[Crystalline keratopathy due to kappa chains in a monoclonal gammopathy]. / Queratopatía cristalina por cadenas kappa en gammapatía monoclonal.

CASE REPORT: The following case shows corneal crystal formation in a patient in whom thee systemic work-up led to the diagnosis of a monoclonal gammopathy with increased monoclonal immunoglobulin G (IgG). We present the corneal signs and subsequent haematological investigations undertaken to establish this important association. DISCUSSION: Systemic work-up of a patient with corneal deposits showed a monoclonal gammopathy with increased monoclonal immunoglobulin (IgG-type kappa). Corneal crystals, a rare, but significant, clinical finding, may be the initial presentation in a patient with monoclonal gammopathy.

[Pediatric surgery 2.0]. / Cirugía pediátrica 2.0.

New tools from the web are a complete breakthrough in management of information. The aim of this paper is to present different resources in a friendly way, with apps and examples in the different phases of the knowledge management for the paediatric surgeon: search, filter, reception, classification, sharing, collaborative work and publication. We are assisting to a real revolution on how to manage knowledge and information. The main charateristics are: immediateness, social component, growing interaction, and easiness. Every physician has clinical questions and the Internet gives us more and more resources to make searchs easier. Along with them we need electronic resources to filter information of quality and to make easier transfer of knowledge to clinical practice. Cloud computing is on continuous development and makes possible sharing information with differents users and computers. The main feature of the apps from the Intenet is the social component, that makes possible interaction, sharing and collaborative work.

[Evidence based ophthalmology: critical appraisal skills on clinical trials on treatments]. / Oftalmología basada en evidencias: evaluación crítica de los ensayos clínicos sobre tratamiento.

PURPOSE: To analyse and provide the tools to answer three questions that must be asked about a clinical trial on treatments: evaluation of validity (internal validity, so that results are not biased); clinical importance of these results and their application to individual patients. We provide simple statistics tools, clinical trial design, and clinical epidemiology for the evaluation and analysis of clinical trials on treatments. METHODS: Review of the medical literature. RESULTS: For the evaluation of papers on treatment and for using a treatment efficiently, we need to know if the clinical trials that support it are trustworthy, if the treatment has clinical importance and if it can be applied to my patients. CONCLUSIONS: It is of paramount importance to check that the sample of the clinical assay has been correctly randomized, because randomization is necessary to comply with mathematical laws of application of statistical tests. Follow-up of patients must be complete in order to measure precision of results and evaluate the efficacy of treatment.

[Intraocular lens power calculation after corneal photorefractive surgery. Literature review]. / El cálculo de la lente intraocular tras cirugía foto-refractiva corneal. Revisión de la literatura.

OBJECTIVE: Revision of methods for estimating corneal power (Kpost) and effective lens position (ELP) for cataract surgery after corneal refractive surgery. METHODS: Review of medical literature. RESULTS: To calculate the intraocular lens that achieves emetropia after corneal refractive surgery it is necessary to correct the Kpost and to estimate the effective lens position again correcting it. There are different formulae depending on the available information. Ideally, we need pre (Kpre) and post-treatment keratometry record (Kpost) and pre (Rpre) and post (Rpost) refraction. In this way, we can use the Aramberri's double-K method in the formula for calculating intraocular lens power. CONCLUSIONS: Previously to keratorefractive procedure is advisable to have pre-treatment refraction and keratometry (K and method) registered: Kpre value is critical to calculate the ELP.

[Upper eyelid surgery for treatment of congenital blepharoptosis]. / Cirugía del párpado superior para el tratamiento de las ptosis congénitas.

OBJECTIVE: [corrected] To revise techniques and indications for surgical treatment of childhood blepharoptosis. METHODS: Review of the medical literature and case reports. RESULTS: The treatment of blepharoptosis is not easy. There are different techniques for its correction, depending on invasivity and aetiological approach. Most used techniques are resection of the levator muscle through a skin incision in moderate ptosis and frontal suspension for severe cases. The indication of each technique depends on the type of ptosis, severity, features of levator muscle and age. CONCLUSIONS: Simple congenital ptosis is the most frequent type of ptosis in children although is necessary to consider types associated to rectus superior palsy, blepharofimosis syndrome and Marcus-Gunn phenomenon. It is important to evaluate ptosis severity and its repercussions on visual acuity and compensating torticolli. The timing for surgical treatment varies depending on age, severity and laterality.