Purpose To determine in vivo corneal biomechanical properties in patients without refractive errors and patients with moderate‐high myopic and hyperopic spherical refractive errors. Methods A comparative study was carried out to measure Corneal Hysteresis (CH, mmHg) and Corneal Resistance Factor (CRF, mmHg) of 384 eyes of 201 patients classified in four groups. Moderate myopia (< 6 D, n=203), high myopia (> 6 D, n=43), moderate‐high hyperopia (> 2 D, n=62), and emetropic group (n=76). Corneal compensated intraocular pressure (IOPcc),and Goldman correlated intraocular pressure (IOPg) were also studied. Central corneal thickness (CCT, microns) was measured by ultrasonic pachymetry. Patients with ocular pathology or astigmatism greater than the spherical refractive error were not considered. A multiple‐comparison analysis was made to establish differences among the groups. Results Mean values were: CH= 10.59±1.52, CRF= 10.52±1.69 and CCT= 556.3 for the moderate myopia group, CH=10.04 ±1.55, CRF=10.23 ±1.82 and CCT=543.75 for the high myopia group, CH=11.16 ±1.88, CRF=10.69 ±2.07 and CCT=555.43 for the hyperopia group, CH=10.66 ±1.30 , CRF=10.48±1.14 and CCT=558.10 for the control group. Although these results of the biomechanical parameters showed higher values corresponding to the hyperopia group and lower to the myopia group, these differences were not statistically significant. Conclusion CH and CRF are greater in hyperopic patients in comparison with myopic and emetropic eyes. We do not find statistical significant differences between moderate myopia and high myopia. There are significant differences in CH between the high myopia and the hyperopia groups.
Purpose The iridocorneal endothelial (ICE) syndrome is a rare proliferative corneal endotheliopathy of unknown etiology. Common manifestations include corneal edema,iris stromal abnormalities, peripheral anterior synechiae and glaucoma, which does not usually respond to medical treatment. We want to know what is the most successful surgical practice for the control of intraocular presure (IOP) in these patients. Methods We presents a case of man of 27 years with ocular hypertension in the right eye (RE) difficult to control for 6 months. AV 8/10 in his RE. Iris atrophy with corectopia, uveal ectropion and peripheral anterior synechiae were observed in RE. Abnormalities of angle and endothelial disruption without corneal edema led to a diagnosis of ICE syndrome. We performed an Ahmed valve implant in that eye. Two months after surgery the IOP remains controlled with topical beta‐blocker. Results The ICE syndrome is usually unilateral disorder that can develop glaucoma resistant to medical treatment. There is a lack of consensus on the surgical technique of choice. It is described a higher survival rate of valve implants on trabeculectomy at 3 and 5 years as well as higher rates of failure than other glaucoma, due to endothelialization of the fistula. The use of Mitomycin would be indicated in these cases. Conclusion When is not possible to perform a classical filtering surgery due to angle morphological characteristics, the placement of a valve implant should be considered.
Purpose To determine the validity of the non mydriatic retinograph for the early diagnosis and follow‐up of diabetic retinopathy Methods 367 eyes of diabetic patients were examined using a non mydriatic retinograph. 45º and 30º pictures were taken of 9 fields, with and without pupilar dilation. Retina was examined in mydriasis with slit lamp biomicroscopy and conventional oftalmoscopy. Both methods were compared to determine their validity in the diagnosis and gradeing of diabetic retinopathy. Results For the early diagnosis of diabetic retinopathy there was obtained a sensibility of 88‐95 %, with a specificity of 96 %. 9,5 % of the photos were not valid. To obtain a good sensibility of the retinograph in establishing the grade of diabetic retinopathy, being comparable to the established one, the conventional exploration, it was necessary to realize photos in all the nine fields and with pupilar dilation. The sensibility of detecting edema was low Conclusion The non mydriatic retinograph is a useful a tool for the screening of diabetic retinopathy in the population. Nevertheless, to determine the correct grade of the pathology, in order to permit a good follow‐up of the retinopathy, the obtained sensibility was insufficient not being adequate to substitute the indirect oftalmoscopy and slit lamp biomicroscopy.
Purpose To report the use of photodynamic therapy without verteporfin as treatment for patients with focal retinal pigment epithelial leaks secondary to central serous chorioretinopathy (CSC). Methods Four symptomatic patients with CSC without clinical improvement in a period of time up to three months were included. Photodynamic therapy without verteporfin was applied without any other treatment. Results Neurosensory detachment and fluorescein leakage resolved in all patients within two months. Visual acuity improved in all of them and none lost vision or suffered any treatment‐related complications. Conclusion The treatment of CSC with photodynamic therapy without verteporfin may result in resolution of persistent neurosensory detathment and fluorescein leakage. Although this case series is limited in follow‐up and number of patients, the encouraging results, lack of complications and cheap procedure suggest that further investigation is warranted. Commercial interest
Purpose A descriptive, retrospective study about the surgical activity at the One‐day surgery Unit (ODSU) of the Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, during the years 1995 to 2007. Methods To review the surgical activity of the ODSU, the following variables were analyzed: sex, age, diagnosis, risk of anaesthesia and applied anaesthesia, surgical technique, intra‐ and postoperative complications, medication, morbidity, criteria of discharge from hospital, waiting list time as well as the grade of information given to the patient, comfort, sanitary attention, and grade of satisfaction. These data were obtained from a personal questionnaire and a phone call and were statistically analyzed by the StatView program. Results During the period of 1995 to 2007 13.585 surgical interventions were realized at the ODSU, among those 4.734 ophthalmologic surgeries (34, 8%). The average age of the patients was 56, 53 years. The 56 % were males. In the 22, 9% of the cases the employed anaesthesia was retrobulbar. The surgical techniques were: phacoemulsification and IOL 3550 (26, 1%), extracapsular cataract extraction 256 (1, 8%). In the 95% of the cases the patients were discharged from hospital, the remaining 5% is composed of non intervention, ocular hypertension, infection, retrobulbar haematoma and fever. The grade of general satisfaction was qualified as high (85%), with the acceptance to return to the ODSU in the 76% of the cases Conclusion The ODSU offers a safe, fast and comfortable alternative to classic hospitalisation.
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