Revisión de la literatura sobre la evidencia disponible actualmente para el manejo de las queratitis infecciosas con PACK-CXL / Review of the literature on the currently available evidence for the management of infectious keratitis with PACK-CXL

Las queratitis infecciosas (QI) son una de las causas más comunes de ceguera a nivel mundial, especialmente en países en vías de desarrollo, y puede llegar a representar del 5,1 al 32,3% de todas las indicaciones de queratoplastia penetrante. Sin embargo, realizar una queratoplastia terapéutica «en caliente» está asociado con una mayor incidencia de recurrencia de la QI y rechazo del injerto. El tratamiento estándar incluye antimicrobianos (ATM) de amplio espectro y, una vez identificado el patógeno causante y el antibiograma, continuar con un tratamiento dirigido, según la sensibilidad del germen. La aparición de cepas multirresistentes a los ATM está aumentando progresivamente a un ritmo alarmante en los últimos tiempos. Asimismo, la diversidad de los microorganismos causantes (bacterias, hongos, parásitos, virus) dificulta en ocasiones la realización de un diagnóstico clínico correcto, retrasando el inicio de un tratamiento efectivo. Se estima que solo un 50% de los ojos tendrá un buen resultado visual si se retrasa la terapia. En definitiva, todos estos factores hacen que sea muy importante la identificación de alternativas al tratamiento ATM. Por las propiedades ATM del cromóforo fotoactivado (riboflavina) y la luz ultravioleta de longitud de onda 200-400nm, utilizada en múltiples aplicaciones médicas y no médicas para la desinfección, se ha propuesto el cromóforo fotoactivado para el cross-linking corneal en el tratamiento de las QI, como una herramienta adicional en el arsenal terapéutico de las QI. Debe diferenciarse del cross-linking empleado para el manejo del queratocono progresivo. El objetivo de esta revisión es actualizar la evidencia disponible sobre la eficacia y seguridad del cromóforo fotoactivado para el cross-linking en las QI (AU)

Infectious keratitis (IK) is one of the most common causes of monocular blindness worldwide, especially in developing countries, and may account for 5.1 to 32.3% of all indications for penetrating keratoplasty (PK). However, performing a therapeutic PK on a “hot eye” is associated with a higher incidence of IK recurrence and graft rejection. Standard treatment includes antimicrobials (ATM) and, once the causative pathogen has been identified, must be continued with targeted treatment, depending on antibiogram sensitivity. However, appearance of multiresistant strains to ATM is progressively increasing at an alarming rate. Besides that, the diversity of the causative microorganisms (bacteria, fungi, parasites, viruses) may hinder the clinical diagnosis and secondarily the proper treatment from the beginning. It is estimated that only 50% of eyes will have a good visual result if the correct therapy is delayed. All these factors make the identification of alternatives to ATM treatment of paramount importance. Due to the ATM properties of photoactivated chromophore (riboflavin) and ultraviolet light of wavelength 200-400nm, used in multiple medical and non-medical applications for disinfection, photoactivated chromophore for corneal cross-linking (CXL) of IK, as an addition to the therapeutic arsenal for the management of IK has been proposed. It must be differentiated from CXL used for the management of progressive keratoconus. The objective of this review is to update the available evidence on the efficacy and safety of photoactivated chromophore for corneal CXL in IKs (AU)

Review of the literature on the currently available evidence for the management of infectious keratitis with PACK-CXL.

Infectious keratitis (IK) is one of the most common causes of monocular blindness worldwide, especially in developing countries and may account for 5.1%-32.3% of all indications for penetrating keratoplasty (PK). However, performing a therapeutic PK on a "hot eye" is associated with a higher incidence of IK recurrence and graft rejection. Standard treatment includes antimicrobials (ATM) and, once the causative pathogen has been identified, must be continued with targeted treatment, depending on antibiogram sensitivity. However, appearance of multiresistant strains to ATM is progressively increasing at an alarming rate. Besides that, the diversity of the causative microorganisms (bacteria, fungi, parasites, viruses) may hinder the clinical diagnosis and secondarily the proper treatment from the beginning. It is estimated that only 50% of eyes will have a good visual result if the correct therapy is delayed. All these factors make the identification of alternatives to ATM treatment of paramount importance. Due to the ATM properties of photoactivated chromophore (riboflavin, RB) and ultraviolet (UV) light of wavelength (λ) 200-400 nanometers (nm), used in multiple medical and non-medical applications for disinfection, photoactivated chromophore for corneal cross-linking (CXL) of IK (PACK-CXL), as an addition to the therapeutic arsenal for the management of IK has been proposed. It must be differentiated from CXL used for the management of progressive keratoconus (KC). The objective of this review is to update the available evidence on the efficacy and safety of PACK-CXL in IKs.

"White-puncture": A simple technique to prevent tearing of the anterior capsule during capsulorhexis in intumescent white cataracts. / Blancopunción: una técnica simple para prevenir el desgarro de la cápsula anterior durante la capsulorrexis en cataratas blancas intumescentes.

In order to avoid radial tearing of the anterior capsule while performing continuous circular capsulorhexis (CCC) in a white intumescent cataract, called the "Argentinian flag sign" when CCC is associated with a previous capsular stain with trypan blue, an initial puncture of the anterior capsule is performed with a 30G needle as the first step of the surgical procedure, that means, prior to any previous aperture of the anterior chamber. This act seems to allow the pressure of the intracrystalline space and the pressure of the anterior chamber to be equalized, as the liquefied content of the intumescent white cataract is released into a presumably hermetic anterior chamber, avoiding the dreaded anterior capsular radial tear. This technique, called "white-puncture", has been used in 174 cases without any associated complications.

¿Cumplimos correctamente los protocolos de prevención en oftalmología?: a propósito de la última epidemia por coronavirus / Do we correctly comply with prevention protocols in ophthalmology? About the latest coronavirus epidemic

No disponible

De PRK a LASEK y de Lasek a PRK / From PRK to LASEK, and from LASEK to PRK

No disponible

[Choroidal metastases in breast and lung cancer. Prevalence and clinical features. A prospective study]. / Las metástasis coroideas en el cáncer de mama y pulmón. Prevalencia y características clínicas. Estudio prospectivo.

PURPOSE: To analyze the prevalence of choroidal metastases in patients with breast and lung cancer and report their clinical, ophtalmological and angiographic features. MATERIAL AND METHOD: 88 patients who in 1997 had been diagnosed of breast cancer (60 cases) and lung cancer (28) by the oncology unit in the University Hospital of Elche, underwent a thorough ophtalmological examination in search for choroidal metastases. Eighty six patients were newly diagnosed of cancer; the remaining two patients, in a complete remission status, relapsed during this period. RESULTS: Total prevalence of choroidal metastases in the sample was 4.54% (4 cases). Prevalence in lung cancer was 7.14% (2 cases) compared to 3.33% (2 cases) in breast cancer. Choroidal involvement was found in the following stages: 2 out of 7 patients (28.5%) in stage IV with disseminated breast cancer and 2 out of 9 patients (22.22%) in stage IV with disseminated lung cancer. CONCLUSIONS: Approximately one fourth of the patients showing disseminated breast and lung cancer (stage IV) showed metastases in the choroid. It appears from this study, that younger patients suffering from lung cancer are at greater risk of choroidal involvement (Arch Soc Esp Oftalmol 2002; 77: 23-28).

Alteraciones topográficas y paquimétricas inducidas por el uso de lentes de contacto de porte prolongado / Topographic and pachymetric alterations caused by contact lenses for prolonged use

Objetivo: Evaluar las alteraciones paquimétricas y topográficas inducidas por el uso de lentes de contacto blandas y Dk/t >100, tras 3 semanas de porte continuado. Métodos: Se incluyeron 24 ojos de 12 pacientes con edades comprendidas entre 19 y 32 años, a los cuales se les adaptó la nueva lente de contacto Focus® Night & Day. Se analizaron distintos parámetros topográficos poder corneal central, radios corneales a los 3, 5, 7 mm, queratometría simulada y paquimetría antes de la adaptación y al 1.er y 21 día de la misma. En el análisis estadístico utilizamos el test de Wilcoxon para muestras apareadas y el análisis vectorial para valorar la esfera, cilindro y eje del astigmatismo inducido por el porte de la lente. Resultados: La refracción media de los sujetos fue de 3,28 D. El poder corneal central medio inicial fue de 42,5 D. No se encontraron diferencias significativas en poder corneal y radios tras 21 días de uso de la lente. La paquimetría media inicial fue de 541,46 µm y de 557,64 µm tras 24 h de porte. Se encontraron diferencias significativas en los datos paquimétricos tras el uso de la lente. Conclusiones: No se producen alteraciones topográficas significativas tras el porte continuado de las lentes de contacto (21 días). El aumento del espesor corneal tras el porte de la lente fue en todos los casos <5 por ciento (AU)

No disponible