Background. Persistent infection with high-risk human papillomavirus (HR-HPV) has been demonstrated to be the necessary causal factor for developing cervical cancer. To know the most prevalent HR-HPV in different geographical areas is important to design diagnostic tests and implementation of vaccines. Objectives. The goal of this study is to evaluate the prevalence of HR-HPV in a total of 1001 patients, 198 with normal cytology results, 498 with low-grade squamous intraepithelial lesion (LSIL), and 205 with high-grade squamous intraepithelial lesion (HSIL) who attended our gynaecology department for opportunistic screening of HPV infection. Study design. Cervical samples were taken in a PreservCyt vial (Cytyc Corporation, Boxborough, MA). Hybrid capture assay was carried out following the manufacturer's instructions (Digene Corp., Gaithersburg, MD). All samples were further studied with polymerase chain reaction (PCR) (Linear Array HPV Genotyping Test, Roche Diagnostics, Mannheim, Germany). Results. Genotype 16 was the most prevalent HR-HPV in the three groups, 17.8% in the patients with normal cytology results, 22.3% in the LSIL group, and 60% in the HSIL group. Genotype 18 had a very low prevalence in all groups. Other HR-HPV genotypes such as genotype 31, genotype 58 and genotype 52 were found in significant numbers in HSIL patients. Discussion. Our data show that genotypes 16, 31, 58, and 52 are the most prevalent HR-HPV in cervical samples with severe intraepithelial lesion in Spain. There may be some geographical variation in prevalence of carcinogenic types, and it must be considered for designing diagnostic tests and vaccine.

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Glaucoma drainage devices may be indicated in glaucoma associated to complex congenital anomalies or dysgenesis of the anterior segment, secondary glaucomas such as those developed after congenital cataract surgery, severe primary congenital glaucoma after failed angle surgery and in eyes with severe conjunctival scarring. They can be combined with several other procedures, such as cataract extraction, intraocular lens implantation, keratoplasty or pars plana vitrectomy. This procedure may achieve a sustained and prolonged intraocular pressure reduction in children, with early post-operative success as high as 90 %, although it decreases over time, to 40-60 % survival at 4-6 years using the Kaplan-Meier analysis and most children need to reinitiate glaucoma treatment postoperatively. We must bear in mind that complications may occur, especially tube malposition and exposure, and multiple repeated surgeries may be necessary.The advantages and complications should be weighed in each individual case. KeywordsAhmed valve, complications, glaucoma drainage device (GDD), glaucoma, paediatric, surgery should be considered and caution should be taken when selecting the most adequate one, which may be a GDD or some other procedure. IndicationsGDD may be indicated in glaucoma associated to complex congenital anomalies or dysgenesis of the anterior segment, such as Peter's syndrome or aniridia and secondary glaucomas such as those developed after congenital cataract surgery or in Sturge-Weber syndrome. 3Regarding primary congenital glaucoma, although goniotomy and trabeculotomy are undoubtedly the treatments of choice, in severe cases GDD may also be considered, as the prognosis following surgery is closely related to the severity of the glaucoma. Al-Hazmi et al. 28 have shown how severe primary congenital glaucoma had worse results than moderate or mild cases, regardless of the surgical procedure performed, with trabeculotomy achieving a success rate of only 10 % after one year in severe cases, versus 40 and 90 % in moderate and mild cases, respectively.Severe conjunctival scarring is a clear indication for GDD surgery.3