[Refractive state in patients with phacoemulsification of cataract in uncommon situations]. / Estado refractivo en pacientes sometidos a facoemulsificación de catarata con situaciones especiales.

BACKGROUND: We undertook this study to determine the refractive state in patients who underwent non-complicated phacoemulsification under unusual situations. METHODS: This was a clinical, open, transversal, prospective and comparative study. Patients had the following conditions: congenital cataracts, hyperopia, myopia, and emetropia with previous corneal transplantation or vitreous cavity filled with silicone oil. RESULTS: Thirty-six eyes were included in our study vs. control group (52 emetropic eyes). There was no statistical significance in spherical equivalent 6 weeks postoperatively, with 59% of patients within +1.00 D, 73% +2.00 D and 28% > +2.00 D. CONCLUSIONS: Refractive state was favorable with an average of 0.96 D +/- 6.27.

Estado refractivo en pacientes sometidos a facoemulsificación de catarata con situaciones especiales / Refractive state in patients with phacoemulsification of cataract in uncommon situations

BACKGROUND: We undertook this study to determine the refractive state in patients who underwent non-complicated phacoemulsification under unusual situations. METHODS: This was a clinical, open, transversal, prospective and comparative study. Patients had the following conditions: congenital cataracts, hyperopia, myopia, and emetropia with previous corneal transplantation or vitreous cavity filled with silicone oil. RESULTS: Thirty-six eyes were included in our study vs. control group (52 emetropic eyes). There was no statistical significance in spherical equivalent 6 weeks postoperatively, with 59% of patients within +1.00 D, 73% +2.00 D and 28% > +2.00 D. CONCLUSIONS: Refractive state was favorable with an average of 0.96 D +/- 6.27.

[Strabismus-associated Parinaud syndrome]. / Síndrome de Parinaud asociado a otros estrabismos.

OBJECTIVE: We undertook this study to describe the causes of Parinaud syndrome (PS) with diplopia to determine a topographic diagnosis and prognosis. METHODS: We studied patients with PS from January 1980 to January 2004 and reviewed causes and treatment. We identified all strabismus associated with PS. RESULTS: We included 18 patients with diplopia, 6 females and 12 males. Median age was 28 years old, SD 22 (10; CI 95%). Results are strabismus related: III nerve palsy in 15 patients (79%), optical nerve damage in 8 (44.4%), VII nerve palsy in 3, IV nerve palsy 2, bilateral III nerve palsy 2, nystagmus 2, Foville syndrome 2, one-and-a-half syndrome (1). The following causes were reported: tumors (6), brain stroke (4), cranial trauma (3), neurocysticercosis (2). Orthoposition under botulinum toxin treatment was obtained in 1.72 +/- 1.1 (0.65 CI 95%). Surgery was done in nine patients, and only one patient had spontaneous resolution of diplopia and PS. CONCLUSIONS: It is important to identify the topographic diagnosis and prognosis of brain diseases such as the complete study of strabismus-related PS. In this way we can learn more about the extent of damage and can identify recurrences quickly in order to offer better control.

[Evolution of threshold retinopathy of prematurity after argon laser treatment under indirect ophthalmoscopy]. / Evolución de los pacientes con retinopatía de prematuro en estadio umbral tratados con láser de argón mediante oftalmoscopia indirecta.

BACKGROUND: We undertook this study to evaluate the long-term effects of threshold retinopathy of prematurity (ROP) treatment using Argon laser under indirect ophthalmoscopy, as well as to analyze ocular diseases in those patients. METHODS: This is a descriptive, observational, longitudinal and prospective study carried out from March 1991 to February 2005, including patients with threshold retinopathy of prematurity for treatment using Argon laser under indirect ophthalmoscopy. Related ocular diseases were also reported. Descriptive statistics were applied. RESULTS: Follow-up was maintained for 14 years, 6.50 +/- 1.39 (CI 95%, p < 0.05), and 170 patients were studied. Weight was 1216.50 +/- 152.03 g (CI 95%, p < 0.05). Retinopathy was not present in 42% (72), in stage I-III, 46% (78), and threshold stage, 12% (20). Forty eyes were treated with Argon laser. After treatment, no progressive disease was found in 92.75%. We found high myopia in 20%, macular displacement 7.5%, strabismus 35%, retinal detachment (5%), optical nerve atrophy 5%, and ocular atrophy 5%. CONCLUSIONS: We were able to demonstrate that Argon laser treatment under indirect ophthalmoscopy has been effective in the control of threshold disease. The most important related ocular diseases were strabismus and myopia. Long-term monitoring has permitted us to initiate timely treatment for ocular diseases related to prematurity.

[Prevalence of premature retinopathy. 12-year detection in hospital "20 de Noviembre"]. / Prevalencia de retinopatía del prematuro. 12 años de detección en el Centro Médico 20 de Noviembre.

BACKGROUND: We undertook this study to determine the prevalence of premature retinopathy in a third level care hospital. METHODS: We carried out a descriptive, observational, longitudinal and prospective study from March 1991 to February 2004, including newborns with low birthweight of <1500 g and <35 weeks of gestation, evaluating the peripheral retina under pharmacological midryasis weekly during 4 weeks starting the 4th week of extrauterine life. The ROP international classification was used. RESULTS: Within our 12-year study, 2558 children were born, 62% were full term and 38% were premature. From 735 live premature births, 170 fulfilled inclusion criteria: 42% (72) did not present changes regarding retinopathy with a prevalence of 9.79, 46% (78) were in stages I-III with a prevalence of 10.61, and 12% (20) were in umbral stage with a prevalence of 2.72%. CONCLUSIONS: The prevalence of premature retinopathy in a third level hospital was 10.61% in stages I-III and 2.72% in umbral stage. This has allowed the evaluation of the peripheral retinal and the ability to plan treatment in the umbral stage to prevent future complications of blindness from disease progression in these cases.

Síndrome de Parinaud asociado a otros estrabismos / Parinaud syndrome associated with other strabismus

Objetivo: Describir los estrabismo asociados al Síndrome de Parinaud (SP). Métodos: Se estudiaron pacientes con SP de 1998 a 2004 asociados a otros estrabismos. Resultados: Total 18 pacientes, 6 mujeres y 12 hombres. Edad: 28 años DE 22 (10; 1C 95 por ciento). Lesión al III nervio craneal en 15 pacientes (79 por ciento), II nervio: 8 pacientes (44.4 por ciento), VII nervio: 3 pacientes, hemiparesia: 3, lesión a IV nervio 2, parálisis bilateral de III nervio 2, nistagmus 2, Síndrome de foville 2, y síndrome de uno y medio 1 paciente. Causas: Accidente vascular cerebral 4, uno de ellos asociado a infarto agudo de miocardio, traumatismo cráneo-encefálico 3, tumor cerebral 6, neurocisticercosis 2. Se obtuvo ortoposición con toxina botulínica en 1.72 +/- 1.1 (0.65 IC 95) y cirugía en 9, mejoría espontánea 1. Conclusiones: Identificar el diagnóstico topográfico y pronóstico de la lesión cerebral asociada a SP es muy importante en el control y vigilancia del paciente así como para ofrecer una rehabilitación mas dirigida.

Objective: To describe the causes of Parinaud syndrome (PS) with diplopia to determine a topographic diagnosis and prognosis. Method: We studied patients with SP from January 1980 to January 2004; causes and treatment. We identified all strabismus associated to PS. Results: We included 18 patients with diplopia, 6 female and 12 male. Age: 28 years old, SD 22 (10; CI 95 percent). Related strabismus: III nerve palsy in 15 patients (79 percent), optical nerve damage in 8 (44.4 percent), VII nerve palsy in 3, IV nerve palsy 2, bilateral III nerve palsy 2, nystagmus 2, Foville syndrome 2, One and half syndrome 1. Causes: Tumor 6, brain stroke 4, cranial trauma 3, neurocisticercosis 2. Ortoposition with botulinum toxin treatment was obtained with 1.72 +/-1.1 (0.65; IC 95 percent) inyections. Surgery was done in 9 patients, only one patient had spontaneous resolution of diplopia and SP. Conclusions: To identify the topographic diagnosis and prognosis of brain diseases in PS is very important to complete the study of strabismus. In this way we can know more about of damage extension and we can identify recurrences quickly to offer a better control.