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Bariatric surgery is booming in France and there is increasing interest in developing new surgical techniques. It is essential to manage such surgery in a multidisciplinary fashion: rigorous coordination is required along with adaptability to the local care available. Organization into centers of excellence is encouraged, and good communication between the hospital medicosurgical team and the private practitioners are highly recommended. Multidisciplinary meetings for therapeutic decisions are invaluable because they allow the direct exchange of information between the hospital staff and private practitioners. The selection of one member of the hospital team as liaison for each patient can facilitate the organization of postsurgical follow up Long-term follow-up of these patients is mandatory but often very difficult to maintain beyond one year. Organized coordination between hospital and private practitioners should improve this follow-up.

Fetal mortality and morbidity remain dramatically increased in diabetic women. To evaluate the benefit of a preconceptional education combined with a good metabolic control, we compared the outcome of pregnancy in 2 groups of type I diabetic women: group A (n = 21) planned before conception versus group B (n = 40) not planned. Both groups were similar related to the type and duration of diabetes, its complications, age, body mass index and different factors of risk. In group A, HbA1C levels wereor = 3 SD of the normal mean of non diabetic values before conception and during the pregnancy course andor = 3 SD in group B. We observed a significant reduction (p0.05) of the main adverse events regarding fetus outcome (fetal, perinatal and neonatal mortality, malformations) and obstetrical complications in the planned group. These data lead to the need of an extensive policy of early planification of pregnancy in diabetic women.

This study presents the first clinical and functional results on the implantation of a new multifocal IOL model, the Domilens type PROGRESS 1. A group of 20 patients underwent extracapsular extraction of cataract with continuous circular capsulorhexis and IOL implantation in the capsular bag. In 65% of the cases, final visual acuity from a far distance proved to be greater than or equal to 8/10 without correction, while visual acuity from a short distance was J2 without the need of additional lenses. BAT identified a decrease in visual acuity of 0.01 Snellen lines at a medium lighting level and 0.05 at the maximum level. The perimetric results obtained with the C 30-2 threshold programme of the Humphrey field analyzer showed a foveal sensitivity threshold of 32.5 dB +/- 9.25 dB and a mean defect of -2.22 dB +/- 2.90 dB. The Vistech VCTS 6500 underlined a decrease in the sensitivity to space frequency contrast of 6.0 c/d versus a control group of patients with monofocal IOL (P0.05). This reduction involved a wider range of space frequencies (3.0, 6.0, 12.0 c/d) in comparison with a group of phakic subjects (P0.05). With the on-off PEV patterns, a slight decrease in contrast sensitivity threshold was found versus patients with monofocal IOL statistically non significant (P0.05). At a medium space frequency of 2.33 c/d, a decrease in contrast sensitivity versus phakic subjects (P0.05) was observed. Depth of focus went from infinite to 19 cm. from the eye.