Ahmed valve, suture-less implantation: A new approach to an easier technique.

Purpose Tissue adhesives have been used in ophthalmology instead of sutures to minimize the operating time. This case series investigated the effectiveness and safety of use of cyanoacrylate in Ahmed valve implantation through pars plana for refractory glaucoma. Patients and methods Seventeen eyes of 17 patients with refractory glaucoma underwent Ahmed valve scleral suture-less implantation through pars plana with a cyanoacrylate suture of the plate. Refractory glaucoma was defined as intraocular pressure (IOP) ≥ 21 mm Hg with antiglaucoma eye drops, good adherence to treatment, and no previous glaucoma surgery. IOP control and development of complications were evaluated during the follow-u…

Tratamiento Focal Macular guiado por el mapa de grosor retiniano del HD-OCT Cirrus® versus Angiografía Fluoresceínica en las Oclusiones Venosas de la Retina

Macular laser photocoagulation guided by spectral-domain optical coherence tomography versus fluorescein angiography for diabetic macular edema.

Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Rosa Dolz-Marco1, J Fernando Arevalo3, Salvador García-Delpech1, J Luis Mullor4, Manuel Díaz-Llopis1,2,51Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Retina and Vitreous Service, Clinical Ophthalmology Center, Caracas, Venezuela; 4Unit of Experimental Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 5University of Valencia, Faculty of Medicine, Valencia, SpainBackground: The aim of this study was to compare the efficacy of spectral-domain optical coherence tomography…

Imaging Quality of Bifocal Piggyback Intraocular Lens versus ReSTOR and TECNIS Multifocal Lenses

Purpose The imaging quality provided by a piggyback integrated by a monofocal intraocular lens (IOL) + a bifocal IOL of zero power and +3.75 diopters of addition is compared with the optics quality of a simple multifocal IOL of the same power and addition. Methods The imaging quality was evaluated by determining the modulation transfer function (MTF), using an artificial eye simulating in vivo conditions of the anterior chamber, including an artificial cornea and a wet cell containing physiologic solution where the IOL was positioned. The MTFs of the bifocal piggyback for near and distance vision were measured, with pupil diameters of 3 and 5 mm, and compared with the MTFs of an equivalent …

Kyrieleis´ vasculitis in acute retinal necrosis

Ester Francés-Muñoz1, Roberto Gallego-Pinazo1, Ruth López-Lizcano1, Salvador García-Delpech1, J Luis Mullor3, Manuel Díaz-Llopis1,21Department of Ophthalmology, Hospital La Fe, Valencia, Spain; 2University of Valencia, Valencia, Spain; 3Unit of Experimental Ophthalmology. Fundación para la Investigación del Hospital Universitario La Fe. Valencia, Valencia, SpainAbstract: We report the first case in the literature of Kyrieleis´ vasculitis related to acute retinal necrosis by Varicella zoster virus in a 76-year-old woman with bilateral involvement. In our patient the arterial lesions appeared 15 days after …

Prophylaxis of Pseudophakic Cystoid Macular Edema with Intraoperative Pegaptanib

The purpose of this study was to determine the efficacy of an intraoperative intravitreal pegaptanib injection during phacoemulsification in preventing the development of pseudophakic cystoid macular edema (CME) following cataract surgery.This prospective, controlled pilot study was carried out at the Department of Ophthalmology, Nuevo Hospital Universitario y Politécnico La Fe, Valencia (Spain). Five hundred patients with cataract and healthy retina were included in the study. Patients were assigned in a 1:1 ratio to receive an intraoperative intravitreal pegaptanib injection (n=250) or not (control group, n=250) associated with standardized phacoemulsification surgery and postoperative tr…

Q fever: a new ocular manifestation

P Udaondo1,3, S Garcia-Delpech1,2, D Salom1,2, M Garcia-Pous1, M Diaz-Llopis1,21Department of Ophthalmology, Nuevo Hospital Universitario y Politecnico La Fe, Valencia, Spain; 2Faculty of Medicine, Universitat de València, Valencia, Spain; 3Universidad Cardenal Herrera CEU, Valencia, SpainAbstract: Q Fever is a zoonosis caused by Coxiella burnetii. Ocular manifestations are rare in this infection. We describe the case of a man complaining of an intense retro-orbital headache, fever, arthralgia, and bilateral loss of vision, who showed an anterior uveitis accompanied by exudative bilateral inferior retinal detachment and optic disk edema. At the beginning, a Vogt–Koyanag…

Evaluation of the improvement of sensibility with the new IOL Master software version 5.4.3

Purpose To evaluate the improvement of sensibility of the new IOL-Master version 5.4.3 compared with the version 4.08. Methods 214 eyes of 115 patients were examined in a cataract preoperative evaluation making use of both IOL-Master software versions 5.4.3 and 4.08. The type and severity of the lens opacification was assessed by slitlamp biomicroscopy. Results In 182 of the eyes examined both versions were capable to determine the AL; in 29 the version 4.01 could not determine AL whereas the version 5.4.3 was able to measure it; these cases showed posterior capsular cataract (16), dense nuclear cataract (11), posterior synechiae (1) and asteroid hyalosis (1). Finally, the AL of 3 eyes coul…

Fulminant bilateral Haemophilus influenzae keratitis in a patient with hypovitaminosis A treated with contaminated autologous serum

We report on a patient with hypovitaminosis A treated with autologous serum (AS) who had bilateral infectious ulcers positive for Haemophilus influenzae. The patient suffered a perforation of his right eye and total healing of his left eye with a residual leukoma. In cases of severe malnutrition, serum levels of vitamins and bacteriostatic and growth factors are reduced, so AS would not only be ineffective but also increase the risk of secondary corneal infection. The prophylactic use of a topical antibiotic would be useful in treatment with AS, especially in patients who do not use and adequately store the eye drops, as in our patient.

Lentes de contacto y cálculo de lente intraocular: sorpresa refractiva usando el método biométrico de no contacto IOLMaster

Early lipoic acid intake protects retina of diabetic mice

The aim of this study was to test the effect of lipoic acid treatment on the retina after a short diabetic insult. Diabetes was induced by alloxan and mice were divided into sub-groups; control, diabetic, diabetic+insulin and all groups received+/-lipoic acid (100 mg/kg body weight) for 3 weeks. GSH content, MDA concentration, GPx activity were measured and electroretinograms (ERG) were recorded. Early administration of lipoic acid to diabetic mice prevented the statistically significant decreases of GSH content and GPx activity and normalized MDA concentration. Moreover, lipoic acid restored electroretinogram b-wave amplitude of diabetic animals to control values. Lipoic acid has a protect…

Aqueous Humor Levels of Vascular Endothelial Growth Factor in Retinitis Pigmentosa

PURPOSE To determine the level of vascular endothelial growth factor A (VEGF-A) in aqueous humors of patients with retinitis pigmentosa (RP). METHODS A prospective, comparative control study. Aqueous humor was collected from 16 eyes of 16 patients with RP. The level of VEGF-A was determined with a commercially available enzyme-linked immunosorbent assay kit. The control group comprised 16 aqueous samples from 16 patients about to undergo cataract surgery and without any other ocular or systemic diseases. RESULTS The concentration of VEGF-A in aqueous humor was markedly lower in patients with RP than in control subjects (Mann-Whitney U test, P < 0.001). The level of VEGF-A was 94.9 +/- 99.8 …

Diffractive corneal inlay for presbyopia

[EN] A conceptually new type of corneal inlays for a customized treatment of presbyopia is presented. The diffractive inlay consists on a small aperture disc having an array of micro-holes distributed inside the open zones of a Fresnel zone plate. In this way, the central hole of the disc lets pass the zero order diffraction and produces an extension of the depth of far focus of the eye, while the diffracted light through the holes in the periphery produce the near focus. Additionally, the micro-holes in the inlay surface fulfill the essential requirement of allowing the flow of nutrients through it to the cells of the corneal stroma. Theoretical and optical-bench experimental results for t…

Management of macular edema due to branch retinal vein occlusion with intravitreal injections of pegaptanib sodium

Purpose To evaluate the efficacy of Pegaptanib Sodium as single therapy for macular edema due to non-ischemic branch retinal vein occlusion. Methods In this uncontrolled prospective pilot study 17 patients have been included with non-ischemic branch retinal vein occlusion. All of them showed macular edema in the OCT with central foveal thickness higher than 350 microns (mean, 541 +/- 140) and decrease in visual acuity lower than 0,5 Snellen ETDRS charts notation (mean, 0,16+/-0,14). After an initial injection of Pegaptanib Sodium evaluations were programmed every 5 weeks and further retreatments were developed in cases with macular thickness higher than 300 microns. No other therapies were …

Efficacy and safety of the pars plana clip in the Ahmed valve device inserted via the pars plana in patients with refractory glaucoma

Manuel Diaz-Llopis1,2,3, David Salom1,3, Salvador Garc&amp;iacute;a-Delpech1,2,3, Patricia Udaondo1,3, Jose Maria Millan3,5, J Fernando Arevalo61Department of Ophthalmology, La Fe University Hospital of Valencia, Valencia, Spain; 2Department of Ophthalmology of the Valencia University, Valencia, Spain; 3Biomedical Network Research Centre on Rare Diseases (CIBERER), Valencia, Spain; 4Catholic University San Vicente Martir, Valencia, Spain; 5Department of Genetics, La Fe University Hospital of Valencia, Valencia, Spain; 6Clinica Oftalmologica Centro Caracas, Retina and VItreous Service, Caracas, DC, VenezuelaPurpose: To evaluate the efficacy and safety of the pars plana clip (PPC) in the Ahme…

Bleeding Follicular Conjunctivitis due to Influenza H1N1 Virus

Influenza H1N1 or A virus is a new virus serotype capable of human-to-human transmission. This infection causes a flu syndrome similar to that of seasonal influenza, with only one case of conjunctivitis described and no clinical details or microbiological confirmation. Its diagnosis is performed by PCR of pharyngeal smear of the patients affected. We report the first well-documented case in the medical literature of conjunctivitis by H1N1 virus.

Chronic alcohol feeding induces biochemical, histological, and functional alterations in rat retina.

Aims: Ethanol consumption originates a wide spectrum of disorders, including alteration of visual function. Oxidative stress is included among the mechanisms by which alcohol predisposes nervous tissue to injury. Retina, which is the neurosensorial eye tissue, is particularly sensitive to oxidative stress. Methods: In this study we analyze the effect of long-term alcohol consumption on oxidative stress parameters of the rat retina, and its correlation to retinal function, as well as to the expression of the antiapoptotic protein Bcl-2. We also study the protective effect of ebselen, a synthetic selenoorganic antioxidant. Results: Herein we show that ethanol has a toxic effect on rat retina …

Q fever: a new ocular manifestation

P Udaondo1,3, S Garcia-Delpech1,2, D Salom1,2, M Garcia-Pous1, M Diaz-Llopis1,21Department of Ophthalmology, Nuevo Hospital Universitario y Politecnico La Fe, Valencia, Spain; 2Faculty of Medicine, Universitat de Val&amp;egrave;ncia, Valencia, Spain; 3Universidad Cardenal Herrera CEU, Valencia, SpainAbstract: Q Fever is a zoonosis caused by Coxiella burnetii. Ocular manifestations are rare in this infection. We describe the case of a man complaining of an intense retro-orbital headache, fever, arthralgia, and bilateral loss of vision, who showed an anterior uveitis accompanied by exudative bilateral inferior retinal detachment and optic disk edema. At the beginning, a Vogt&amp;ndash;Koyanag…

A new trifocal corneal inlay for presbyopia

[EN] Corneal inlays (CIs) are the most recent surgical procedure for the treatment of presbyopia in patients who want complete independence from the use of glasses or contact lenses. Although refractive surgery in presbyopic patients is mostly performed in combination with cataract surgery, when the implantation of an intraocular lens is not necessary, the option of CIs has the advantage of being minimally invasive. Current designs of CIs are, either: small aperture devices, or refractive devices, however, both methods do not have good performance simultaneously at intermediate and near distances in eyes that are unable to accommodate. In the present study, we propose the first design of a …

Intravitreal pegaptanib sodium for refractory pseudophakic macular oedema.

Evaluate the efficacy of intravitreal pegaptanib sodium (Macugen®) in refractory pseudophakic cystoid macular oedema (CME). Prospective, nonrandomized, interventional case series. Four eyes of four patients with refractory pseudophakic CME to pars plana vitrectomy and intravitreal bevacizumab and triamcinolone, were treated with pegaptanib sodium, with a mean follow up of 4 months. Pre- and postinfection examinations included assessment of best-corrected visual acuity (BCVA) using the Early Treatment Diabetic Retinopathy Study chart (ETDRS), fluorescein angiography (FA), and optical coherence tomography (OCT). Visual acuity increased in all patients after intravitreal pegaptanib sodium. OCT…

Intravitreal pegaptanib for refractory macular edema secondary to retinal vein occlusion

Patricia Udaondo1,2, Salvador Garcia-Delpech1,3, David Salom1,3, Maria Garcia-Pous1,3, Manuel Diaz-Llopis1,31Nuevo Hospital Universitario y Politecnico La Fe, Valencia, Spain; 2University Cardenal Herrera CEU, Valencia, Spain; 3Faculty of Medicine, University of Valencia, Valencia, SpainPurpose: To assess the efficacy of intravitreal Pegaptanib sodium (Macugen&amp;reg;) injection in the management of refractory macular edema secondary to branch retinal vein occlusion.Methods: This is a prospective, nonrandomized, interventional case series. Five eyes of five patients with macular edema refractory to either bevacizumab or triamcinolone were treated with intravitreal injection of Pegaptanib s…

Acute endothelial failure after cosmetic iris implants (NewIris&amp;reg;)

Maria Garcia-Pous1, Patricia Udaondo2, Salvador Garcia-Delpech2, David Salom1, Manuel D&amp;iacute;az-Llopis21Faculty of Medicine, University of Valencia, Valencia, Spain; 2Ophthalmology Department, Hospital Universitario La Fe, Valencia, SpainAbstract: We report a case of an acute endothelial failure after the implantation of a new cosmetic, colored, artificial iris diaphragm implant called NewIris&amp;reg;. A 21-year-old woman came to us complaining of progressive loss of vision and pain after NewIris lenses had been implanted. Decreased visual acuity, corneal edema, and increased intraocular pressure in both eyes appeared only 3 weeks after the surgery. The lenses were removed as soon as…

Clinical magnification and residual refraction after implantation of a double intraocular lens system in patients with macular degeneration

Purpose To evaluate the efficacy of a standard double intraocular lens (IOL) system (IOL-Vip) in patients with low vision and central scotoma due to macular degeneration and assess the predictability of the residual refraction and magnification. Setting Ophthalmology Department, Hospital General Universitario, Valencia, Spain. Methods This interventional prospective noncomparative case series comprised 13 consecutive surgical procedures in 10 patients with central scotoma. Follow-up was 12 months. Evaluation included the difference between preoperative and postoperative best corrected visual acuity (BCVA), refraction, position of the IOLs, endothelial cell density, and occurrence of postope…

Acute endothelial failure after cosmetic iris implants (NewIris®)

We report a case of an acute endothelial failure after the implantation of a new cosmetic, colored, artificial iris diaphragm implant called NewIris(®). A 21-year-old woman came to us complaining of progressive loss of vision and pain after NewIris lenses had been implanted. Decreased visual acuity, corneal edema, and increased intraocular pressure in both eyes appeared only 3 weeks after the surgery. The lenses were removed as soon as possible but had already severely affected the endothelial cell count. NewIris implants are an alternative to cosmetic contact lenses, but they are not as safe as other phakic anterior chamber intraocular lenses, nor are they a good option for the patient.

Levels of thrombopoietin in aqueous humor of patients with noninfectious acute anterior uveitis

Jos&amp;eacute;-Juan Mondejar,1,4 David Salom,1,3 Salvador Garcia-Delpech,1,2 Manuel Diaz-Llopis11Ophthalmology Department, School of Medicine, University of Valencia, 2Ophthalmology Department, Hospital Universitario La Fe, 3Ophthalmology Department, Hospital de Manises, Valencia, 4Ophthalmology Department, Hospital General Universitario de Alicante, Alicante,&amp;nbsp;SpainPurpose: To measure thrombopoietin (TPO) levels in the serum and aqueous humors of patients with noninfectious acute anterior uveitis.Methods: A prospective, comparative, controlled study. Serum and aqueous humors were obtained from the eyes of 16 patients with noninfectious acute anterior uveitis. TPO levels were measu…

Intravitreal Plasmin Without Associated Vitrectomy as a Treatment for Refractory Diabetic Macular Edema

To determine the effectiveness of a low-dose intravitreal injection of autologous plasmin enzyme (APE), without the performance of a vitrectomy, as a treatment for refractory diffuse diabetic macular edema (DDME).Prospective, comparative, interventional case series.Sixteen patients with bilateral DDME who had not responded to prior laser photocoagulation. All patients received an injection in 1 eye, while the other eye served as a control.Intravitreal 0.2 mL APE injection under topical anesthesia. The APE was obtained using a simplified method.Central macular thickness (CMT) at 1 and 6 months, determined by optical coherence tomography (OCT) and best corrected visual acuity (BCVA).All patie…

Fractal-structured multifocal intraocular lens

[EN] In this work, we present a new concept of IOL design inspired by the demonstrated properties of reduced chromatic aberration and extended depth of focus of Fractal zone plates. A detailed description of a proof of concept IOL is provided. The result was numerically characterized, and fabricated by lathe turning. The prototype was tested in vitro using dedicated optical system and software. The theoretical Point Spread Function along the optical axis, computed for several wavelengths, showed that for each wavelength, the IOL produces two main foci surrounded by numerous secondary foci that partially overlap each other for different wavelengths. The result is that both, the near focus an…

Prophylaxis of Macular Edema with Intravitreal Ranibizumab in Patients with Diabetic Retinopathy after Cataract Surgery: A Pilot Study

The purpose of this study was to evaluate the effectiveness of intravitreal ranibizumab (Lucentis, Genentech, South San Francisco, Calif, USA) combined with cataract surgery for the prevention of clinically significant macular edema (CSME) in patients with diabetic retinopathy (DR). This prospective interventional case series included fifty-four eyes of 54 patients with a previous diagnosis of nonproliferative diabetic retinopathy (NPDR) without macular edema preoperatively. Subjects were assigned in a 1 : 1 ratio to receive an intraoperative intravitreal ranibizumab injection (n=27) or not (control group,n=27) associated with standardised phacoemulsification surgery. The main outcome measu…