to model filter cake removal by natural cleanup when the well is put under a drawdown pressure difference. A flow simulator taking into account the near-well permeability variation has been developed using a cylindrical grid with very small gridblocks around the well. Laboratory data obtained on sandstones damaged with an oil-based mud have been used as input data to model filter cake removal by natural cleanup. The purpose of this modelling is to optimize the applied drawdown pressure, to study the variation of well productivities as a function of the pressure drawdown, and to get the best possible well performance preventing sand production problems in poorly consolidated formations. Introduction Deep offshore reservoirs are usually developed in very severe conditions, thus, their development costs are very high. The profitability of such developments requires a production scheme involving a limited number of wells having very high productivities and acceptable life spans of several years without any dramatic interruption. To reach these objectives, horizontal wells of great length are generally considered. These wells are mostly completed open-hole (non-cemented), avoiding any possibility of efficient remediation or stimulation in the case of any major damage created in the vicinity of the wellbore. Therefore, the clean up of these wells when they are put initially into production must resorb the greatest part of the damage generated during drilling and completion operations. An additional complication comes from the fact that these wells can exhibit sand production from the formation when drilled in non- or poorly-consolidated reservoirs (turbidites) if the clean up process is not carefully optimized. The questions are: which pressure drawdown has to be applied, and according to which procedure? In this paper, a simplified methodology is proposed to simulate the flow of a single liquid phase, namely oil, in the close vicinity of an horizontal well during its clean up period when a pressure drawdown is imposed between the wellbore and the reservoir formation. This work constitutes a first approach in order to provide qualitative information on the capacity of self cleaning of a horizontal well drilled in an oil pool with an oil-based mud. Numerical results are presented that show the influence of the pressure drawdown imposed during the clean up period on both the velocity of the produced oil at the wellbore, and the respective contribution of contrasted permeability zones on the total flow rate of the well. The presence of an external filter cake, together with an internal damage zone due to mud filtration, is also studied. Ultimately, these results will be used within more complete wellbore modelling that will include other features such as sand grain pulling from the reservoir formation. Afterwards, an extension of the model will take into account the mechanisms of formation damage and permeability restoration while assuming that the wells are drilled with a water-based mud.

A clinicopathologic case of a 41-year-old female patient exhibited a single cutaneous tumor at the inner part of the free margin of the inferior left eyelid. It was a pink, fleshy, and nodular well-circumscribed exophytic mass with thin vessels on its surface. Experienced already for 20 years, this lesion had been observed 6 years before and has not exhibited much change since then. However, its clinical appearance argued for a possible small basal cell carcinoma, which had grown over the inferior left lachrymal duct. After surgical removal, histopathology showed that the tumor was an amelanotic dermal nevus. No disturbance of lachrymal drainage was observed after surgery. This case shows that nodular amelanotic tumors of the eyelid, even when located on the inner segment of the eyelid, may be a nevus.

The purpose of this work was the development of an antiprotease treatment for the cornea and later for other ocular tissues. Indeed, many proteases participate in various ocular pathologies and no really effective treatments are currently available.We worked on bovine corneas in organ cultures, incubated in the presence and absence of bacterial collagenase. We used procyanidolic oligomers from grape seeds (PCO) as the antiproteolytic agent, added to the cultures in two different concentrations.The corneas incubated in the presence of collagenase were quickly attacked and their degradation was practically complete after 24 hours. With the low concentration used (0.066 mg/ml), proteolysis was only slightly inhibited. With the higher concentration of PCO (1 mg/ml), the collagenolysis was completely prevented and the corneas were completely preserved.These results show that the protective effect of the PCO against proteolytic attack, demonstrated previously on other tissues, proved to be effective also for the cornea in vitro. An adequate method of administration in clinical practice must now be developed in order to obtain an effective clinical antiproteolytic treatment.

A 46-year-old female patient had a tumor of the free margin area of the superior right eyelid, appearing as the fourth recurrence of a primary lesion, occurring 24 years before. The lesion was covered with a thick layer of keratin, giving it a grayish and black color. Excision was performed without involving the free margin. Histopathology disclosed that the tumor was a seborrheic keratosis, which was not completely removed. As the lesion was benign, no further surgery was performed but regular examination was recommended to the patient.

A 43-year-old female patient had an amelanotic single tumor thickening the upper right eyelid and observed since early childhood. Clinically, it appeared as a firm mass, without sharp margins, giving a thickened appearance to the superior eyelid. The ophthalmic clinical examination was normal but some subcutaneous nodules attested to the diffusion of the disease recognized as a limited form of neurofibromatosis 1. Although well tolerated, it gave rise to a cosmetic disturbance and the patient was willing to undergo an excision. A complete surgical excision was performed on the lesions and the pathological study disclosed a typical neurofibroma. Regular observation of the different cutaneous nodules was recommended.

There are numerous variants of cutaneous tumors involving the eyelids. Tumors of a different nature may at times be observed simultaneously in the same area of the eyelid. A clinicopathologic case of a 36-year-old male patient with 2 different cutaneous tumors at the nasal part of the left eyelid is reported. One was a nodular tumor on the inner canthus with a pearly appearance; the other had a papillomatous pattern. After surgical removal, the histopathological study of the tumors disclosed a typical basal cell carcinoma and a squamous cell papilloma. Both tumors can be commonly observed on the eyelids and surgical excision cured the patient.

A 25-year-old-male patient had one keratinized tumor on the inferior right eyelid, first observed 5 months before. Its size had been increasing for the last three weeks. The visual function was normal. Clinical examination disclosed a papillomatous lesion on the cutaneous middle part of the eyelid. A surgical excision was performed under local anesthesia. The histopathological study found a papillomatous epidermal proliferation with both structural and cytological atypias, concluding with a precancerous keratosis of the eyelid.

Retinal detachment (RD) is a major complication of cataract surgery, which can be treated by either primary vitrectomy without indentation or the scleral buckling procedure. The aim of this study is to compare the results of these two techniques for the treatment of pseudophakic RD.The charts of 40 patients (40 eyes) treated with scleral buckling for a primary pseudophakic RD were retrospectively studied and compared to the charts of 32 patients (32 eyes) treated with primary vitrectomy without scleral buckle during the same period by the same surgeons. To obtain comparable samples, patients with giant retinal tears, vitreous hemorrhage, and severe preoperative proliferative vitreoretinopathy (PVR) were not included. Minimal follow-up was 6 months.The primary success rate was 84% in the vitrectomy group and 82.5% in the ab-externo group. Final anatomical success was observed in 100% of cases in the vitrectomy group and in 95% of cases in the ab-externo group. Final visual acuity was 0.5 or better in 44% of cases in the vitrectomy group and 37.5% in the ab-externo group. The duration of the surgery was significantly lower in the ab-externo group, whereas the hospital stay tended to be lower in the vitrectomy group. In the vitrectomy group, postoperative PVR developed in 3 eyes and new or undetected breaks were responsible for failure of the initial procedure in 2 eyes.Primary vitrectomy appears to be as effective as scleral buckling procedures for the treatment of pseudophakic RD.

A case of meibomian carcinoma of the left eyelid is reported in a 72-year-old female patient. The tumor had been present on the left eyelid for months. Clinically, the tumor appeared as a reddish mass implanted on the external part of the free margin of the left superior eyelid. An excisional biopsy disclosed meibomian carcinoma. A total resection of the left superior eyelid was followed by plastic surgery. Results after a one-month follow-up were very satisfactory. This case is emphasizes the importance of an early diagnosis which enabled us to perform a rather conservative treatment limited to the removal of the affected eyelid. The diagnosis of meibomian carcinoma is infrequent but it must be kept in mind in cases of tumor without the typical clinical characteristics of a basal cell or squamous cell carcinoma. Complete removal surgery may bring a curative effect and histopathology has a key role in the diagnosis of meibomian carcinoma.

A clinicopathologic case of an 89-year-old female patient with a single cutaneous tumor at the outer part of the outer left eyelids is reported. It was a pink nodular mass, well circumscribed, exophytic and with thin vessels. After surgical removal, histopathology showed that the tumor was a typical basal cell carcinoma, with many cystic-like cavities. Basal cell carcinomas can be commonly observed on the eyelids and surgical excision of these small size lesions is an easy way to perform a curative treatment. As often in other tumors, early diagnosis is probably the easiest way to improve the prognosis.

Dysembryoplastic neoplasm, the limbal dermoid is a benign congenital tumor involving the outer coat of the eye. This congenital tumor affected the right eye of a 6-year-old girl. The lesion was typically hemispheric, covered with pink skin, located in the inferior and temporal part of the cornea, and devoid of any major consequences except the cosmetic appearance of the eye. There were no other major abnormalities in the clinical examination but a single skin tag could be observed at the homolateral preauricular area without any visible cutaneous fistula next to it. This additional change allowed us to establish the diagnosis of a minor form of Goldenhar syndrome. This malformative syndrome typically includes several changes: dermoid and/or dermolipoma, preauricular tags and/or cutaneous fistulas in the same area, vertebral abnormalities etc. These findings may be limited to dermoid and cutaneous tags, as in our report. Such changes must be looked for in all limbal dermoids.

Demonstrate eventual differences and evaluate the medical costs of treatment of a cataract in traditional hospitalisation and out-patient surgical conditions.We conducted a study of minimisation costs in 3 ophthalmologic hospital departments. This retrospective study randomly selected the medical files of 250 patients (100 operated in the out-patient surgical department and 150 operated in traditional surgical conditions). Costs were evaluated on direct hospital costs, according to the standard costs method and the method of true costs.The mean total cost of a cataract is of 10,984 F in traditional hospital conditions and of 7,683 F in out-patient surgical conditions.In terms of direct hospital costs, treatment of cataracts in out-patient surgery appears more economic compared with traditional surgery. The difference in cost concerned the fixed hospital charges (structures and staff).Out-patient surgery will progress in France in the next few years, but traditional hospitalisation will still be required in ophthalmologic practice.

Human skin fibroblasts and corneal keratocytes were compared for their GAG-biosynthetic activity as a function of passage number (in vitro replicative senescence) by comparing the fraction of total label (3H-glucosamine) incorporated in total glycoconjugates and individual GAG-s. It appeared that keratocytes synthesised about as much non-GAG glycoconjugates (glycoproteins) as fibroblasts. Incorporation in GAG-s increased with passage number for fibroblasts and remained constant for keratocytes. Hyaluronan as % of total GAG-s was somewhat higher in fibroblasts than in keratocytes. A strong increase of incorporation was seen at the latest passage (15th) close to replicative senescence of fibroblasts but titration with hyaluronectin showed a decrease of hyaluronan concentration, interpreted as a sign of post-synthetic degradation of hyaluronan in pre-senescent fibroblasts. Regulation of GAG-biosynthesis as a function of passage number permitted thus to differentiate fibroblast and keratocyte phenotypes.

This study presents a series of algorithms developed to estimate hydraulic roughness coefficients for overland flow. The algorithms are combinations of neural networks that use surface configuration parameters and the local flow Reynolds number as inputs, and provide an estimate of the roughness coefficient (Darcy–Weisbach, Manning, or Chezy). Results presented here show that as new neural networks are combined into the stacked algorithm, the estimate errors become gradually smaller. The Final Prediction Error index has been used to identify the optimum network size. Additionally, the dataset used to develop the neural networks, developed from measurements taken at approximately equal Reynolds number intervals, has been found to benefit the algorithms predicting Chezy coefficients. The scarcity of data points in some regions of the output space for the Darcy–Weisbach and Manning models caused a reduction in the predictability of the algorithms for these regions and prevented the use of more complex neural networks. The algorithms have been tested for a wide range of input variables in a detailed sensitivity analysis and have produced reasonable results in all cases.

Corneal immunoglobulin deposits are an unusual complication of lymphoproliferative affections such as monoclonal gammapathy of indeterminate significance, essential cryoglobulinemia, or multiple myeloma. Although uncommon, this crystalline keratopathy may be the first clinical sign of these malignant disorders. We report two cases of paraproteinic crystalline keratopathy: the first case is associated with a multiple myeloma, combined with cryoglobulinemia, and the second case with monoclonal gammapathy of indeterminate significance. In both cases, corneal crystalline deposits appeared before general clinical symptoms. In the first case, the systemic therapy made no change in the biomicroscopic aspect of the corneal deposit, despite immunoglobulin level normalization in the serum. Conversely, in the second case, we noticed a substantial regression of the corneal crystalline deposits as the systemic normalization. A review of the literature clarified the variety of clinical dorms of paraproteinic crystalline keratopathy, the physiopathogenics hypotheses that are currently being discussed, and the possible therapeutic modalities.

The ICE syndrome includes 3 variants of the same disease, previously believed to be independent entities. All 3 share clinical and histopathological features such as endothelial abnormalities, iris damage, and progressive closure of the iridocorneal angle. Seven cases of ICE syndrome are reported, affecting 6 women and 1 man, with a mean age of 40 years. Corectopia was found in 5 eyes, a uveal ectropion in 2 cases, and other iris changes in 3 cases. The endothelial changes of the cornea were confirmed by a speculum microscopy in 5 cases. There were 5 cases of Chandler syndrome, 1 of Cogan-Reese syndrome, and 1 case of iris essential atrophy in our series. Ocular hypertony was observed in 3 cases, 2 of which needed to be operated. In one patient, a corneal edema was observed.

Cornea is a highly differentiated tissue rich in extracellular matrix (ECM) specifically distributed in space in order to insure its dual role--transparency and protection of inner eye-tissues. Corneal ECM is especially rich in collagens. Since the characterisation of a number of distinct collagen types it appeared that most of them are present in the cornea. Their synthesis follows a specific program of sequential expression of the different collagen types to be synthesised during the development and maturation of the cornea. The precise regulation of the diameter and orientation of fibers, and of the interfibrillar spaces is partially at least attributed to interactions between glycosaminoglycans and collagens. The 'program' of vectorial collagen synthesis and GAG-collagen interactions changes also with age and in several pathological conditions as corneal dystrophies and wound healing. The Maillard reaction, especially in diabetes, is one of these important factors involved in age-dependent modifications of corneal structure and function. Far from being inert, corneal collagens were shown to have relatively short half-lives. The biosynthesis of corneal collagens was studied also during wound healing. The refibrillation of wounded corneas does not follow the original 'program' of ECM-synthesis as shown by the comparative study of wound healing using biochemical and morphometric methods. This review recapitulates briefly previous and recent studies on corneal collagens in order to present to clinicians and scientists an overview of the state of the art of this important field at the intersection of eye research and matrix biology.

A 76-year-old-female patient fell in her garden, inducing a right orbital wound in which no foreign body was primarily found. As pain and diplopia followed the orbital trauma, a CT-scan was performed, disclosing a linear external foreign body in the right orbit. An anterior orbitotomy was performed to remove an 18-mm-long wooden foreign body. Histopathology of the tissue surrounding the foreign body showed an inflammatory fibrous tissue with small granulomas around telluric particles. Improvement after the operation was dramatic with complete disappearance of diplopia the day following surgery. Antibiotics were prescribed and tetanus prophylaxis was performed.

Uveal effusion exhibits various clinical presentations, some of which may lead to erroneous diagnosis and mimic a choroidal tumor. A 73-year-old female patient displayed a choroidal lesion with a tumoral appearance spontaneously affecting her right eye. Ultrasonography did not establish the diagnosis, leaving doubt for a tumor. In addition to the tumor - like lesion, a moderate inflammation was found in her right eye. The clinical course was favorable and one month after the initial examination, no fundus abnormalities were observed. The delay imposed by the MRI examination contributed to the lack of any active treatment. Apart from cases occurring postoperatively, the diagnosis of uveal effusion may sometimes be difficult to establish. In order to avoid enucleation and even if ultrasonography is helpful in reaching the correct diagnosis, it seems appropriate to wait and regularly follow up the patients when the diagnosis is not certain. The clinical course might be helpful to establish the diagnosis. Our case suggests that in pseudotumoral forms of uveal effusion, we should repeat clinical examination and ultrasonography in order to manage these patients appropriately.

A clinicopathologic case of an 80-year-old male patient with a single cutaneous tumor on the upper part of the left eyelid is reported. It was a grayish and pigmented mass covered with a thick keratin layer, well circumscribed, and exophytic. After surgical removal, histopathology showed that the tumor had a papillomatous pattern and was growing under a thick layer of hyperkeratosis. It was a typical squamous cell papilloma. This tumor belongs to the benign eyelid tumor group and can be found on the eyelids of elderly people.

To establish a phenotype-genotype correlation of various autosomal-dominant corneal dystrophies among French subjects.Retrospective molecular genetic study and clinicopathologic correlation.Forty-four subjects from 26 unrelated French families were included in this study, and 60 corneal buttons could be examined at the histologic and ultrastructural levels.Light microscopy and transmission electron microscopy were performed on corneal specimens obtained during keratoplasty. Blood samples were collected for DNA analysis.After genomic DNA extraction from peripheral blood leukocytes of each family member, exons of the TGFBI gene were amplified by polymerase chain reaction (PCR), and the PCR products were directly sequenced on both strands.Four different mutations were found to be responsible for dystrophy of granular type (R555W, R124L, R124H, and R124L+delT125-delE126), three other different mutations produced a lattice type (R124C, H626R, and A546T), and the last mutation identified was associated with the honeycomb-shaped dystrophy (R555Q). Each subtype of dystrophy showed, histologically and ultrastructurally, specific characteristics that are easily recognizable. However, besides these stereotyped forms, differential histologic diagnosis of atypical forms remains difficult, and these forms could be misdiagnosed.The characteristic biomicroscopic appearance and histopathologic features of each "classic" dystrophy present a significant degree of specificity and generally provide an accurate diagnosis. However, atypical forms in which clinical and histologic data alone could be misleading, are unequivocally diagnosed after DNA analysis.

The authors report a case of unilateral, stable, localized, and well-circumscribed choriocapillaris atrophy associated with retinal pigment epithelium dispersion and atrophy. The anterior segment was normal. Facial examination revealed a homolateral malar hypoplasia. The other eye was normal. The electrophysiologic study did not confirm pigmentary degeneration of the retina. The patient's history included a difficult delivery using obstetrical forceps. The authors review the main ocular lesions secondary to birth trauma. In this case, they favored a traumatic chorioretinal lesion secondary to an obstetrical traumatism. In this context, progressive facial hemiatrophy is the main differential diagnosis.

A 73-year-old male patient was treated for conjunctival in situ carcinoma invading the cornea of his right eye. The patient had been previously operated on for two corneoconjunctival lesions on the same eye (one was a pterygium, the other was simple epithelial hyperplasia) and was regularly followed for a systemic lymphoplasmocytic lymphoma (Waldenström's disease). After a corneoconjunctival excision of the tumor, the histological analysis was performed and established the diagnosis of in situ carcinoma. The tumor recurred a few months later and radiation therapy was then given. No recurrence was observed after this latter treatment.

SAGD is a very promising recovery process to produce heavy oils and bitumen resources. The method ensures both a stable displacement of steam and economical rates by using gravity as the driving force and a pair of horizontal wells for injection/production. After several years of small scale field tests (pilots), the method is now considered as mature and large scale projects are scheduled in a near future (in Canada for instance). Nevertheless, both technical and economical success of the process require a satisfactory development of the steam chamber, which can be achieved by well monitoring (i.e. steam trap control). This paper presents a general methodology based on numerical investigations to obtain and maintain an optimized development of the chamber throughout the production life of the wellpair. First, the methodology is explained on a synthetic case and applied to a real field case example. Field data are first history matched with the model and then the proposed approach is used to evaluate how the oil production could have been enhanced and optimized further. It is shown that an optimized steam chamber development is obtained by adjusting the steam injection rate to the potential of the reservoir (fluids and geology) and by monitoring the production rate during the process/operations to keep the steam chamber as large as possible but away enough from the production well to prevent any steam breakthrough. The results are in good agreement compared with Butler's analytical model (oil rate and steam chamber shape). A very good history match is obtained in the field case example. The proposed methodology shows that oil production rate can be doubled when injection/production rates are adapted to the SAGD reservoir potential.

A 63-year-old male patient was operated of a single conjunctival papillomatous lesion located on the left caruncle. The curative tumoral excision was followed by its histological analysis. Histologically, the tumor associated an epithelial squamous papilloma with a subepithelial nevus, confirming a combination of two different lesions.

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.

The present work was carried out to clarify the three-dimensional fine structure of extracellular matrix in the cornea, using ultrarapid-freezing and deep-etching methods for electron microscopy. Fresh and glutaraldehyde-fixed samples of human and rabbit posterior corneas were ultrarapidly-frozen onto a copper block cooled by liquid helium or liquid nitrogen, freeze-fractured, deeply etched for 8-10 min and rotary replicated with platinum-carbon. Replicas were examined in a transmission electron microscope equipped with a tilting device. Only structures with repeatedly observed, similar architectural profiles free from ice crystal damage, were taken into account. The very recognizable major collagen fibrils revealed 8-10 nm subfibrils running helically along the fibril long axis. The other extracellular matrix components consisted of: (1) 8-12 nm interfibrillar bridging filaments, frequently ornamented with globular domains, joining neighbouring collagen fibrils like steps of a ladder; (2) 10-20 nm filaments with relatively large globular domains, running on the surface of collagen fibrils along their long axes, and projecting finger-like structures into interfibrillar spaces sometimes attaching to adjacent collagen fibrils; (3) 10-15 nm beaded filaments with a periodicity of 75-110 nm, forming extended networks, especially at the interlamellar interfaces; and (4) 8-14 nm straight or sinuous strands consisting of 4-6 nm repeating subunits or modules, forming extended sheets by lateral association at the Descemet's membrane/stroma interface. In the light of the information available from studies on the localization of extracellular matrix components in the cornea, and by reference to the structural models of extracellular matrix molecules and macromolecular assemblies, we have related the deep-etched extracellular matrix structures described above to: (1) proteoglycans; (2) fibril-associated collagens with interrupted triple helices or FACIT collagens; (3) type VI collagen; and (4) fibronectin, respectively.

An 18-year-old female patient developed a mass in the superomedial angle of her left orbit. After evaluation, this tumor was surgically removed. A dysembryoplastic cyst lined with conjunctival epithelium was diagnosed by light microscopic examination. Clinical and pathological data are detailed. The characteristics of dysembryoplastic orbital cysts are reviewed.

to evaluate the efficacy and the safety of low dose intraocular tissue plasminogen activator (rt-PA) in the treatment of traumatic hyphema and postoperative fibrinous membrane.Six microg to 10 microg of rt-PA was injected into the anterior chamber to treat severe fibrinous postoperative membranes and total traumatic hyphemae.Thirteen eyes of 13 patients were treated. Four cases of traumatic hyphema and 9 cases of fibrinous membranes were included. Complete fibrinolysis within 24 hours was observed in 4 cases (30.8%). A partial success was noted in 7 eyes (53.8%). No beneficial effect was observed in two cases of traumatic hyphema associated with intravitreal hemorrhage after penetrating trauma. No side effect attributable to rt-PA occurred.Low dose intraocular rt-PA appears to be safe and effective in the treatment of postoperative fibrinous membrane and endocular hemorrhage limited to the anterior chamber.

Some new substituted pyrano[3,2-b]thioxanthen-6-ones and pyrano[2,3-c]thioxanthen-7-ones were prepared and their cytotoxic activity was evaluated using acronycine as the reference compound. The conformation of the molecules was also investigated in an effort to correlate this parameter with the biological activity. Copyright © 2001 Elsevier Science Ltd.

The synthesis and cytotoxic activity of some new 2,2-dimethyl-2H-anthra[2,3-b]pyran-6,11-diones is described. Certain compounds possess interesting activity against murine leukemia L-1210 cells. Relationships between the biological activity and the pyrano-ring conformations are discussed. Copyright © 2001 Elsevier Science Ltd.

Background: The intrastromal corneal ring (ISR) is a refractive device recently introduced for clinical application that is implanted in the mid-peripheral corneal stroma in order to correct myopia without invasion of the central optical zone. First clinical results of intracorneal ring segment implantation were published recently. These results reveal striking similarities to our own experimental data, only briefly published up to now. The aim of this study is to present the refractive and histopathological data of ISR implants in rabbits and to compare these results with the clinical data actually available. Methods: Expansion/constriction effects were evaluated with a ring of constant size (7.5×0.5×0.2 mm) in channels of 7.0, 7.5, or 8.0 mm in diameter, volume effects by implantation of 7.5-mm rings with varying thickness (0.2, 0.3, 0.4 mm) into a channel of 7.5 mm, respectively. Refractive power was measured preoperatively and at day (D) 7, D14, D30 for the first and the second experiment, plus D60, D90 for the second experiment. Histological evaluations of the induced morphological changes were additionally performed at all time intervals. Results: Significant (P

This study was conducted to determine whether indirect grid laser therapy is effective in reducing focal diabetic macular edema characterised by focal leaks and hard exsudates involving the para-foveal area (less than 300 microns from the center of the fovea). Since focal coagulation of microaneurysms in such a critical location can be deleterious, indirect grid pattern laser treatment may be used in such cases.

Basal cell carcinoma of the skin is the most common human cancer. It is also the most frequent malignant tumor of the eyelid. In Europe, its most common clinical presentation is a hard indurated, and sometimes ulcerated nodule. The authors report a giant palpebral basal cell carcinoma in a black non albinos Cameroonian patient. The ethnic origin, localization and macroscopic aspect are discussed. The problems connected with diagnosis and treatment of malignant tumors in Africa are noted.

Cavernous hemangioma is the most common primary vascular orbital tumor in adults. Generally the benign tumor arises within the muscle cone, revealed by proptosis with choroidal folds, and more rarely develops in other orbital localizations. We report the case of a 42-year-old female African patient who had a cavernous hemangioma in an unusual anterior localization. Clinically, a small superficial tumor was palpated in the right superior nasal orbital angle. After complete surgical excision, the histopathological study established the diagnosis of cavernous hemangioma

A 29-year-old female patient displayed a dense and hard left orbital mass, inferiorly, 3 years after she was treated through a neurosurgical approach for a left orbital varix. The lesion was hyperdense on CT-scan and was removed through a trans-conjunctival approach, with an excellent result. The histological diagnosis was a phlebolith.

To analyze the interest of protected drills to perform endoscopic endonasal DCR.[corrected] Fifty patients suffering from chronic epiphora were operated successively. None of those patients had had prior nasal surgery. The same surgeons (BF and ER) did the surgical procedure for all the cases. The technical steps were: endoscopic visualization of the middle meatus and evaluation of the anatomic variations of the nose; identification of the lacrymal bag with a 1 mm light in the canaliculus; unciformectomy; the maxillary bone was drilled with a 3.2 mm bit (straightshot Xomed), protected and irrigated; the lacrymal bag was opened by cissors and the flap was pushed in the ethmoid and coagulated.The suction-irrigation system was efficient to clean the surgical site, with a good endoscopic control. The protected bit didn't damage the 4-mm optics and the septal wall mucosa, even in narrow noses. The staightshot bit (Xomed) was tough enough to drill the maxillary bone in only 68 % of the surgical cases. In 28 % the drilling was unsatisfactory and in 4 % it was inefficient. The functional results at 6 month were good in 85 %. There was no difference between normal and narrow noses.The concept of protected bits perfectly matches the endoscopic endonasal DCR. The visual comfort and security of the surgical procedure are increased. Short term results are equivalent to external DCR, but are rather inefficient and expensive.

A 78-year-old-male-patient had his left eye affected by a 10 mm thick choroidal malignant melanoma. The size of the tumor did not allowed to keep the eye, and no conservative treatment was used for therapy. Enucleation was performed and histopathological study of the eye showed a mushroom-shaped and mixed-cell choroidal melanoma, devoid of transcleral extension, but harboring intrascleral infiltration. A period of 2 year-follow-up without metastasis was observed since the removal of the tumoral eye.

We report a case of xeroderma pigmentosum in a 9-year-old back Cameroonian boy. The diagnosis was based on typical clinical presentation of the disease: cutaneous atrophy, hypepigmented macules, and areas of depigmentation on sun exposed regions of the skin. Multiple tumoral lesions were localized on the head. Ocular findings were also present: conjunctival hyperemia, peripheral corneal opacification. Excision of the tumors and potoprotection was proposed for this patient. The role of tribal black African marriage traditions in disease transmission is discussed.

To investigate tissue changes induced by the implantation of expanded polytetrafluoroethylene (e-PTFE) used as encircling scleral buckling, an experimental and histopathological study was performed in rabbits. The eyes of 12 rabbits were implanted during 20-128 days with e-PTFE episcleral implants. Of these, 8 eyes were uncomplicated and enabled us to perform the histopathological study, 2 others were discarded for too short a time of implantation and, in 2 additional eyes, the episcleral implant was exposed with a wide conjunctival erosion. Surrounding the implant, a constant encapsulation was combined with numerous giant cells, forming a granuloma caused by irregularities of the implant outline. Its porous structure allowed a peripheral colonization by fibrovascular tissue. Scleral thinning and scleral invagination were the main scleral changes. No change of the conjunctiva made us suspect that a granuloma occurred before it was found histologically. The granulomatous changes did not seem to modify the apparently good experimental tolerance of the material after its implantation.