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Signes-Soler I, Javaloy J, Montés-Micó R, Muñoz G, Montalbán R, Hernández A, Albarrán-Diego C. Vision-Related Quality of Life after Cataract Surgery in West Africa. West Afr J Med 2023; 40:329-335. [PMID: 37018220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
PURPOSE To study vision related quality of life (VRQoL) before and after a massive cataract campaign in West Africa and the relationship with visual indicators. METHODS All the patients who received cataract surgery in Burkina Faso during a blindness prevention campaign were examined. VRQoL was assessed using a modified version of the WHO/PBD VF20. The questionnaire was changed to reflect the socioeconomic and local culture. Patients were interviewed by local interviewers before and three months after surgery. A quality of life related to vision index (QoL-RVI) was calculated. RESULTS A total of 305 patients underwent cataract extraction in at least one eye, of these, a total of 196 (64%) completed the study. Mean age was 61.97 ± 14.39 years. The majority of eyes had poor visual acuity (VA<20/200, log MAR: 1.0) preoperatively (88.70%) with a mean VA of logMAR 2.17 ± 0.70 (20/2000) which improved to 0.86 ± 0.64 LogMAR (20/150) 3 months after cataract surgery. QoL-RVI improved postoperatively in 90.2% of patients, did not change in 3.1% and was worse in 6.7%. Statistically significant differences were detected (Wilcoxon test p <0.05) for all items tested before and after surgeries. Correlations for the patients after operations showed that there was a statistically significant relation between a global estimated QoL-RVI and the VA previous to the surgery (-0.196 p=0.014), regarding the same index and the VA after the procedures (-0,35 p=0,00018). CONCLUSION Cataract surgery increases the quality of life of patients living in a developing country such as Burkina Faso and the improvement correlates with the recovery of the visual acuity.
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Javaloy J, Druchkiv V, Beltrán J, Moya J, Albarrán-Diego C, Montalbán R, Muñoz G. Retinal detachment after phacoemulsification in refractive surgery clinics: a large series analysis with variable follow-up during 16 years. Graefes Arch Clin Exp Ophthalmol 2021; 259:1555-1567. [PMID: 33791845 DOI: 10.1007/s00417-021-05160-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the long-term incidence of pseudophakic retinal detachment (PRD) after phacoemulsification and the weight of the main risk factors in the appearance of such complication in a large sample. To implement a customized formula and a software calculation program able to quantify the risk of suffering PRD applicable to all lens extraction patients. METHODS Retrospective cumulative risk analysis conducted on 178,515 eyes operated under similar conditions in a group of refractive surgery clinics (Clínica Baviera SL) located in a relatively limited geographical area (Spain). A survival analysis was performed and the data were modelled using the Weibull regression to determine the risk over a period of 16 years and to estimate the association of different risk factors: sex, age, axial length (AXL) of the eye, intraoperative posterior capsule rents (PCR), and YAG laser capsulotomies. The resulting estimates were translated into a predictive equation for hazard rates and survival probabilities. Later, an application was developed to make prediction available for the clinical community in order to estimate the potential risk of any hypothetical case before lens surgery. RESULTS Globally, 1521 (0.85%) cases of PRD were diagnosed during the period. The risk for PRD was significantly greater in males (5.48 [2.94-10.2]; p < 0.001), in long eyes (1.24 [1.21-1.26]; p < 0.001), and also after posterior capsule rents (13.97 [11.61-16.82]; p < 0.001). Posterior capsule rupture increased the risk of PRD up to fourteen times. CONCLUSIONS From weaker to stronger impact, age, axial length, sex, and intraoperative posterior capsule rent were significant risk factors for the appearance of PRD after lens extraction.
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Javaloy J, Signes-Soler I, Moya T, Litila S. Cataract surgery in surgical camps: outcomes in a rural area of Cameroon. Int Ophthalmol 2020; 41:283-292. [PMID: 32979111 DOI: 10.1007/s10792-020-01580-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/29/2020] [Indexed: 11/29/2022]
Abstract
AIM To assess the complications and visual outcomes of cataract surgery during an outreach eye camp in Cameroon in which two foreign ophthalmologists operate alongside a local one. MATERIALS AND METHODS This is a retrospective and comparative cohort study. The patients were consecutively assigned to three groups depending on the ophthalmologist who performed the cataract surgeries. All eyes underwent manual sutureless incision cataract surgery with posterior chamber intraocular lens (PCIOL) implantation under peribulbar anesthesia. Postoperative visits were scheduled for the first day, first week and second month after the procedures. Intra- and postoperative complications, best-corrected visual acuity and also refractive errors were assessed. RESULTS A total of 263 eyes underwent cataract extraction with PCIOL implantation. The percentage of eyes in which two or more lines of corrected distance visual acuity decreased were 2.4%, 2.7% and 0% for groups A, B and C, respectively. The percentage of eyes with good visual outcome (uncorrected distance visual acuity UDVA > 20/60) were, respectively, 82.09%, 81.43% and 80.82% for the three groups. Similar results were found between the three groups regarding complications. Ocular hypertension, transient corneal edema and hyphema were the incidences registered at the first postoperative control performed 24 h after surgery. The most common complication observed 2 months after surgery was posterior capsular opacity (2.6%). CONCLUSION High-volume cataract surgery in low- and middle-income countries may have good visual outcomes and a low rate of complications when the procedures are performed by either foreign or local ophthalmologists. SYNOPSIS A program of high-volume cataract surgery carried out in a rural environment with few resources can give good visual outcomes in the hands of both foreign and local experienced ophthalmologists.
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Javaloy J, Rivera E, Montalbán R, Beltrán J, Muñoz G, Rohrweck S. Diffractive trifocal pseudophakic intraocular lenses in high myopic eyes: 2-year assessment after implantation. Graefes Arch Clin Exp Ophthalmol 2019; 257:1331-1339. [DOI: 10.1007/s00417-019-04302-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 02/17/2019] [Accepted: 03/20/2019] [Indexed: 02/04/2023] Open
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Signes-Soler I, Javaloy J, Muñoz G, Moya T, Montalbán R, Albarrán C. Safety and Efficacy of the Transition from Extracapsular Cataract Extraction to Manual Small Incision Cataract Surgery in Prevention of Blindness Campaigns. Middle East Afr J Ophthalmol 2017; 23:187-94. [PMID: 27162451 PMCID: PMC4845617 DOI: 10.4103/0974-9233.175890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To compare the safety and the visual outcomes of two experienced cataract surgeons who converted from extracapsular cataract extraction (ECCE) to manual small incision cataract surgery (MSICS) during a campaign for the prevention of blindness. METHODS Two surgeons used the ECCE technique (ECCE group) during a campaign in Burkina Faso on 93 consecutive cataract patients with a corrected distance visual acuity (CDVA) <20/80 in the best eye. Both surgeons used MSICS for the first time on 98 consecutive cases in another campaign in Kenya after theoretical instructional courses. RESULTS There were no significant differences in CDVA at 3 months postoperatively. There were 69% of eyes with uncorrected distance visual acuity ≥20/60 in the MSICS group and 49% eyes in the ECCE group. Spherical equivalents ranged between -1D and +1D in 55% of the MSICS group versus 43% in the ECCE group. There were significant differences in the changes in the vertical component of astigmatism (J45) but not the horizontal (J0) component. There were no significant differences in the intraoperative complications. The most common postoperative complication was corneal edema on the first day in 40.86% and 19.38% of the ECCE and MSICS groups, respectively. CONCLUSION Transitioning from ECCE to MSICS for experienced cataract surgeons in surgical campaigns is safe. The rate of complications is similar for both techniques. Slightly better visual and refractive outcomes can be achieved due to the decreased induction of corneal astigmatism.
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Moya T, Javaloy J, Montés-Micó R, Beltrán J, Muñoz G, Montalbán R. Reply: To PMID 26248348. J Refract Surg 2015; 31:854-855. [PMID: 27030833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Moya T, Javaloy J, Montés-Micó R, Beltrán J, Muñoz G, Montalbán R. Implantable Collamer Lens for Myopia: Assessment 12 Years After Implantation. J Refract Surg 2015; 31:548-56. [PMID: 26248348 DOI: 10.3928/1081597x-20150727-05] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 06/17/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the long-term refractive and visual stability and the risks related to the implantation of Implantable Collamer Lens (ICL; STAAR Surgical, Monrovia, CA) phakic intraocular lens (PIOL) for myopia. METHODS This retrospective, consecutive, cumulative clinical study was performed in a group of 144 eyes implanted with ICL PIOL for myopia. Only the cases with clinical data available 12 years after the implantation were included in the series. Corrected distance visual acuity (CDVA), uncorrected distance visual acuity, spherical equivalent, refractive astigmatism, endothelial cell density, ICL vaulting, and postoperative complications were analyzed. RESULTS Mean spherical equivalent refraction was -16.90±4.26 diopters (D) preoperatively and -1.77±1.93 D 12 years postoperatively. Mean CDVA at the first and last visit were 0.31±0.19 logMAR and 0.22±0.22 logMAR, respectively (Mann-Whitney U test, P<.001). Twelve years postoperatively, 8.9% of eyes had lost more than two lines of CDVA. The incidence of clinically relevant cataracts (13.88%) was significantly linked to the use of the V3 model ICL (chi-square test, P=.007). During the follow-up period, a significant reduction in PIOL vaulting was observed (Kruskal-Wallis test, P<.05), and the mean endothelial cell density decreased by 19.75%. CONCLUSIONS The ICL PIOL provided good refractive outcomes and stability in the long term. The incidence of cataracts is low when the latest models of this PIOL are used.
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Abbouda A, Javaloy J, Alió JL. Confocal microscopy evaluation of the corneal response following AcuFocus KAMRA inlay implantation. J Refract Surg 2014; 30:172-8. [PMID: 24763721 DOI: 10.3928/1081597x-20140217-04] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/13/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the corneal appearance on confocal microscopy after AcuFocus KAMRA Inlay (AcuFocus, Inc., Irvine, CA) implantation and evaluate the visual acuity compared to the confocal microscopy data. METHODS Twelve eyes of 12 patients implanted with one of three models of the AcuFocus KAMRA Inlay (ACI 7000, 7000T, and 7000PDT) were prospectively evaluated by confocal microscopy 6 months after implantation. Additionally, 4 eyes of 4 patients explanted during the follow-up period were evaluated. RESULTS Among the eyes implanted, mean epithelial thickness was 54.6 ± 22 μm. The subbasal nerve plexus was detected in 10 patients. The corneal nerves per unit area were 2.73 ± 2.1 sprouts/mm(2). The branch pattern was found in 8 patients. The mean keratocyte density value was 540 ± 210 cells/mm(2). A low grade of keratocyte activation was found in all patients. Among the eyes explanted, the mean wound healing opacity was 1,092.75 ± 1,877.35 μm/pixel. CONCLUSIONS The corneal tolerance to the KAMRA Inlay appeared to be good. The inlay modified the normal structure of the corneal layer, but it was not associated with severe complications of the eye. Keratocyte activation was the finding most associated with a negative visual outcome. Confocal microscopy can be useful to evaluate the long-term evolution of the corneal layer changes following KAMRA Inlay implantation.
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Alió JL, Soria F, Abdou AA, Peña-García P, Fernández-Buenaga R, Javaloy J. Comparative outcomes of bimanual MICS and 2.2-mm coaxial phacoemulsification assisted by femtosecond technology. J Refract Surg 2014; 30:34-40. [PMID: 24864326 DOI: 10.3928/1081597x-20131217-04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the efficacy and safety outcomes of bimanual microincision cataract surgery (MICS) versus 2.2-mm coaxial phacoemulsification assisted by Femtosecond LenSx (Alcon-LenSx Inc., Aliso Viejo, CA). METHODS This prospective, randomized, observational, comparative case series comprised 50 cataractous eyes of 50 patients receiving femtosecond laser refractive lens surgery followed by a bimanual MICS technique with two 1-mm incisions (25 patients) (FemtoMICS group) and a coaxial phacoemulsification technique with a 1-mm paracentesis and a 2.2-mm principal incision (25 patients) (FemtoCoaxial group). The main outcomes measures were: ultrasound power, effective phacoemulsification time, postoperative spherical equivalent, higher-order aberrations (corneal and internal), corneal thickness, endothelial cell count, macular thickness, and complications during and after surgery. Both groups were absolutely comparable for all variables preoperatively. RESULTS Mean ultrasound power was 1.8% ± 0.9% for MICS and 14.7% ± 4.9% for 2.2-mm incisions (P < .001). Effective phacoemulsification time values for MICS and 2.2-mm incisions were 1.5 ± 0.9 and 4.5 ± 2.9 sec, respectively (P = .002). Mean postoperative spherical equivalent was −0.26 for FemtoMICS and −0.33 for FemtoCoaxial (P > .05). The efficacy index at 1 month postoperatively was 160.2% for FemtoMICS and 149% for FemtoCoaxial. No significant differences were found in corneal thickness, endothelial cell count, and macular thickness. Complications included posterior capsule rupture (4%) and anterior capsule rupture with no posterior capsule tear (4%) for FemtoMICS and bridges due to incomplete capsulorhexis (4%) for FemtoCoaxial. CONCLUSIONS MICS and coaxial phacoemulsification techniques assisted by the Femtosecond LenSx achieved excellent safety and efficient outcomes. The FemtoMICS technique was surgically and statistically more efficient than the FemtoCoaxial technique.
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Alió JL, Abdou AA, Soria F, Javaloy J, Fernández-Buenaga R, Nagy ZZ, Filkorn T. Femtosecond laser cataract incision morphology and corneal higher-order aberration analysis. J Refract Surg 2013; 29:590-5. [PMID: 24016345 DOI: 10.3928/1081597x-20130819-01] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 05/13/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE Analysis of the femtosecond laser refractive lens surgery corneal incision configuration and corneal higher-order aberration (HOA) effect from the first postoperative day. METHODS High-resolution anterior segment optical coherence tomography was used to assess 20 eyes undergoing femtosecond laser refractive lens surgery with 2.2-mm minimal incision. The primary incision (tri-planar) actual length, cord length, surface angle, surface irregularity, and regional pachymetry values and the secondary incision (uni-planar) length, angle, surface irregularity, and pachymetry values were analyzed. Hartmann-Shack aberrometer was used to assess corneal HOAs to correlate the effect. Assessment was done preoperatively and 1 month postoperatively. RESULTS The actual length, cord length, and surface angle means for the primary incision in the first postoperative day and month were 1.50 ± 0.1 and 1.47 ± 0.2 mm (P = .5), 1.41 ± 0.1 and 1.42 ± 0.2 mm (P = .8), and 27° ± 4° and 23° ± 5° (P = .07), respectively. The length and surface angle for the secondary incision in the first postoperative day and month were 1.17 ± 0.01 and 1.04 ± 0.1 mm (P = .05) and 52° ± 3° and 42° ± 5° (P = .007). The regional pachymetry values for the primary and secondary incisions were significantly increased in the first postoperative day and then significantly decreased after 1 month. All irregularities occurred in the posterior surface (endothelium): 2 cases of posterior gap (first day) and 1 case of posterior retraction (first month). The HOAs had not significantly changed preoperatively and after 1 month. CONCLUSIONS The femtosecond laser refractive lens surgery incision is stable and does not significantly change the HOA.
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Javaloy J, Alió JL, Rodriguez AE, Vega A, Muñoz G. Effect of platelet-rich plasma in nerve regeneration after LASIK. J Refract Surg 2013; 29:213-9. [PMID: 23446019 DOI: 10.3928/1081597x-20130129-04] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 12/11/2012] [Indexed: 01/24/2023]
Abstract
PURPOSE To investigate the effect of topical eye application of platelet-rich plasma (E-PRP) on the recovery of corneal sensitivity after LASIK and the anatomical recovery of the sub-basal corneal plexus as studied by confocal microscopy. METHODS This was a randomized, consecutive, controlled, prospective and masked study on 108 myopic eyes receiving LASIK. The main variables of the study were the increase in corneal sensitivity (Cochet-Bonet aesthesiometer; Luneau, Paris, France) and the aspect of the sub-basal nerve plexus (confocal microscope). Additionally, a biomicroscopic study of the epithelial status of the cornea and a subjective questionnaire were completed. Each eye of each patient was assigned to one of two groups: 54 eyes treated with balanced saline solution and 54 fellow eyes receiving PRP drops for 3 months. RESULTS No significant differences were detected when the corneal sensitivity thresholds were compared at any postoperative visit in both groups (P > .05 for all comparisons). Almost identical sub-basal fiber densities were estimated for both groups before LASIK (t test, P = .66). However, the type and severity of staining detected during the slit-lamp examinations at the first and third month postoperatively were significantly less evident in the E-PRP treatment group (Wilcoxon test, P < .05). CONCLUSIONS PRP drops have beneficial effects for promoting epithelial status after LASIK but have no positive effect on recovery of corneal sensitivity, probably due to the limited bioavailability of growth factors in corneal stroma when the substance is topically administered.
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Alió JL, Plaza-Puche AB, Javaloy J, Ayala MJ, Vega-Estrada A. Clinical and Optical Intraocular Performance of Rotationally Asymmetric Multifocal IOL Plate-Haptic Design Versus C-Loop Haptic Design. J Refract Surg 2013; 29:252-9. [PMID: 23557223 DOI: 10.3928/1081597x-20130318-04] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 01/17/2013] [Indexed: 11/20/2022]
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Vega-Estrada A, Alio JL, Brenner LF, Javaloy J, Plaza Puche AB, Barraquer RI, Teus MA, Murta J, Henriques J, Uceda-Montanes A. Outcome analysis of intracorneal ring segments for the treatment of keratoconus based on visual, refractive, and aberrometric impairment. Am J Ophthalmol 2013; 155:575-584.e1. [PMID: 23218702 DOI: 10.1016/j.ajo.2012.08.020] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 08/29/2012] [Accepted: 08/29/2012] [Indexed: 01/13/2023]
Abstract
PURPOSE To analyze the outcomes of intracorneal ring segment (ICRS) implantation for the treatment of keratoconus based on preoperative visual impairment. DESIGN Multicenter, retrospective, nonrandomized study. METHODS A total of 611 eyes of 361 keratoconic patients were evaluated. Subjects were classified according to their preoperative corrected distance visual acuity (CDVA) into 5 different groups: grade I, CDVA of 0.90 or better; grade II, CDVA equal to or better than 0.60 and worse than 0.90; grade III, CDVA equal to or better than 0.40 and worse than 0.60; grade IV, CDVA equal to or better than 0.20 and worse than 0.40; and grade plus, CDVA worse than 0.20. Success and failure indices were defined based on visual, refractive, corneal topographic, and aberrometric data and evaluated in each group 6 months after ICRS implantation. RESULTS Significant improvement after the procedure was observed regarding uncorrected distance visual acuity in all grades (P < .05). CDVA significantly decreased in grade I (P < .01) but significantly increased in all other grades (P < .05). A total of 37.9% of patients with preoperative CDVA 0.6 or better gained 1 or more lines of CDVA, whereas 82.8% of patients with preoperative CDVA 0.4 or worse gained 1 or more lines of CDVA (P < .01). Spherical equivalent and keratometry readings showed a significant reduction in all grades (P ≤ .02). Corneal higher-order aberrations did not change after the procedure (P ≥ .05). CONCLUSIONS Based on preoperative visual impairment, ICRS implantation provides significantly better results in patients with a severe form of the disease. A notable loss of CDVA lines can be expected in patients with a milder form of keratoconus.
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Signes-Soler I, Piñero DP, Javaloy J. Prevalence of visual problems in a rural population of Kenya. Acta Ophthalmol 2013; 91:e165-6. [PMID: 22974434 DOI: 10.1111/j.1755-3768.2012.02507.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Montalbán R, Alio JL, Javaloy J, Piñero DP. Comparative analysis of the relationship between anterior and posterior corneal shape analyzed by Scheimpflug photography in normal and keratoconus eyes. Graefes Arch Clin Exp Ophthalmol 2013; 251:1547-55. [PMID: 23334367 DOI: 10.1007/s00417-013-2261-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/16/2012] [Accepted: 01/03/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To analyze and compare the relationship between anterior and posterior corneal shape evaluated by a tomographic system combining the Scheimpflug photography and Placido-disc in keratoconus and normal healthy eyes, as well as to evaluate its potential diagnostic value. METHODS Comparative case series including a sample of 161 eyes of 161 subjects with ages ranging from 7 to 66 years and divided into two groups: normal group including 100 healthy eyes of 100 subjects, and keratoconus group including 61 keratoconus eyes of 61 patients. All eyes received a comprehensive ophthalmologic examination including an anterior segment analysis with the Sirius system (CSO). Antero-posterior ratios for corneal curvature (k ratio) and shape factor (p ratio) were calculated. Logistic regression analysis was used to evaluate if some antero-posterior ratios combined with other clinical parameters were predictors of the presence of keratoconus. RESULTS No statistically significant differences between groups were found in the antero-posterior k ratios for 3-, 5- and 7-mm diameter corneal areas (p ≥ 0.09). The antero-posterior p ratio for 4.5- and 8-mm diameter corneal areas was significantly higher in the normal group than in the keratoconus group (p<0.01). The k ratio for 3, 5, and 7 mm was significantly higher in the keratoconus grade IV subgroup than in the normal group (p<0.01). Furthermore, significant differences were found in the p ratio between the normal group and the keratoconus grade II subgroup (p ≤ 0.01). Finally, the logistic regression analysis identified as significant independent predictors of the presence of keratoconus (p<0.01) the 8-mm anterior shape factor, the anterior chamber depth, and the minimal corneal thickness. CONCLUSIONS The antero-posterior k and p ratios are parameters with poor prediction ability for keratoconus, in spite of the trend to the presence of more prolate posterior corneal surfaces compared to the anterior in keratoconus eyes.
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Montalbán R, Piñero DP, Javaloy J, Alió JL. Scheimpflug photography-based clinical characterization of the correlation of the corneal shape between the anterior and posterior corneal surfaces in the normal human eye. J Cataract Refract Surg 2012; 38:1925-33. [PMID: 22981614 DOI: 10.1016/j.jcrs.2012.06.050] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 06/14/2012] [Accepted: 06/19/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the correlation of the mean curvature and shape factors between both corneal surfaces for different corneal diameters measured with a Scheimpflug photography-based system. SETTING Vissum Corporation, Alicante, Spain. DESIGN Case series. METHODS Randomly selected healthy normal eyes had a comprehensive ophthalmologic examination including anterior segment analysis with the Sirius system as follows: anterior and posterior mean corneal radius for 3.0 mm, 5.0 mm, and 7.0 mm; anterior and posterior mean shape factor for 4.5 mm and 8.0 mm; central (CCT) and minimum corneal thickness; and anterior chamber depth (ACD). RESULTS The study enrolled 117 eyes (117 subjects; aged 7 to 80 years). The mean anterior mean corneal radius:posterior mean corneal radius ratio was 1.19 (range 1.12 to 1.27) for all corneal diameters (P = .86). The correlation coefficient between the anterior and posterior mean corneal radius was 0.85 or more for all corneal diameters. The anterior mean shape factor:posterior mean shape factor ratio for the 2 corneal diameters analyzed was approximately 1 (range 0.45 to 4.03). The correlations between anterior and posterior mean shape factors were extremely poor and not significant. Multiple regression analysis showed that the central posterior mean corneal radius was significantly correlated with the anterior mean corneal radius, CCT, and spherical equivalent (R(2) = 0.77, P<.01). CONCLUSIONS Central posterior corneal curvature could be predicted from the anterior corneal curvature, pachymetry, and the refractive status of the eye but not from the corneal shape factor. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Signes-Soler I, Javaloy J, Montes-Mico R, Muñoz G. Cataract surgery in West Africa: is couching still a choice? Acta Ophthalmol 2012; 90:e488-9. [PMID: 22429385 DOI: 10.1111/j.1755-3768.2011.02361.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alió JL, Plaza-Puche AB, Montalban R, Javaloy J. Visual outcomes with a single-optic accommodating intraocular lens and a low-addition-power rotational asymmetric multifocal intraocular lens. J Cataract Refract Surg 2012; 38:978-85. [PMID: 22624896 DOI: 10.1016/j.jcrs.2011.12.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 11/24/2011] [Accepted: 12/07/2011] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the visual outcomes and intraocular optical quality in patients with a low-addition (add) power multifocal refractive intraocular lens (IOL) with rotational asymmetry and a single-optic accommodating IOL. SETTING Vissum Instituto Oftalmológico de Alicante, Miguel Hérnandez University, Alicante, Spain. DESIGN Prospective comparative nonrandomized consecutive case series. METHODS Consecutive cataract patients had implantation of a low-add-power refractive multifocal IOL with rotational asymmetry (Lentis-Mplus LS-312 MF15) (multifocal group) or a single-optic accommodating IOL (Crystalens HD) (accommodating group). Distance and near visual acuities were evaluated. Ocular optical quality, intraocular aberrations, defocus curve, and contrast sensitivity were evaluated postoperatively. RESULTS Of the 66 eyes (40 patients; age 61 to 81 years), 31 were in the multifocal group and 35 were in the accommodating group. Postoperatively, both groups had a significant improvement in the uncorrected and corrected distance visual acuities and uncorrected (UNVA) and corrected near (CNVA) near visual acuities (P <.01). Distance-corrected near visual acuity was significantly better in the multifocal group postoperatively (P ≤.04). No significant differences in UNVA and CNVA were detected postoperatively (P ≥.09). In the defocus curve, the multifocal group had significantly better visual acuities at several defocus levels. The accommodating group had better contrast sensitivity under photopic conditions at all spatial frequencies (P ≤.04). The multifocal group had significantly higher postoperative intraocular tilt (P <.01). CONCLUSIONS Both IOLs restored distance vision. The refractive multifocal IOL provided better near visual rehabilitation.
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Montalbán R, Piñero DP, Javaloy J, Alió JL. Intrasubject repeatability of corneal morphology measurements obtained with a new Scheimpflug photography–based system. J Cataract Refract Surg 2012; 38:971-7. [DOI: 10.1016/j.jcrs.2011.12.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 11/22/2011] [Accepted: 12/06/2011] [Indexed: 10/28/2022]
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Muñoz G, Albarrán-Diego C, Javaloy J, Sakla HF, Cerviño A. Combining Zonal Refractive and Diffractive Aspheric Multifocal Intraocular Lenses. J Refract Surg 2012; 28:174-81. [DOI: 10.3928/1081597x-20120215-02] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 01/05/2012] [Indexed: 11/20/2022]
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Alio JL, Plaza-Puche AB, Javaloy J, Ayala MJ, Moreno LJ, Piñero DP. Comparison of a New Refractive Multifocal Intraocular Lens with an Inferior Segmental Near Add and a Diffractive Multifocal Intraocular Lens. Ophthalmology 2012; 119:555-63. [DOI: 10.1016/j.ophtha.2011.08.036] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 08/22/2011] [Accepted: 08/22/2011] [Indexed: 10/14/2022] Open
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Alió JL, Plaza-Puche AB, Javaloy J, Ayala MJ. Comparison of the Visual and Intraocular Optical Performance of a Refractive Multifocal IOL With Rotational Asymmetry and an Apodized Diffractive Multifocal IOL. J Refract Surg 2012; 28:100-5. [DOI: 10.3928/1081597x-20120110-01] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 11/08/2011] [Indexed: 11/20/2022]
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Muñoz G, Albarrán-Diego C, Ferrer-Blasco T, Javaloy J, García-Lázaro S. Single versus double femtosecond laser pass for incomplete laser in situ keratomileusis flap in contralateral eyes: Visual and optical outcomes. J Cataract Refract Surg 2012; 38:8-15. [DOI: 10.1016/j.jcrs.2011.06.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 06/19/2011] [Accepted: 06/22/2011] [Indexed: 10/14/2022]
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Javaloy J, Alió JL, Rodríguez A, González A, Pérez-Santonja JJ. Epidemiological Analysis of an Outbreak of Diffuse Lamellar Keratitis. J Refract Surg 2011; 27:796-803. [DOI: 10.3928/1081597x-20110411-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Accepted: 03/25/2011] [Indexed: 11/20/2022]
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Alió JL, Toffaha BT, Piñero DP, Klonowski P, Javaloy J. Cross-linking in Progressive Keratoconus Using an Epithelial Debridement or Intrastromal Pocket Technique After Previous Corneal Ring Segment Implantation. J Refract Surg 2011; 27:737-43. [DOI: 10.3928/1081597x-20110705-01] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 06/14/2011] [Indexed: 11/20/2022]
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