Estudio comparativo entre tonómetros Goldmann y ORA en pacientes recién diagnosticados de GPAA o HTO, sin tratamiento / Comparison of Goldmann and ORA tonometers in newly diagnosed, untreated, POAG and OHT eyes

Antecedentes y objetivo Las propiedades biomecánicas corneales en ojos de pacientes recién diagnosticados de glaucoma e hipertensión oculares (HTO) y que no han recibido tratamiento previo son de gran interés, porque pueden suponer una fuente de error en la medida de la presión intraocular (PIO) medida mediante tonometría de aplanación Goldmann (TAG) y Ocular Response Analyzer® (ORA). El principal objetivo de este estudio es evaluar los valores de la PIO obtenidos con la TAG y el ORA, en pacientes con glaucoma primario de ángulo abierto (GPAA) e HTO que no han recibido tratamiento antiglaucomatoso previo. Materiales y métodos Estudio transversal, observacional con observador enmascarado. Se incluyeron pacientes recién diagnosticados de GPAA e HTO, que no habían recibido tratamiento tópico hipotensor previo. Resultados Se incluyeron 51 pacientes con GPAA y 34 pacientes con HTO. Se encontró un valor de la PIO corneo compensada (PIOcc) significativamente mayor que el de la PIO TAG en el grupo de GPAA (p=0,0002), mientras que no se encontraron diferencias significativas entre ambos tonómetros en el grupo de HTO (p=0,1). Conclusiones La TAG parece infraestimar la PIO «real» en pacientes con GPAA sin tratamiento hipotensor previo, mientras que parece ser más exacta en pacientes con HTO (AU)

Background and objective The corneal biomechanical properties in naïve, untreated glaucoma and ocular hypertension (OHT) eyes is interesting, because it may be a source of error in intraocular pressure (IOP) measurements by Goldmann applanation tonometer (GAT) and ocular response analyzer (ORA). The main objective of this study was to evaluate the IOP values obtained using GAT and the ORA, in primary open angle glaucoma (POAG) and in OHT untreated eyes. Material and methods Observational, masked, cross sectional observational study. Newly diagnosed, untreated POAG and OHT eyes were included. Results Fifty-one POAG and 34 OHT eyes were analyzed. We found that IOPcc (IOP corneal-compensated) was significantly higher than GAT IOP in POAG (P=.0002) while we did not find any significant difference between both tonometers in OHT (P=.1). Conclusions GAT seems to underestimate the real IOP in untreated POAG eyes and it seems to be quite accurate in OHT eyes (AU)

Comparison of Goldmann and ORA tonometers in newly diagnosed, untreated, POAG and OHT eyes.

BACKGROUND AND OBJECTIVE: The corneal biomechanical properties in naïve, untreated glaucoma and ocular hypertension (OHT) eyes is interesting, because it may be a source of error in intraocular pressure (IOP) measurements by Goldmann applanation tonometer (GAT) and Ocular Response Analyzer (ORA) The main objective of this study was to evaluate the IOP values obtained using GAT and the ORA, in primary open angle glaucoma (POAG) and in OHT untreated eyes. MATERIAL AND METHODS: Observational, masked, cross sectional observational study. Newly diagnosed, untreated POAG and OHT eyes were included. RESULTS: 51 POAG and 34 OHT eyes were analyzed. We found that IOPcc (IOP corneal-compensated) was significantly higher than GAT IOP in POAG (p = 0.0002) while we did not find any significant difference between both tonometers in OHT (p = 0.1). CONCLUSIONS: GAT seems to underestimate the real IOP in untreated POAG eyes and it seems to be quite accurate in OHT eyes.

Results of the treatment of patients with exudative AMD during the COVID-19 pandemic.

BACKGROUND AND OBJECTIVE: The SARS-CoV-2 pandemic has caused chaos in all health systems on the planet. It has been difficult to cope with COVID 19, but also to maintain the activity in other specialties. In ophthalmology, the scientific societies recommended providing urgent care, including the intravitreal treatment of patients with active neovascular age-related macular degeneration (AMD), since a delay in treatment implies a potential loss of visual acuity (VA). The main objective of this study was to measure the impact of the coronavirus lockdown on the activity and visual results in patients with neovascular AMD in Area 3 of Madrid. MATERIAL AND METHOD: A retrospective observational study was conducted of all patients with neovascular AMD who attended a consultation and/or received intravitreal treatment in the 3 months before the lockdown. RESULTS: In the 3 months before the lockdown, 144 patients with neovascular AMD were treated, of whom only 51 attended a consultation during the lockdown and, at 6 months after it, only 117 patients had resumed their follow-up. Mean VA before the lockdown was 58.0 ±â€¯23.7 letters and was statistically significantly reduced to 53.0 ±â€¯27.1 letters at 6 months after the lockdown. We also observed a significant decrease in the number of visits during the lockdown, despite the security measures implemented. CONCLUSIONS: Our study shows that patients with neovascular AMD have had a statistically significant decrease in VA due to the lockdown. A VA of almost 58 letters was reduced to 53 at 6 months after the lockdown. The percentage of patients who lost 15 or more letters doubled. We observed a 63.3% loss of temporary follow-up during the lockdown and a 14.58% loss of permanent follow-up at 6 months after the lockdown.

Resultados del tratamiento de los pacientes con DMAE exudativa durante la pandemia por COVID-19 / Results of the treatment of patients with exudative AMD during the COVID-19 pandemic

Antecedentes y objetivo La pandemia SARS-CoV-2 ha supuesto un caos organizativo para todos los sistemas sanitarios del planeta. No solo ha sido complicado hacer frente a la COVID 19, sino también ajustar la actividad asistencial en otras especialidades. En oftalmología las recomendaciones de las sociedades científicas eran dar asistencia urgente y dentro de esta se contemplaba el tratamiento intravítreo de los pacientes con degeneración macular asociada a la edad neovascular (DMAEn) activa, puesto que el retraso en el tratamiento supone una pérdida potencialmente irrecuperable de agudeza visual (AV). El objetivo primario del presente estudio es medir el impacto en la actividad y los resultados visuales del confinamiento por coronavirus en los pacientes con DMAEn en el área 3 de la Comunidad de Madrid. Material y método Se plantea un estudio observacional retrospectivo de todos los pacientes con DMAEn que habían acudido a consulta y/o recibido tratamiento intravítreo los 3 meses previos al inicio del confinamiento. Resultados Los 3 meses previos al confinamiento se atendieron a 144 pacientes con DMAEn de los cuales solo 51 acudieron durante el confinamiento y a los 6 meses tras el confinamiento solo 117 pacientes han retomado su seguimiento. La AV media antes del confinamiento era de 58±23,7 letras y se redujo de forma estadísticamente significativa a 53±27,1 letras a los 6 meses tras el confinamiento. También observamos una disminución significativa del número de visitas durante el confinamiento a pesar de las medidas de seguridad implementadas. Conclusiones Nuestro estudio demuestra que los pacientes con DMAEn presentan una disminución estadísticamente significativa de la AV durante el confinamiento. De una AV de casi 58 letras, se redujo a 53 a los 6 meses del confinamiento. El porcentaje de pacientes que perdió 15 o más letras se duplicó (AU)

Background and objective The SARS-CoV-2 pandemic has caused chaos in all health systems on the planet. It has been difficult to cope with COVID 19, but also to maintain the activity in other specialties. In ophthalmology, the scientific societies recommended providing urgent care, including the intravitreal treatment of patients with active neovascular age-related macular degeneration (AMD), since a delay in treatment implies a potential loss of visual acuity (VA). The main objective of this study was to measure the impact of the coronavirus lockdown on the activity and visual results in patients with neovascular AMD in Area 3 of Madrid. Material and method A retrospective observational study was conducted of all patients with neovascular AMD who attended a consultation and/or received intravitreal treatment in the 3 months before the lockdown. Results In the 3 months before the lockdown, 144 patients with neovascular AMD were treated, of whom only 51 attended a consultation during the lockdown and, at 6 months after it, only 117 patients had resumed their follow-up. Mean VA before the lockdown was 58.0±23.7 letters and was statistically significantly reduced to 53.0±27.1 letters at 6 months after the lockdown. We also observed a significant decrease in the number of visits during the lockdown, despite the security measures implemented. onclusions Our study shows that patients with neovascular AMD have had a statistically significant decrease in VA due to the lockdown. A VA of almost 58 letters was reduced to 53 at 6 months after the lockdown. The percentage of patients who lost 15 or more letters doubled. We observed a 63.3% loss of temporary follow-up during the lockdown and a 14.58% loss of permanent follow-up at 6 months after the lockdown (AU)

[Results of the treatment of patients with exudative AMD during the COVID-19 pandemic]. / Resultados del tratamiento de los pacientes con DMAE exudativa durante la pandemia por COVID-19.

Background and objective: The SARS-CoV-2 pandemic has caused chaos in all health systems on the planet. It has been difficult to cope with COVID 19, but also to maintain the activity in other specialties. In ophthalmology, the scientific societies recommended providing urgent care, including the intravitreal treatment of patients with active neovascular age-related macular degeneration (AMD), since a delay in treatment implies a potential loss of visual acuity (VA).The main objective of this study was to measure the impact of the coronavirus lockdown on the activity and visual results in patients with neovascular AMD in Area 3 of Madrid. Material and method: A retrospective observational study was conducted of all patients with neovascular AMD who attended a consultation and/or received intravitreal treatment in the 3 months before the lockdown. Results: In the 3 months before the lockdown, 144 patients with neovascular AMD were treated, of whom only 51 attended a consultation during the lockdown and, at 6 months after it, only 117 patients had resumed their follow-up. Mean VA before the lockdown was 58.0 ± 23.7 letters and was statistically significantly reduced to 53.0 ± 27.1 letters at 6 months after the lockdown. We also observed a significant decrease in the number of visits during the lockdown, despite the security measures implemented. Conclusions: Our study shows that patients with neovascular AMD have had a statistically significant decrease in VA due to the lockdown. A VA of almost 58 letters was reduced to 53 at 6 months after the lockdown. The percentage of patients who lost 15 or more letters doubled. We observed a 63.3% loss of temporary follow-up during the lockdown and a 14.58% loss of permanent follow-up at 6 months after the lockdown.

Aniridic glaucoma: An update.

Aniridia is a congenital bilateral ocular disorder with dominant autosomal inheritance. More than 50% of patients will develop aniridic glaucoma (AG) during their lives. Open angle glaucoma is more common in aniridia, but a closed angle mechanism has been described in relation with anterior rotation of the rudimentary iris, occluding trabecular meshwork. Diagnosis and follow-up of AG is difficult in relation with the presence of keratopathy, nystagmus and foveal hypoplasia. Central corneal thickness usually measures more than 600 microns, which prevents achieving a reliable value of intraocular pressure. Medical treatment of AG is no different from the rest of glaucoma. It is recommended to use preservative free formulations, and combined therapy is often required. Surgical treatment is needed in many cases. There is no consensus on the first line surgery for AG, but in open angle AG, angle surgery is usually first choice, and glaucoma drainage devices are the next preferred surgical technique. In closed angle AG glaucoma drainage devices are usually the first choice, with trabeculectomy as the second preferred surgical technique.

Ex-PRESS® implant as the first surgical option in the iridocorneal endothelial syndrome.

Our purpose is to report the intermediate-term results of the Ex-PRESS® implant as the first surgical option in patients with Iridocorneal Endothelial (ICE) Syndrome. We describe two patients diagnosed from ICE syndrome with medically uncontrolled glaucoma and finally treated with an Ex-PRESS® implant, associating a cataract surgery in one of them. Three years after surgery, intraocular pressure remains stable without any additional medical antiglaucomatous treatment, with a well-located implant surrounded by a diffuse filtering bleb and no sight-threatening adverse events have been documented. In addition, no progression of the disease has been registered. This report encourage the Ex-PRESS® implant to be considered the first surgical option in this patients as it allows a permeable ostium in spite of the progressive synechial angle closure typical of the ICE syndrome.

Implante Ex-PRESS® como primera opción quirúrgica en el síndrome iridocorneo-endotelial / Ex-PRESS® implant as the first surgical option in the iridocorneal endothelial syndrome

Se plantea como objetivo dar a conocer los resultados a mediano plazo del implante Ex-PRESS® como primera opción quirúrgica en pacientes con síndrome iridocorneo-endotelial (ICE). Se incluye la descripción de dos mujeres con diagnóstico de síndrome ICE y glaucoma no controlado por medicación, tratadas con el implante Ex-PRESS® y con cirugía de catarata asociada en una de ellas. La presión intraocular se mantiene estable tres años después de la intervención sin necesidad de tratamiento médico adicional anti-glaucoma, con un implante bien colocado y rodeado por una ampolla de filtración difusa, sin eventos adversos documentados que pudieran suponer una amenaza para la vista, y sin un progreso registrado en el curso de la patología. El presente informe propone considerar los implantes Ex-PRESS® como primera opción quirúrgica, al posibilitar la existencia de un ostium permeable, a pesar del cierre progresivo del ángulo sinequial típico del síndrome ICE (AU)

Our purpose is to report the intermediate-term results of the Ex-PRESS® implant as the first surgical option in patients with Iridocorneal Endothelial (ICE) Syndrome. We describe two patients diagnosed from ICE syndrome with medically uncontrolled glaucoma and finally treated with an Ex-PRESS® implant, associating a cataract surgery in one of them. Three years after surgery, intraocular pressure remains stable without any additional medical antiglaucomatous treatment, with a well-located implant surrounded by a diffuse filtering bleb and no sight-threatening adverse events have been documented. In addition, no progression of the disease has been registered. This report encourage the Ex-PRESS® implant to be considered the first surgical option in this patients as it allows a permeable ostium in spite of the progressive synechial angle closure typical of the ICE syndrome (AU)

Aniridic glaucoma: An update. / Actualización en glaucoma anirídico.

Aniridia is a congenital bilateral ocular disorder with dominant autosomal inheritance. More than 50% of patients will develop aniridic glaucoma (AG) during their lives. Open angle glaucoma is more common in aniridia, but a closed angle mechanism has been described in relation with anterior rotation of the rudimentary iris, occluding trabecular meshwork. Diagnosis and follow-up of AG is difficult in relation with the presence of keratopathy, nystagmus and foveal hypoplasia. Central corneal thickness usually measures more than 600 microns, which prevents achieving a reliable value of intraocular pressure. Medical treatment of AG is not different from the rest of glaucoma. It is recommended to use preservative free formulations, and combined therapy is often required. Surgical treatment is needed in many cases. There is no consensus on the first line surgery for AG, but in open angle AG, angle surgery is usually first choice, and glaucoma drainage devices are the next preferred surgical technique. In closed angle AG glaucoma drainage devices are usually the first choice, with trabeculectomy as the second preferred surgical technique.

[Late onset lens particle glaucoma in Marfan syndrome]. / Glaucoma tardío por partículas de cristalino en síndrome de Marfan.

CASE REPORT: A case is presented of an acute onset lens particle glaucoma originating from a crystalline lens spontaneously dislocated into the vitreous for more than 20 years in a patient diagnosed with Marfan syndrome. DISCUSSION: Marfan syndrome is a connective tissue disorder with autosomal dominant inheritance caused by fibrillin gene mutation. Ectopia lentis is the predominant ocular abnormality and a major diagnostic criterion. An association between Marfan syndrome and glaucoma has also been demonstrated. The reported case is unusual in that a complete spontaneous lens dislocation to vitreous was present and progressed to secondary lens particle open angle glaucoma.

Ocular residual astigmatism's effect on high myopic astigmatism LASIK surgery.

PURPOSE: To analyze the effect of ocular residual astigmatism (ORA) on the effectiveness of LASIK for treating high myopic astigmatism. METHODS: This is an observational, cross-sectional study. We studied 116 consecutive myopic eyes with -3 diopters (D) or more of astigmatism that underwent LASIK surgery. The magnitude of uncorrected residual refractive astigmatism 3 months postoperatively was measured. RESULTS: The mean preoperative cylinder was -4.0±0.83 D (range, -7.5 to -3 D) and the mean preoperative ORA was 0.82±0.5 D. The mean residual refractive cylinder 3 months postoperatively was -0.78±0.83 D (range, -3 to 0 D). No correlation was found between ORA and the refractive cylinder 3 months postoperatively (P=0.6). CONCLUSION: In eyes with high myopic astigmatism undergoing LASIK, ORA was not correlated with the residual postoperative cylinder.

Effects of pterygium on the biomechanical properties of the cornea: a pilot study.

OBJECTIVE: To investigate the changes induced by a pterygium or its surgical removal on the biomechanical properties of the cornea and to determine factors that might affect these parameters. METHODS: This prospective pilot interventional, non-randomized, observer-masked study included 20 eyes of 20 patients with a unilateral primary pterygium (pterygium group) and 19 fellow healthy eyes (control group). The bare sclera technique with one-minute application of 0.02% mitomycin C intraoperatively was performed in all cases. The follow-up period was one month. The preoperative and postoperative biomechanical properties of the cornea were measured using the Reichert ocular response analyzer (ORA). RESULTS: The corneal hysteresis (CH) decreased significantly (P<.01) in eyes with a pterygium compared to the control eyes, while surgery did not significantly change the CH compared to preoperatively. There were no significant changes in the corneal resistance factor or the central corneal thickness. CONCLUSIONS: Primary active pterygium (grades 1 or 2) induce a reduction of corneal biomechanical features. Further studies are needed in populations, with longer follow-ups and bigger pterygium that may involve wider keratectomy to confirm our results.

Efecto del pterigión en las propiedades biomecánicas de la córnea: estudio piloto / Effects of pterygium on the biomechanical properties of the cornea: a pilot study

Objetivo: Investigar los cambios inducidos en la biomecánica de la córnea por la presencia de pterigión o por su exéresis quirúrgica, así como determinar los factores que influyen sobre dichos parámetros. Métodos: Estudio piloto, intervencional y prospectivo, con observador enmascarado que incluía 20 ojos de 20 pacientes con pterigión primario unilateral (grupo pterigión) y 19 ojos adelfos sanos (grupo control). Se realizó una resección simple del pterigión con aplicación intraoperatoria de mitomicina C 0,02% durante un minuto sobre el lecho escleral. El periodo de seguimiento fue de un mes. Las propiedades biomecánicas de la córnea fueron determinadas preoperatoria y postoperatoriamente mediante el analizador de respuesta ocular Reichert (ORA). Resultados: La presencia de pterigión disminuyó significativamente la histéresis corneal (HC) en comparación con el grupo control (p<0,01). No encontramos diferencias estadísticamente significativas entre las medidas pre- y postoperatorias de la HC, del factor de resistencia corneal, ni del espesor corneal central. Conclusión: La presencia de un pterigión primario activo (grados 1 y 2) conduce a una reducción de las propiedades biomecánicas de la córnea. Serían necesarios nuevos estudios con un mayor tiempo de seguimiento y pterigiones más avanzados, con queratectomías más amplias para confirmar estos efectos(AU)

Objective: To investigate the changes induced by a pterygium or its surgical removal on the biomechanical properties of the cornea and to determine factors that might affect these parameters. Methods: This prospective pilot interventional, non-randomized, observer-masked study included 20 eyes of 20 patients with a unilateral primary pterygium (pterygium group) and 19 fellow healthy eyes (control group). The bare sclera technique with one-minute application of 0.02% mitomycin C intraoperatively was performed in all cases. The follow-up period was one month. The preoperative and postoperative biomechanical properties of the cornea were measured using the Reichert ocular response analyzer (ORA). Results: The corneal hysteresis (CH) decreased significantly (P<0.01) in eyes with a pterygium compared to the control eyes, while surgery did not significantly change the CH compared to preoperatively. There were no significant changes in the corneal resistance factor or the central corneal thickness. Conclusions: Primary active pterygium (grades 1 or 2) induce a reduction of corneal biomechanical features. Further studies are needed in populations, with longer follow-ups and bigger pterygium that may involve wider keratectomy to confirm our results(AU)

[Effectiveness of topical bevacizumab in bilateral primary lipid keratopathy]. / Eficacia de bevacizumab tópico en queratopatía lipoidea bilateral primaria.

CASE REPORT: A 75-year-old man with bilateral idiopathic lipid keratopathy underwent a penetrating keratoplasty in the left eye. One month later, there was deep corneal neovascularisation extending across the bed and the graft-host interface, with a whitish opacity surrounding the vessels. Topical bevacizumab (25mg/mL) was administered 4 times daily for 2 months with partial regression of corneal neovascularization. DISCUSSION: Topical bevacizumab may be useful in preventing a recurrence of lipid deposition after penetrating keratoplasty in patients with bilateral primary lipid keratopathy, although its long-term efficacy needs to be assessed.

Eficacia de bevacizumab tópico en queratopatía lipoidea bilateral primaria / Effectiveness of topical bevacizumab in bilateral primary lipid keratopathy

Caso clínico: Varón de 75 años con queratopatía lipoidea bilateral primaria. Es intervenido de queratoplastia penetrante en ojo izquierdo. Al mes se observa neovascularización corneal profunda extendiéndose sobre el lecho y la interfase injerto-huésped, con opacidad blanquecina alrededor de los neovasos. Se inicia tratamiento con bevacizumab tópico (25mg/mL) 4 veces/día durante 2 meses, con regresión parcial de la neovascularización corneal. Discusión: Bevacizumab tópico puede ser útil en la prevención de la recidiva de la queratopatía lipoidea tras queratoplastia penetrante en pacientes con queratopatía lipoidea bilateral primaria, aunque sería conveniente determinar su eficacia a largo plazo(AU)

Case report: A 75-year-old man with bilateral idiopathic lipid keratopathy underwent a penetrating keratoplasty in the left eye. One month later, there was deep corneal neovascularisation extending across the bed and the graft-host interface, with a whitish opacity surrounding the vessels. Topical bevacizumab (25mg/mL) was administered 4 times daily for 2 months with partial regression of corneal neovascularization. Discussion: Topical bevacizumab may be useful in preventing a recurrence of lipid deposition after penetrating keratoplasty in patients with bilateral primary lipid keratopathy, although its long-term efficacy needs to be assessed(AU)

[Effect of mitomycin C on corneal regrowth after laser-assisted sub-epithelial keratectomy (LASEK)]. / Efecto de la mitomicina C en el engrosamiento corneal tras queratectomía subepitelial con láser excimer (LASEK).

PURPOSE: To study the effect of mitomycin C (MMC) on the corneal regrowth after laser-assisted sub-epithelial keratectomy (LASEK). METHODS: We performed a prospective, controlled, observer-masked study of 64 consecutive eyes scheduled to undergo LASEK to correct their myopia. The patients were divided into two age-matched groups, with group 1 including 32 eyes in which the ablation depth was ≤ 50 µm and received no MMC. Group 2 consisted of 32 eyes in which the ablation depth exceeded 50 µm and were treated with intra-operative 0.02% MMC for 30 seconds over the ablated zone. A masked observer measured the central corneal thickness (CCT) 1 and 3 months after surgery. We compared the change in CCT between both groups up to 3 months after surgery. RESULTS: The mean patient age was 31.5 years (SD 4.6) and 31.6 (SD 8.7) years in groups 1 and 2, respectively (P=.9). Group 1 showed a mean CCT of 444.0 (SD 41.3) µm one month after surgery and 450.3 (SD 43.5) µm three months after surgery (P=.04). CCT in group 2 was 399.7 (SD 31.2) µm and 407.9 (SD 32.6) µm one and three months after surgery, respectively (P=.006). The difference in the CCT increases between both groups was not statistically significant (P=.6). CONCLUSIONS: A single intraoperative application of 0.02% MMC for 30 seconds did not seem to cause a substantial change in the post-surgical corneal thickening expected after LASEK.

Efecto de la mitomicina C en el engrosamiento corneal tras queratectomía subepitelial con láser excimer (LASEK) / Effect of mitomycin C on corneal regrowth after laser-assisted sub-epithelial keratectomy (LASEK)

ObjetivoEstudiar el efecto de la mitomicina C (MMC) en el engrosamiento corneal tras queratectomía subepitelial con láser excimer (LASEK).MétodosRealizamos un estudio prospectivo, controlado, enmascarado de 64 ojos consecutivos operados con LASEK para corregir su miopía. Separamos dos grupos empatados por edad. Los 32 ojos en los que la profundidad de ablación era ≤ 50 micras (μm) fueron incluidos en el grupo 1 y no recibieron MMC. Los 32 ojos en los que la profundidad de ablación era > 50μm se incluyeron en el grupo 2 y recibieron MMC al 0,02% durante 30 seg. sobre el lecho ablacionado. Un observador enmascarado midió el grosor corneal central (GCC) al mes y tres meses tras la cirugía. Se comparó el cambio en el GCC postoperatorio entre los dos grupos.ResultadosLa media de edad era de 31,5 (DE 4,6) años y 31,6 (DE 8,7) años en los grupos 1 y 2 respectivamente (p=0,9). En el grupo 1, la media del GCC era 444,0 (DE 41,3) μm al mes y 450,3 (DE 43,5) μm a los tres meses (p=0,04). El GCC en el grupo 2 era 399,7 (DE 31,2) μm al mes y 407,9 (DE 32,6) μm tres meses tras la cirugía (p=0,006). La diferencia entre los incrementos de GCC entre los dos grupos no fue estadísticamente significativa (p=0,6).ConclusionesUna única aplicación intraoperatoria de MMC al 0,02% durante 30 seg. no parece causar un cambio sustancial en el incremento del grosor corneal postoperatorio observado tras LASEK(AU)

PurposeTo study the effect of mitomycin C (MMC) on the corneal regrowth after laser-assisted sub-epithelial keratectomy (LASEK).MethodsWe performed a prospective, controlled, observer-masked study of 64 consecutive eyes scheduled to undergo LASEK to correct their myopia. The patients were divided into two age-matched groups, with group 1 including 32 eyes in which the ablation depth was ≤ 50μm and received no MMC. Group 2 consisted of 32 eyes in which the ablation depth exceeded 50μm and were treated with intra-operative 0.02% MMC for 30seconds over the ablated zone. A masked observer measured the central corneal thickness (CCT) 1 and 3 months after surgery. We compared the change in CCT between both groups up to 3 months after surgery.ResultsThe mean patient age was 31.5 years (SD 4.6) and 31.6 (SD 8.7) years in groups 1 and 2, respectively (P=.9). Group 1 showed a mean CCT of 444.0 (SD 41.3) μm one month after surgery and 450.3 (SD 43.5) μm three months after surgery (P=.04). CCT in group 2 was 399.7 (SD 31.2) μm and 407.9 (SD 32.6) μm one and three months after surgery, respectively (P=.006). The difference in the CCT increases between both groups was not statistically significant (P=.6).ConclusionsA single intraoperative application of 0.02% MMC for 30seconds did not seem to cause a substantial change in the post-surgical corneal thickening expected after LASEK(AU)

[Morphometric analysis of corneal endothelium after intravitreal ranibizumab (Lucentis) in age-related macular degeneration treatment]. / Análisis morfométrico del endotelio corneal tras ranibizumab intravítreo en la degeneración macular asociada a la edad.

PURPOSE: To determine the effect of intravitreal injection of 0.5mg ranibizumab on the corneal endothelium in patients with age-related macular degeneration (AMD). METHODS: Observational, prospective case series pilot study. Twenty-six eyes of 26 consecutive patients with AMD were evaluated. All participants received one monthly intravitreal injections of 0.5mg ranibizumab for three consecutive months. The follow-up period was 6 months. Central corneal specular microscopy was performed before injection and at 7 days and 6 months after the first intravitreal injection. The endothelial cell density, coefficient of variation of cell size, and percentage of hexagonal cells were analyzed and the central corneal thickness was measured. RESULTS: There were no significant differences in the endothelial cell densities, coefficients of variation of cell size and percentages of hexagonal cells before injection and at 7 days and 6 months after the first intravitreal ranibizumab injection (P>0.5). There was also no significant difference in central corneal thickness measurements through the follow-up period (P>0.5). CONCLUSIONS: Repeated intravitreal injections of 0.5mg ranibizumab do not seem to cause substantial changes in the corneal endothelium.