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Pérez-Peralta L, Rivera-De la-Parra D, Graue-Hernández EO, Hernández-Jiménez S, Almeda-Valdés P, Velázquez-Jurado H, Jiménez-Corona A. [Authors' reply to the letter to the editor "Artificial intelligence and screening for visual impairment related to diabetic retinopathy and macular edema"]. GAC MED MEX 2024. [PMID: 38588511 DOI: 10.24875/gmm.24000056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Affiliation(s)
- Liliana Pérez-Peralta
- Instituto de Oftalmología, Fundación "Conde de Valenciana", Ciudad de México, México
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | - David Rivera-De la-Parra
- Instituto de Oftalmología, Fundación "Conde de Valenciana", Ciudad de México, México
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | | | - Sergio Hernández-Jiménez
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | - Paloma Almeda-Valdés
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | - Héctor Velázquez-Jurado
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | - Aída Jiménez-Corona
- Instituto de Oftalmología, Fundación "Conde de Valenciana", Ciudad de México, México
- Dirección General de Epidemiología, Secretaría de Salud, Ciudad de México, México
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Salcedo-Ledesma A, Córdoba A, Zatarain-Barrón NC, Graue-Hernández EO, Garfias Y, Morales Flores N, García-Sánchez GA, García-Santisteban D, Linares-Alba MA, García-Santisteban R, Navas A. Subconjunctival Sirolimus-Loaded Liposomes for the Treatment of Moderate-to-Severe Dry Eye Disease. Clin Ophthalmol 2023; 17:1295-1305. [PMID: 37181078 PMCID: PMC10167993 DOI: 10.2147/opth.s405841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/20/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose To determine the effectiveness of subconjunctival application of a novel sirolimus liposomal formulation for the treatment of dry eye. Methods A randomized, triple-blind, Phase II clinical trial. Thirty-eight eyes of 19 patients were included. Nine patients (18 eyes) assigned to the sham group (Sham) and 10 patients (20 eyes) to sirolimus-loaded liposomes group (Sirolimus). The treatment group received three doses of subconjunctival liposome-encapsulated sirolimus and the sham group received three doses of liposomal suspension without sirolimus. Subjective (Ocular Surface Disease Index, OSDI) and measured (corrected distance visual acuity, conjunctival hyperemia, tear osmolarity, Schirmer's test, corneal/conjunctival staining and matrix metalloproteinase-9) variables were measured. Results Sirolimus-entrapped liposomes-treated group OSDI scores changed from 62.19 (± 6.07) to 37.8 (± 17.81) (p=0.0024), and conjunctival hyperemia from 2.0 (± 0.68) to 0.83 (± 0.61) (p<0.0001); Sham group with OSDI scores from 60.02 (± 14.2) to 36.02 (± 20.70) (p=0.01), and conjunctival hyperemia from 1.33 (± 0.68) to 0.94 (± 0.87) (p=0.048). All the other evaluated outcomes only showed significant differences in the sirolimus group: corneal/conjunctival staining score (p=0.0015), lipid layer interferometry (p=0.006), and inferior meibomian gland dropout (p=0.038). No local or systemic adverse effects regarding the medication itself were reported, and the administration route was well accepted. Conclusion Our findings suggest that sub-conjunctival sirolimus-loaded liposomes are effective in reducing both signs and symptoms of dry eye in patients with poorly controlled moderate-to-severe DED, while avoiding other topical administration adverse effects. Further investigation with a larger sample size is required to determine long-term effects.
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Affiliation(s)
- Alfredo Salcedo-Ledesma
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
- PECEM MD/PhD Program, Faculty of Medicine, UNAM, Mexico City, Mexico
| | - Andrea Córdoba
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | - Naomi C Zatarain-Barrón
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | - Yonathan Garfias
- Department of Biochemistry, Faculty of Medicine, UNAM, Mexico City, Mexico
- Research Unit, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | - Norma Morales Flores
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
| | | | | | | | | | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City, Mexico
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Morales-Flores N, Murillo-López AP, Pedro-Aguilar L, Graue-Hernández EO, Navas A. [Results of one decade of optical keratoplasty in pediatric patients]. GAC MED MEX 2023; 159. [PMID: 36857726 DOI: 10.24875/gmm.22000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/05/2022] [Indexed: 03/03/2023] Open
Affiliation(s)
- Norma Morales-Flores
- Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Conde de Valenciana, Ciudad de México, México
| | - Ana P Murillo-López
- Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Conde de Valenciana, Ciudad de México, México
| | - Lucero Pedro-Aguilar
- Banco de Ojos, Instituto de Oftalmología Conde de Valenciana, Ciudad de México, México
| | - Enrique O Graue-Hernández
- Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Conde de Valenciana, Ciudad de México, México
| | - Alejandro Navas
- Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Conde de Valenciana, Ciudad de México, México
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Navas A, Graue-Hernández EO, Perez VL, Garfias Y. Editorial: Dry eye disease syndrome. Front Med (Lausanne) 2023; 9:1104593. [PMID: 36687451 PMCID: PMC9846630 DOI: 10.3389/fmed.2022.1104593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Alejandro Navas
- Cell and Tissue Biology and Cornea Departments, Instituto de Oftalmología Fundación de Asistencia Privada Conde de Valenciana, I.A.P, Mexico City, Mexico,*Correspondence: Alejandro Navas ✉
| | - Enrique O. Graue-Hernández
- Cell and Tissue Biology and Cornea Departments, Instituto de Oftalmología Fundación de Asistencia Privada Conde de Valenciana, I.A.P, Mexico City, Mexico,Enrique O. Graue-Hernández ✉
| | - Victor L. Perez
- Department of Ophthalmology, School of Medicine, Duke University, Durham, NC, United States,Victor L. Perez ✉
| | - Yonathan Garfias
- Cell and Tissue Biology and Cornea Departments, Instituto de Oftalmología Fundación de Asistencia Privada Conde de Valenciana, I.A.P, Mexico City, Mexico,Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico,Yonathan Garfias ✉
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Morales-Flores N, Murillo-López AP, Pedro-Aguilar L, Graue-Hernández EO, Navas A. Authors' reply to the letter about comments on the article "Results of one decade of optical keratoplasty in pediatric patients". GAC MED MEX 2023; 159:362-363. [PMID: 37699213 DOI: 10.24875/gmm.m23000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 09/14/2023] Open
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Morales-Flores N, Murillo-López AP, Pedro-Aguilar L, Graue-Hernández EO, Navas A. Results of one decade of optical keratoplasty in pediatric patients. GAC MED MEX 2023; 159:116-121. [PMID: 37094240 DOI: 10.24875/gmm.m22000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/05/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Keratoplasty in the pediatric population has been considered a high-risk procedure. OBJECTIVE To know the demographic data of patients younger than 18 years treated with optical keratoplasty, indications for surgery and its results. MATERIAL AND METHODS A retrospective study was carried out at Conde de Valenciana Ophthalmology Institute, in which the medical records of patients younger than 18 years treated with optical keratoplasty from 2009 to 2019 were analyzed. RESULTS A total of 53 eyes were included. The most common diagnosis and procedure were keratoconus and penetrating keratoplasty, respectively. Mean initial visual acuity was 2.05 ± 0.99 logMAR, and 0.82 ± 1.33 at last visit. Survival time was 130.34 months. Four failures were recorded. As for associated surgeries, corneal wound closure was recorded in seven eyes prior to transplant; during the keratoplasty procedure, anterior vitrectomy in two eyes, and after the transplant, Ahmed valve implantation and re-suture. A total of eight eyes had glaucoma, five of them diagnosed prior to transplantation. Regarding rejection, 15 eyes had an episode during follow-up, and mean time to transplant rejection was 10.8 months. CONCLUSION Prolonged graft survival can be achieved with better knowledge and management of different associated factors.
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Garcia-Terraza AL, Jimenez-Collado D, Sanchez-Sanoja F, Arteaga-Rivera JY, Morales Flores N, Pérez-Solórzano S, Garfias Y, Graue-Hernández EO, Navas A. Reliability, repeatability, and accordance between three different corneal diagnostic imaging devices for evaluating the ocular surface. Front Med (Lausanne) 2022; 9:893688. [PMID: 35966863 PMCID: PMC9372285 DOI: 10.3389/fmed.2022.893688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To evaluate repeatability, reproducibility, and accordance between ocular surface measurements within three different imaging devices. Methods We performed an observational study on 66 healthy eyes. Tear meniscus height, non-invasive tear break-up time (NITBUT) and meibography were measured using three corneal imaging devices: Keratograph 5M (Oculus, Wetzlar, Germany), Antares (Lumenis, Sidney, Australia), and LacryDiag (Quantel Medical, Cournon d'Auvergne, France). One-way ANOVAs with post hoc analyses were used to calculate accordance between the tear meniscus and NITBUT. Reproducibility was assessed through coefficients of variation and repeatability with intraclass correlation coefficients (ICC). Reliability of meibography classification was analyzed by calculating Fleiss' Kappa Index and presented in Venn diagrams. Results Coefficients of variation were high and differed greatly depending on the device and measurement. ICCs showed moderate reliability of NITBUT and tear meniscus height measurements. We observed discordance between measurements of tear meniscus height between the three devices, F2, 195 = 15.24, p < 0.01. Measurements performed with Antares were higher; 0.365 ± 0.0851, than those with Keratograph 5M and LacryDiag; 0.293 ± 0.0790 and 0.306 ± 0.0731. NITBUT also showed discordance between devices, F2, 111 = 13.152, p < 0.01. Measurements performed with LacryDiag were lower (10.4 ± 1.82) compared to those of Keratograph 5M (12.6 ± 4.01) and Antares (12.6 ± 4.21). Fleiss' Kappa showed a value of -0.00487 for upper lid and 0.128 for inferior lid Meibography classification, suggesting discrete to poor agreement between measurements. Conclusion Depending on the device used and parameter analyzed, measurements varied between each other, showing a difference in image processing.
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Affiliation(s)
- Abril L. Garcia-Terraza
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
- Faculty of Medicine, Autonomous University of Baja California, Mexicali, Baja California, Mexico
| | - David Jimenez-Collado
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
- School of Medicine, Panamerican University, Mexico City, Mexico
| | - Francisco Sanchez-Sanoja
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
- Faculty of Health Sciences North Campus, Anáhuac University, Mexico City, Mexico
| | - José Y. Arteaga-Rivera
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Norma Morales Flores
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Sofía Pérez-Solórzano
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Yonathan Garfias
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Enrique O. Graue-Hernández
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
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Blanco-Campoy DG, Graue-Hernández EO, Quiróz-Casian N, Vélez-Cordero JR, Yáñez-Soto B. In-vitro evaluation of the evaporation retardation by Meibomian lipids in homogeneous and non-homogeneous evaporation. J Colloid Interface Sci 2022; 625:210-219. [PMID: 35716616 DOI: 10.1016/j.jcis.2022.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 10/31/2022]
Abstract
HYPOTHESIS An important function of the Tear Film Lipid Layer (TFLL) is the retardation of evaporation. We propose two micro-scaled systems to quantify the influence of the TFLL in evaporation for single patients, which may contribute as an improvement on the diagnosis of Meibomian Gland Dysfunctions (MGD). EXPERIMENTS Meibum was extracted from 10 patients with hypersecretory MGD and 9 healthy controls. The lipids were placed over water, and the evaporation was determined in the case of homogeneous evaporation over a surface (pendant drop), and the case where the evaporation depends on a pinned triple contact line (meniscus). FINDINGS For the homogeneous case, the presence of Meibum reduced evaporation in 30%, although there was no significant difference between controls and MGD patients. However, evaporation induced by menisci was 25 % higher in MGD patients. Our results contribute to the evidence of the inhibition of evaporation by Meibum. Our study also suggests that the evaporation induced by contact points may be a more relevant model to measure differences in evaporation due to the composition of Meibum. This model may also have connotations in the occurrence of internal stresses in the tear film, inducing its instability.
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Affiliation(s)
| | - Enrique O Graue-Hernández
- Cornea & Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, 06700, México
| | - Natalia Quiróz-Casian
- Cornea & Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana, IAP, 06700, México
| | - Juan R Vélez-Cordero
- Conacyt - Instituto de Física, Universidad Autónoma de San Luis Potosí 78000, México.
| | - Bernardo Yáñez-Soto
- Conacyt - Instituto de Física, Universidad Autónoma de San Luis Potosí 78000, México.
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González-Abadía A, Graue-Hernández EO, Viesca-Treviño C, Navas A. Belisario Domínguez: A life and death deserving of a medal. J Med Biogr 2021:9677720211065353. [PMID: 34927472 DOI: 10.1177/09677720211065353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Belisario Domínguez was a Mexican physician, ophthalmologist, and politician. He traveled abroad to France, where he studied High School, later he entered the School of Medicine at Sorbonne University in Paris. Back in Mexico, Domínguez installed his medical office in his house. Belisario was recognized for his philanthropic attitude, he also often sought the well-being being of Chiapas and Mexico. In 1911 he became Comitán Municipal President, after the overthrown of presidente Porfirio Díaz.He witnessed the coup against President Francisco Madero by General Huerta. Belisario wrote a speech in which he expressed the shame of having a traitor and murderer as President. As consequence of the speech, he was killed. After Belisario's assassination, an outrage was incited, damaging the image of President Huerta. Belisario's civic value was honored with a medal that bears his name " Belisario Domínguez Medal" in 1953 which is the greatest recognition that can be obtained by a Mexican.
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Affiliation(s)
- Alejandro González-Abadía
- Department of Cornea and Refractive Surgery, 333223Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, 333223Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Carlos Viesca-Treviño
- National Academy of Medicine, Department of History and Philosophy of Medicine, Faculty of Medicine, UNAM, President of the International Society for the History of Medicine, Ciudad de Mexico, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, 333223Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
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Hernández-Jiménez S, García-Ulloa AC, Anaya P, Gasca-Pineda R, Sánchez-Trujillo LA, Peña Baca H, González-Pier E, Graue-Hernández EO, Aguilar-Salinas CA, Gómez-Pérez FJ, Kershenobich-Stalnikowitz D. Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City. BMJ Open Diabetes Res Care 2021; 9:9/1/e002097. [PMID: 34167953 PMCID: PMC8230997 DOI: 10.1136/bmjdrc-2020-002097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/05/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION To assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions. RESEARCH DESIGN AND METHODS Using a cost-effectiveness analysis, we compared the CAIPaDi program versus usual treatment given in Mexican public health institutions. The analysis was based on the IQVIA Core Diabetes Model, a validated simulation model used to estimate long-term clinical outcomes. Data were prospectively obtained from the CAIPaDi program and from public databases and published papers. Health outcomes were expressed in terms of life-years gained and quality-adjusted life years (QALYs). Health and economic outcomes were estimated from a public perspective and discounted at 5% per year over a 20-year horizon. Costs are reported in US dollars (US$) of 2019. A probabilistic sensitivity analysis was performed using life-years gained and QALYs. RESULTS The CAIPaDi costs on average US$559 (95% CI: -$879 to -$239) less than the usual treatment (95% CI: -$879 to -$239) and produced a difference in mean life-years gained (0.48, 95% CI: 0.45 to 0.52) and mean QALYs (1.43, 95% CI: 1.40 to 1.46). The cost-effectiveness ratio resulted in a saving per life-year gained of -US$1155 (95% CI: -$1962 to -$460). Mean differences in QALYs resulted in a saving per QALY of -US$735 (95% CI: -$1193 to -$305). Probabilistic sensitivity analysis proved the results are robust on both life-years gained and QALYs. CONCLUSIONS CAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions.
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Affiliation(s)
| | | | | | | | | | | | | | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana Foundation IAP, Mexico City, Mexico
| | - Carlos Alberto Aguilar-Salinas
- Endocrinology and Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Tlalpan, Mexico
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, Mexico
| | - Franciso Javier Gómez-Pérez
- Endocrinology and Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Tlalpan, Mexico
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Toro-Giraldo L, Morales Flores N, Santana-Cruz O, Ramirez-Miranda A, Navas A, Olivo-Payne A, Lichtinger A, Jimenez-Corona A, Graue-Hernández EO. Cool Crosslinking: Riboflavin at 4°C for Pain Management After Crosslinking for Keratoconus Patients, A Randomized Clinical Trial. Cornea 2021; 40:1-4. [PMID: 33264161 DOI: 10.1097/ico.0000000000002484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore corneal cooling as a method of pain management in corneal-accelerated collagen cross-linking. METHODS This was a prospective and interventional randomized clinical trial registered in the National Institutes of Health Clinical Trials through the identifier NCT030760770. The research was conducted at the Institute of Ophthalmology "Conde de Valenciana." A total of 98 patients were randomly assigned to one of the following 2 groups: cold riboflavin (4°C) group or control group (riboflavin at room temperature). The inclusion criteria were patients of any sex, older than 18 years of age with keratoconus diagnosis who needed management with cross-linking in both eyes because of the evidence of progression. The exclusion criteria were patients who had cross-linking without epithelial debridement, unilateral cross-linking, or any other ocular pathologies besides keratoconus and any cognitive incapacity that would make the understanding of the pain test difficult. The main outcome measures were pain, tearing, photophobia, foreign body sensation, and irritation. RESULTS At 2 hours post-op, pain in the case and control groups was 3.80 ± 3.00 and 8.08 ± 2.21 (P < 0.05), tearing was 1.56 ± 1.96 and 8.29 ± 2.42 (P < 0.05), photophobia was 5.44 ± 3.57 and 7.83 ± 2.64 (P < 0.05), foreign body sensation was 2.20 ± 2.78 and 6.54 ± 2.73 (P < 0.05), and irritation was 3.48 ± 2.98 and 6.79 ± 3.00 (P < 0.05), respectively. A statistical significant difference was maintained in pain values on day 1 (2.79 ± 3.09 and 4.91 ± 3.27 [P < 0.05]), 2 (2.54 ± 2.41 and 4.00 ± 2.43 [P < 0.05]), and 4 (0.45 ± 0.76 and 1.22 ± 1.67 [P < 0.05]). CONCLUSIONS This study demonstrated that pain and associated symptoms decreased significantly in the riboflavin 4°C group.
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Affiliation(s)
- Laura Toro-Giraldo
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Norma Morales Flores
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Omar Santana-Cruz
- Department of Optometry, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico; and
| | - Arturo Ramirez-Miranda
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Andrew Olivo-Payne
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Alejandro Lichtinger
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Aida Jimenez-Corona
- Department of Ocular Epidemiology and Public Health, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea, External Disease and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico
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Vázquez-Durán M, Jiménez-Corona ME, Moreno-Altamirano L, Graue-Hernández EO, Guarneros N, Jiménez-Corona L, Jiménez-Corona A. Social determinants for overweight and obesity in a highly marginalized population from Comitán, Chiapas, Mexico. Salud Publica Mex 2020; 62:477-486. [PMID: 33027859 DOI: 10.21149/10691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 03/11/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We assessed the prevalence of overweight and obesity and its association with some social determinants in a highly marginalized population in Mexico. MATERIALS AND METHODS Cross-sectional study conducted in Comitán, Chiapas, from 2010 to 2012, comprising 1 858 subjects aged ≥20 years. We evaluated proximal, intermediate, and structuralsocial determinants. RESULTS The prevalence of overweight and obesity was 37.9 and 16.5%, respectively. The probability of overweight and obesity was higher in participants with ≥primary school, self-reported non-indigenous origin, and medium level of marginalization compared with those with <primary school, self-reported indigenous origin, and high/very high level of marginalization. CONCLUSIONS The pro-bability of overweight and obesity was higher in population with more favorable social conditions, which may be partially explained by changes in the traditional lifestyle with greater access to high energy foods and physical inactivity.
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Affiliation(s)
- Marisela Vázquez-Durán
- Departamento de Epidemiología Ocular y Salud Visual, Instituto de Oftalmología Conde de Valenciana IAP. Mexico City, Mexico
| | - María Eugenia Jiménez-Corona
- Departamento de Epidemiología, Instituto Nacional de Cardiología Ignacio Chávez, Secretaría de Salud. Mexico City, Mexico
| | | | - Enrique O Graue-Hernández
- Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Conde de Valenciana IAP. Mexico City, Mexico
| | - Noé Guarneros
- Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | | | - Aída Jiménez-Corona
- Departamento de Epidemiología Ocular y Salud Visual, Instituto de Oftalmología Conde de Valenciana IAP. Mexico City, Mexico.,Dirección General de Epidemiología, Secretaría de Salud. Mexico City, Mexico
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Serna-Ojeda JC, García-Mejía M, Graue-Hernández EO, Navas A, Garfias Y. Short-Term Results Analysis in the Allogenic Transplantation of Limbal Stem Cells Expanded on Amniotic Membrane in Patients with Bilateral Limbal Stem Cell Deficiency. J Ocul Pharmacol Ther 2020; 36:238-246. [PMID: 32077779 DOI: 10.1089/jop.2019.0147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose: The objective of this study was to describe the short-term results of allogenic transplantation of limbal stem cells expanded on amniotic membrane for the ocular surface reconstruction. Methods: Prospective nonrandomized, nonmasked study in a single ophthalmological center. Ten patients with bilateral total limbal stem cell deficiency (LSCD) were included. Expression and presence of ABCB5 and Δp63α in amniotic membrane-cultured limbal epithelial stem cells were analyzed, in relationship with clinical changes after allogenic transplantation. An objective evaluation was performed to determine corneal transparency and superficial vascularization. Results: In a median follow-up time of 11.6 months, 7 patients (70%) were considered as failure compared with the preoperative status. ABCB5 and Δp63α are expressed in similar amount in the limbal epithelial cells expanded in vitro and transplanted in patients with bilateral LSCD. Conclusions: Transplantation of allogenic epithelial limbal cells expanded in amniotic membrane could be considered in patients with LSCD due to burns or congenital etiologies such as aniridia, but its benefit is limited for patients with immunologic diseases.
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Affiliation(s)
- Juan Carlos Serna-Ojeda
- Cornea and Refractive Surgery Department, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico.,Instituto Visión Láser, Aguascalientes, Mexico.,Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico
| | - Mariana García-Mejía
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Cornea and Refractive Surgery Department, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico
| | - Alejandro Navas
- Cornea and Refractive Surgery Department, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico
| | - Yonathan Garfias
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Mexico City, Mexico.,Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
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14
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Córdoba A, Graue-Hernández EO, Navas A, Chacon-Camacho OF, Zenteno JC, Ramirez-Miranda A, Bermudez-Magner JA, Ordaz-Robles T, Pérez-Solórzano S, Olivo-Payne A. Giant Ocular Lipodermoid Cyst in Encephalocraniocutaneous Lipomatosis: Surgical Treatment and Genetic Analysis. Am J Case Rep 2019; 20:1566-1571. [PMID: 31649234 PMCID: PMC6824416 DOI: 10.12659/ajcr.918684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Encephalocraniocutaneous lipomatosis is a rare neurocutaneous disorder characterized by cutaneous, ocular, and central nervous system anomalies; its molecular etiology was recently identified. This report describes the surgical treatment and genetic characterization of a giant ocular lipodermoid cyst secondary to encephalocraniocutaneous lipomatosis. CASE REPORT An 11-year-old girl with past medical history of absence seizures presented with a reddish protruding mass in her right eye involving the temporal conjunctiva and the peripheral temporal cornea; eyelid closure was not possible due to mass protrusion. She also presented skin tags at the level of the external canthus and 3 alopecic areas at the level of the scalp compatible with nevus psiloliparus. No family history was reported. A dermoid cyst was suspected and excisional biopsy was performed under general anesthesia. A large conjunctival and lamellar corneoscleral resection was done, followed by a corneal tectonic graft. Molecular analysis was carried out, including PCR and Sanger sequencing on DNA obtained from the mass. After surgery, the patient achieved complete eyelid closure, reduction of ocular surface symptoms, and improved aesthetic appearance. Histological analysis confirmed a lipodermoid cyst; genetic tests confirmed a mosaic activating mutation in FGFR1 (c.1638C>A, p.Asn546Lys). The diagnosis was encephalocraniocutaneous lipomatosis. CONCLUSIONS ECCL is a rare condition; an accurate diagnosis comprising clinical and genetic aspects can facilitate the monitoring of possible complications, improve the multidisciplinary treatment, and provide valuable information for future therapy developments. In this case, the patient's quality of life improved significantly, ocular symptoms disappeared, and a good esthetic appearance was achieved.
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Affiliation(s)
- Andrea Córdoba
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Oscar F Chacon-Camacho
- Department of Genetics, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Juan C Zenteno
- Department of Genetics, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico.,Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | | | - Thania Ordaz-Robles
- Department of Genetics, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Sofia Pérez-Solórzano
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
| | - Andrew Olivo-Payne
- Department of Cornea and Refractive Surgery, Conde de Valenciana Institute of Ophthalmology, Mexico City, Mexico
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15
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Graue-Hernández EO, Gómez-Dantés H, Romero-Martínez M, Bravo G, Arrieta-Camacho J, Jiménez-Corona A. Self-reported hearing loss and visual impairment in adults from Central Mexico. ACTA ACUST UNITED AC 2019; 61:629-636. [DOI: 10.21149/10086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/21/2019] [Indexed: 11/06/2022]
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16
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Graue-Hernández EO, Serna-Ojeda JC, Estrada-Reyes C, Navas A, Arrieta-Camacho J, Jiménez-Corona A. Dry eye symptoms and associated risk factors among adults aged 50 or more years in Central Mexico. Salud Publica Mex 2019; 60:520-527. [PMID: 30550113 DOI: 10.21149/9024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 03/27/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To determine the prevalence of dry eye symptoms (DES) and associated risk factors among adults in Tlaxcala, Mexico. MATERIALS AND METHODS A cross-sectional population-based study that included 1 508 individuals aged ≥50 years who answered the Dry Eye Questionnaire (DEQ5), with a score ranging between 0 and 22; the following categories were defined: no DES (<6); mild-moderate DES (6 to 11) and severe DES (≥12). RESULTS The prevalence of DES was 41.1% (95%CI 38.6-43.6), and was higher in women (OR=2.26, 95%IC 1.70-3.00), in individuals with smoking index of <10 (OR=1.40, 95%CI 1.05-1.87) and ≥10 pack-years (OR=2.29, 95%CI 1.44-3.63), compared to never-smokers, subjects with history of ever consuming alcohol (OR=1.31, 95%CI 1.02-1.70), and those receiving antihypertensive treatment (OR=1.29, 95%CI 1.00-1.65). CONCLUSIONS Dry eye symptoms were highly prevalent in the study population and were associated with sex, smoking, alcohol consumption, and antihypertensive medications.
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Affiliation(s)
- Enrique O Graue-Hernández
- Departamento de Córnea y Refractiva, Instituto de Oftalmología Conde de Valenciana. Mexico City, Mexico
| | - Juan Carlos Serna-Ojeda
- Departamento de Córnea y Refractiva, Instituto de Oftalmología Conde de Valenciana. Mexico City, Mexico
| | - Carlos Estrada-Reyes
- Departamento de Córnea y Refractiva, Instituto de Oftalmología Conde de Valenciana. Mexico City, Mexico
| | - Alejandro Navas
- Departamento de Córnea y Refractiva, Instituto de Oftalmología Conde de Valenciana. Mexico City, Mexico
| | - Jesús Arrieta-Camacho
- Departamento de Segmento Anterior, Instituto de Oftalmología Conde de Valenciana. Mexico City, Mexico
| | - Aida Jiménez-Corona
- Departamento de Epidemiología Ocular y Salud Visual, Instituto de Oftalmología Conde de Valenciana. Mexico City, Mexico.,Dirección General de Epidemiología, Secretaría de Salud. Mexico City, Mexico
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17
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Chacón-Camacho OF, Salgado-Medina A, Alcaraz-Lares N, López-Moreno D, Barragán-Arévalo T, Nava-Castañeda A, Rodríguez-Uribe G, Lieberman E, Rodríguez-Cabrera L, González-Del Angel A, Borbolla AM, Fernández-Hernández L, Graue-Hernández EO, Zenteno JC. Clinical characterization and identification of five novel FOXL2 pathogenic variants in a cohort of 12 Mexican subjects with the syndrome of blepharophimosis-ptosis-epicanthus inversus. Gene 2019; 706:62-68. [PMID: 31048069 DOI: 10.1016/j.gene.2019.04.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 04/10/2019] [Accepted: 04/26/2019] [Indexed: 01/05/2023]
Abstract
Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is an autosomal dominant entity characterized by eyelid malformations and caused by mutations in the forkhead box L2 (FOXL2) gene. Clinical and genetic analyses of large cohorts of BPES patients from different ethnic origins are important for a better characterization of FOXL2 mutational landscape. The purpose of this study is to describe the phenotypic features and the causal FOXL2 variants in a Mexican cohort of BPES patients. A total of 12 individuals with typical facial findings were included. Clinical evaluation included palpebral measurements and levator function assessment. The complete coding sequence of FOXL2 was amplified by PCR and subsequently analyzed by Sanger sequencing. A total of 11 distinct FOXL2 pathogenic variants were identified in our cohort (molecular diagnostic rate of 92%), including 5 novel mutations. Our results broaden the BPES-related mutational spectrum and supports considerable FOXL2 allelic heterogeneity in our population.
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Affiliation(s)
- Oscar F Chacón-Camacho
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Acatzin Salgado-Medina
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Nayeli Alcaraz-Lares
- Department of Orbit and Oculoplastics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Daniel López-Moreno
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | | | - Angel Nava-Castañeda
- Department of Orbit and Oculoplastics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Genaro Rodríguez-Uribe
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Esther Lieberman
- Department of Genetics, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Lourdes Rodríguez-Cabrera
- Department of Orbit and Oculoplastics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
| | - Ariadna González-Del Angel
- Molecular Biology Laboratory, Department of Genetics, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Ana María Borbolla
- Department of Ophthalmology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | | | - Juan Carlos Zenteno
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico; Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
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18
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Córdoba A, Graue-Hernández EO, Gómez-Bastar A, Navas A. Long-term follow-up of persistent low vault after implantable collamer lens exchange. J Cataract Refract Surg 2019; 45:519-522. [DOI: 10.1016/j.jcrs.2018.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/24/2018] [Indexed: 12/28/2022]
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19
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Salazar A, Casanova-Méndez I, Pacheco-Quito M, Velázquez-Soto H, Ayala-Balboa J, Graue-Hernández EO, Serafín-López J, Jiménez-Martínez MC. Low Expression of IL-10 in Circulating Bregs and Inverted IL-10/TNF-α Ratio in Tears of Patients with Perennial Allergic Conjunctivitis: A Preliminary Study. Int J Mol Sci 2019; 20:ijms20051035. [PMID: 30818819 PMCID: PMC6429471 DOI: 10.3390/ijms20051035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/12/2019] [Accepted: 02/22/2019] [Indexed: 12/18/2022] Open
Abstract
Allergic conjunctivitis (AC) is one of the most common ophthalmological disorders seen in clinical practice. Growing evidence from recent years suggests that a subset of IL-10-expressing B cells is involved in inflammatory allergic diseases. In this study, we aimed to evaluate the potential involvement of blood Bregs cells in perennial allergic conjunctivitis (PAC), and interleukins (IL)-1β, IL-6, IL-8, IL-10, and IL-12, and tumor necrosis factor (TNF)-α, were measured in tear samples and compared with healthy controls (HC) using flow cytometry. Non-significant differences in CD19+IL-10+ cell frequency between PAC patients and healthy controls (HC) were observed. Nevertheless, when we analyzed the mean fluorescence intensity (MFI) of IL-10 on CD19+CD38Lo/Med/Hi-gated cells, we observed a significant decrease in MFI in all Bregs subsets in PAC patients. Additionally, tear cytokines showed 2.8 times lower levels of IL-10 than TNF-α in PAC patients when compared to HC. Our findings demonstrate an immunological dysregulation in patients with allergic conjunctivitis, characterized by the low expression of IL-10 in circulating CD19+CD38+ Bregs subsets and an inverted tear IL-10/TNF-α ratio, promoting a local pro-inflammatory microenvironment. These findings highlight the novel pathologic changes involved in ocular allergic diseases. Understanding systemic and local mechanisms will aid the design of immunomodulating therapeutics at different levels.
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Affiliation(s)
- Alberto Salazar
- Departamento de Inmunología, ENCB, Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico.
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Israel Casanova-Méndez
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Michele Pacheco-Quito
- Cornea and Refractive Surgery Department, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Henry Velázquez-Soto
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Julio Ayala-Balboa
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Enrique O Graue-Hernández
- Cornea and Refractive Surgery Department, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
| | - Jeanet Serafín-López
- Departamento de Inmunología, ENCB, Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico.
| | - María C Jiménez-Martínez
- Department of Immunology and Research Unit, Institute of Ophthalmology "Conde de Valenciana Foundation", 06800 Mexico City, Mexico.
- Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico. P.O. Box 70159, 04510 Mexico City, Mexico.
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20
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Navas A, Magaña-Guerrero FS, Domínguez-López A, Chávez-García C, Partido G, Graue-Hernández EO, Sánchez-García FJ, Garfias Y. Anti-Inflammatory and Anti-Fibrotic Effects of Human Amniotic Membrane Mesenchymal Stem Cells and Their Potential in Corneal Repair. Stem Cells Transl Med 2018; 7:906-917. [PMID: 30260581 PMCID: PMC6265633 DOI: 10.1002/sctm.18-0042] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/28/2018] [Indexed: 12/13/2022] Open
Abstract
Acute ocular chemical burns are ophthalmic emergencies requiring immediate diagnosis and treatment as they may lead to permanent impairment of vision. The clinical manifestations of such burns are produced by exacerbated innate immune response via the infiltration of inflammatory cells and activation of stromal fibroblasts. New therapies are emerging that are dedicated to repair mechanisms that improve the ocular surface after damage; for example, transplantation of stem cells (SC) has been successfully reported for this purpose. The pursuit of easily accessible, noninvasive procedures to obtain SC has led researchers to focus on human tissues such as amniotic membrane. Human amniotic mesenchymal SC (hAM-MSC) inhibits proinflammatory and fibrotic processes in different diseases. hAM-MSC expresses low levels of classical MHC-I and they do not express MHC-II, making them suitable for regenerative medicine. The aim of this study was to evaluate the effect of intracameral injection of hAM-MSC on the clinical manifestations, the infiltration of inflammatory cells, and the activation of stromal fibroblasts in a corneal alkali-burn model. We also determined the in vitro effect of hAM-MSC conditioned medium (CM) on α-SMA+ human limbal myofibroblast (HLM) frequency and on release of neutrophil extracellular traps (NETs). Our results show that intracameral hAM-MSC injection reduces neovascularization, opacity, stromal inflammatory cell infiltrate, and stromal α-SMA+ cells in our model. Moreover, in in vitro assays, CM from hAM-MSC decreased the quantity of α-SMA+ HLM and the release of NETs. These results suggest that intracameral hAM-MSC injection induces an anti-inflammatory and anti-fibrotic environment that promotes corneal wound healing. Stem Cells Translational Medicine 2018;7:906-917.
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Affiliation(s)
- Alejandro Navas
- Research Unit, Cell and Tissue Biology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico.,Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
| | - Fátima Sofía Magaña-Guerrero
- Research Unit, Cell and Tissue Biology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico.,Faculty of Medicine, Department of Biochemistry, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alfredo Domínguez-López
- Research Unit, Cell and Tissue Biology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico.,Faculty of Medicine, Department of Biochemistry, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - César Chávez-García
- Research Unit, Cell and Tissue Biology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
| | - Graciela Partido
- Research Unit, Cell and Tissue Biology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
| | - Francisco Javier Sánchez-García
- Laboratorio de Inmunorregulación, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Col Santo Tomás, Mexico
| | - Yonathan Garfias
- Research Unit, Cell and Tissue Biology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico.,Faculty of Medicine, Department of Biochemistry, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Affiliation(s)
- Erick Hernandez-Bogantes
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, DF, Mexico
| | - Juan Carlos Serna-Ojeda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, DF, Mexico
| | - Alejandro Lichtinger
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, DF, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, DF, Mexico
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22
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Serna-Ojeda JC, Graue-Hernández EO, Guzmán-Salas PJ, Rodríguez-Loaiza JL. [Simulation training in ophthalmology]. GAC MED MEX 2017; 153:111-115. [PMID: 28128813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Simulation in medicine is an indispensable tool to improve doctors' responses to different situations, enhancing their performance. However, simulation in ophthalmology is a very recent trend, mainly because of the high complexity of developing newer teaching tools, with the need for highly realistic models, mostly in surgical ophthalmic simulation. DISCUSSION The whole development of simulation in ophthalmology, from the very first attempts that used basic models, to the newer virtual reality models, allows for a comprehensive, faster, and more efficient development of skills necessary in basic and advance procedures in ophthalmology, creating a better learning environment, improving costs, and developing a very promising panorama, in which simulation can be incorporated in teaching programs all around the globe. CONCLUSIONS Simulation in ophthalmology allows for better results in the formation of ophthalmologists, and it is becoming a new tool to achieve better results in medical and surgical procedures, thus improving outcomes and quality of care.
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Romero-Diaz-de-Leon L, Serna-Ojeda JC, Navas A, Graue-Hernández EO, Ramirez-Miranda A. Intraoperative Flap Complications in LASIK Surgery Performed by Ophthalmology Residents. J Ophthalmic Vis Res 2016; 11:263-7. [PMID: 27621782 PMCID: PMC5000527 DOI: 10.4103/2008-322x.188393] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To report the rate of flap-related complications in LASIK surgery performed by in-training ophthalmology residents and to analyze the risk factors for these complications. Methods: We analyzed 273 flap dissections in 145 patients from March 2013 to February 2014. We included all LASIK surgeries performed by 32 ophthalmology residents using a Moria M2 microkeratome. All the flap-related complications were noted. Comparison between both groups with and without complications was performed with an independent Student's t-test and relative risks were calculated. Results: There were 19 flap-related complications out of the 273 flap dissections (6.95%). The most common complication was incomplete flap dissection (n = 10; 3.66%), followed by free-cap (n = 5; 1.83%), and flap-buttonhole (n = 2; 0.73%). There was no significant difference between the complicated and uncomplicated cases in terms of the right versus the left eye, pachymetry results, white-to-white diameter, and spherical equivalent. But this difference was significant for mean keratometry (P = 0.008), K-min (P = 0.01), and K-max (P = 0.03) between these groups. Final visual acuity after rescheduling laser treatment was similar in both groups. Relative risks for flap-related complications were 2.03 for the first LASIK surgery (CI 95% 0.64 to 6.48; P = 0.22) and 1.26 (CI 95% 0.43 to 3.69; P = 0.66) for the surgeon's flap-related complications. Female gender presented an odds ratio of 2.48 (CI 95% 0.68 to 9.00; P = 0.16) for complications. Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye.
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Affiliation(s)
- Lorena Romero-Diaz-de-Leon
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
| | - Juan Carlos Serna-Ojeda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
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Graue-Hernández EO, Ramírez-Miranda A, Navas A. Reply. J Cataract Refract Surg 2016; 42:507-8. [PMID: 27063543 DOI: 10.1016/j.jcrs.2016.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/09/2016] [Indexed: 11/29/2022]
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Vazirani J, Ali MH, Sharma N, Gupta N, Mittal V, Atallah M, Amescua G, Chowdhury T, Abdala-Figuerola A, Ramirez-Miranda A, Navas A, Graue-Hernández EO, Chodosh J. Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: multicentre results. Br J Ophthalmol 2016; 100:1416-20. [DOI: 10.1136/bjophthalmol-2015-307348] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 01/03/2016] [Indexed: 11/03/2022]
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Hernández-Bogantes E, Amescua G, Navas A, Garfias Y, Ramirez-Miranda A, Lichtinger A, Graue-Hernández EO. Minor ipsilateral simple limbal epithelial transplantation (mini-SLET) for pterygium treatment. Br J Ophthalmol 2015; 99:1598-600. [PMID: 26130669 PMCID: PMC4680150 DOI: 10.1136/bjophthalmol-2015-306857] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/06/2015] [Indexed: 01/11/2023]
Abstract
We describe a novel surgical technique for pterygium removal taking advantage of the properties of amniotic membrane and limbal epithelial stem cells. A total of 10 eyes underwent pterygium excision with amniotic membrane coverage of the bare sclera and placement of pieces of limbal epithelium in a linear fashion in the affected limbal area covered by a second amniotic membrane using fibrin glue. After up to 8 months of follow-up, there were no signs of early recurrence or sight-threatening complications. The minor ipsilateral simple limbal epithelial transplantation technique for the treatment of pterygium requires less tissue than the conventional conjunctival autograft, leaving healthy conjunctiva if needed for another procedure in the future and offers the advantages of epithelial stem cells, which in the long term may reduce the rate of recurrence significantly.
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Affiliation(s)
- Erick Hernández-Bogantes
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia, Fundacion Conde de Valenciana, México, D.F, México
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia, Fundacion Conde de Valenciana, México, D.F, México
| | - Yonathan Garfias
- Research Unit, Instituto de Oftalmología, Fundación Conde de Valenciana, México, D.F, México Department of Biochemistry, Faculty of Medicine, UNAM, México, D.F, México
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia, Fundacion Conde de Valenciana, México, D.F, México
| | - Alejandro Lichtinger
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia, Fundacion Conde de Valenciana, México, D.F, México
| | - Enrique O Graue-Hernández
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia, Fundacion Conde de Valenciana, México, D.F, México
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Bolaños-Jiménez R, Navas A, López-Lizárraga EP, de Ribot FM, Peña A, Graue-Hernández EO, Garfias Y. Ocular Surface as Barrier of Innate Immunity. Open Ophthalmol J 2015; 9:49-55. [PMID: 26161163 PMCID: PMC4484240 DOI: 10.2174/1874364101509010049] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 04/06/2015] [Accepted: 04/13/2015] [Indexed: 01/08/2023] Open
Abstract
Sight is one of the most important senses that human beings possess. The ocular system is a complex structure equipped with mechanisms that prevent or limit damage caused by physical, chemical, infectious and environmental factors. These mechanisms include a series of anatomical, cellular and humoral factors that have been a matter of study. The cornea is not only the most powerful and important lens of the optical system, but also, it has been involved in many other physiological and pathological processes apart from its refractive nature; the morphological and histological properties of the cornea have been thoroughly studied for the last fifty years; drawing attention in its molecular characteristics of immune response. This paper will review the anatomical and physiological aspects of the cornea, conjunctiva and lacrimal apparatus, as well as the innate immunity at the ocular surface.
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Affiliation(s)
- Rodrigo Bolaños-Jiménez
- Research Unit, Institute of Ophthalmology, Conde de Valenciana Foundation, Chimalpopoca 14, Obrera, CP 06800, Mexico City, México ; Ophthalmology Department, Regional Hospital, Adolfo López Mateos, ISSSTE, México City, México
| | - Alejandro Navas
- Research Unit, Institute of Ophthalmology, Conde de Valenciana Foundation, Chimalpopoca 14, Obrera, CP 06800, Mexico City, México ; Department of Cataract and refractive surgery, Institute of Ophthalmology, Conde de Valenciana Foundation, Mexico City, México
| | - Erika Paulina López-Lizárraga
- Department of Cataract and refractive surgery, Institute of Ophthalmology, Conde de Valenciana Foundation, Mexico City, México
| | - Francesc March de Ribot
- Department of Retina, Institute of Ophthalmology, Conde de Valenciana Foundation, Mexico City, México
| | - Alexandra Peña
- Ophthalmology Department, Regional Hospital, Adolfo López Mateos, ISSSTE, México City, México
| | - Enrique O Graue-Hernández
- Research Unit, Institute of Ophthalmology, Conde de Valenciana Foundation, Chimalpopoca 14, Obrera, CP 06800, Mexico City, México ; Department of Cataract and refractive surgery, Institute of Ophthalmology, Conde de Valenciana Foundation, Mexico City, México
| | - Yonathan Garfias
- Research Unit, Institute of Ophthalmology, Conde de Valenciana Foundation, Chimalpopoca 14, Obrera, CP 06800, Mexico City, México ; Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, 04510. Mexico City, Mexico
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Figuerola AA, Graue-Hernández EO. December consultation #4. J Cataract Refract Surg 2014. [DOI: 10.1016/j.jcrs.2014.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hernández-Camarena JC, Chirinos-Saldaña P, Navas A, Ramirez-Miranda A, de la Mota A, Jimenez-Corona A, Graue-Hernández EO. Repeatability, Reproducibility, and Agreement Between Three Different Scheimpflug Systems in Measuring Corneal and Anterior Segment Biometry. J Refract Surg 2014; 30:616-21. [DOI: 10.3928/1081597x-20140815-02] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Montano M, López-Dorantes KP, Ramirez-Miranda A, Graue-Hernández EO, Navas A. Multifocal toric intraocular lens implantation for forme fruste and stable keratoconus. J Refract Surg 2014; 30:282-5. [PMID: 24702581 DOI: 10.3928/1081597x-20140320-08] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 12/18/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the results of multifocal toric intraocular lens implantation in two patients (one with forme fruste keratoconus and the other with frank but stable keratoconus). METHODS A 50-year-old woman with forme fruste keratoconus and positive family history of keratoconus and a 42-year-old man with frank keratoconus underwent corneal collagen cross-linking. Uncorrected distance visual acuity was 20/800 in the right eye and 20/400 in the left eye and 20/400 in the right eye and 20/100 in the left eye, respectively. Refractive lens exchange was performed using multifocal toric intraocular lenses in both cases. RESULTS After phacoemulsification, uncorrected distance visual acuity, corrected distance visual acuity, binocular uncorrected distance visual acuity was 20/25 and 20/30 in cases 1 and 2, respectively, and residual refraction was within 0.5 diopters of emmetropia in both cases. Patients were subjectively satisfied. CONCLUSIONS Presbyopic treatment options are scarce for patients with keratoconus and multifocal toric intraocular lenses may be useful in selected cases.
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Chirinos-Saldaña P, Graue-Hernández EO, Hernández-Camarena JC, Navas A, Ramírez-Miranda A, Romero-Díaz de León L, Vizuet-García L, Ortiz-Casas M, López-Espinosa NL, Gaona-Juárez C, Bautista-Hernández LA, Bautista-de Lucio VM. Perfil microbiológico y sensibilidad a antibióticos de microorganismos aislados de infecciones conjuntivales en el Instituto de Oftalmología Fundación Conde de Valenciana. Reporte del año 2012. Revista Mexicana de Oftalmología 2014. [DOI: 10.1016/j.mexoft.2014.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Gomez-Bastar A, Jaimes M, Graue-Hernández EO, Ramirez-Luquin T, Ramirez-Miranda A, Navas A. Long-term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation. Int Ophthalmol 2013; 34:583-90. [PMID: 24114502 PMCID: PMC4028544 DOI: 10.1007/s10792-013-9860-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 09/14/2013] [Indexed: 11/25/2022]
Abstract
To report the long-term refractive outcomes, safety, predictability, efficacy and complications of 349 eyes treated with posterior chamber phakic intraocular lenses (pIOLs). A retrospective review of consecutive clinical cases of patients who underwent spheric implantable collamer lens (ICL) and toric ICL (TICL) implantation. The study included 349 eyes of 216 patients with sphere between +8 to −24 diopters (D) and 0 to −6.5 D of astigmatism. Statistical analysis was performed to identify differences between preoperative and postoperative refractive outcomes. Main outcome measures were preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical errors and spherical equivalent and significant postoperative complications. 194 eyes were treated with TICL and 155 eyes with ICL. The mean age of the patients was 29 ± 6.7 years. The mean preoperative sphere was −10.35 ± 5.1 D (+8 to −24) and the postoperative sphere was −0.09 ± 1.06 D (+3.25 to −6.5), p < 0.001. Preoperative cylinder was −2.63 ± 1.44 (0 to −6.5 D) and postoperative cylinder was −0.97 ± 0.89 D (0 to −3.5), p < 0.001. The preoperative mean spherical equivalent was −11.6 ± 5.12 D (+7.875 to −25.625) and postoperative spherical equivalent was −0.52 ± 1.03 (+2.25 to −6.75), p < 0.001. The mean preoperative UDVA was 1.72 ± 0.49 and postoperative UDVA was 0.23 ± 0.22, p < 0.001. The mean preoperative CDVA was 0.21 ± 0.17 and postoperative CDVA was 0.12 ± 0.138, p < 0.001. The implantation of posterior chamber pIOLs is a safe, predictable and effective strategy to manage refractive errors during long-term follow-up.
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Affiliation(s)
- Arturo Gomez-Bastar
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Chimalpopoca 14, Col Obrera, 06800, Mexico City, Mexico
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Espinosa-Mattar Z, Gomez-Bastar A, Graue-Hernández EO, Navas A. DSAEK for implantable collamer lens dislocation and corneal decompensation 6 years after implantation. Ophthalmic Surg Lasers Imaging Retina 2012; 43 Online:e68-72. [PMID: 22823028 DOI: 10.3928/15428877-20120712-04] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 04/02/2012] [Indexed: 11/20/2022]
Abstract
A 39-year-old woman with a history of high myopia underwent uneventful implantation of phakic posterior chamber implantable collamer lenses (ICLs) 6 years earlier in both eyes with a visual acuity of 20/20 bilaterally. The patient presented as an emergency with sudden decreased vision in her right eye after blunt trauma. Slit-lamp examination showed a partially dislocated ICL in the anterior chamber, associated with ocular hypertension. It was decided to treat her with topical ocular hypotensive agents and surgical repositioning of the ICL. There was a progressive loss of endothelial cells and decreased visual acuity. Descemet stripping automated endothelial keratoplasty was needed to correct the endothelial failure. This case presents a potential complication of the ICL several years after implantation, and should be considered in these types of procedures.
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Affiliation(s)
- Zoraida Espinosa-Mattar
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
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Navas A, Tapia-Herrera G, Jaimes M, Graue-Hernández EO, Gomez-Bastar A, Ramirez-Luquín T, Ramirez-Miranda A. Implantable collamer lenses after intracorneal ring segments for keratoconus. Int Ophthalmol 2012; 32:423-9. [DOI: 10.1007/s10792-012-9582-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 04/21/2012] [Indexed: 11/27/2022]
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Jaimes M, Xacur-García F, Alvarez-Melloni D, Graue-Hernández EO, Ramirez-Luquín T, Navas A. Refractive lens exchange with toric intraocular lenses in keratoconus. J Refract Surg 2011; 27:658-64. [PMID: 21667880 DOI: 10.3928/1081597x-20110531-01] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 05/24/2011] [Indexed: 01/14/2023]
Abstract
PURPOSE To report the clinical characteristics and surgical outcomes of patients with nonprogressive keratoconus treated with in-the-bag toric intraocular lens (IOL) implantation. METHODS A retrospective review was conducted of the medical records of patients diagnosed with keratoconus treated with refractive lens exchange (RLE) and in-the-bag toric IOL implantation (models T3 to T9, AcrySof SN60TT; Alcon Laboratories Inc). Age, pre- and postoperative uncorrected (UDVA) and corrected distance visual acuity (CDVA), objective and subjective refraction, spherical equivalent refraction, total keratometric power, total astigmatism, axis, and toric IOL model and power were analyzed. All cases had topographic and/or refractive stability for at least 1 year prior to undergoing IOL implantation. RESULTS Nineteen eyes of 13 patients (mean age 48.15 ± 6.6 years), including 12 patients with a topographic diagnosis of keratoconus and 1 with pellucid marginal degeneration, were evaluated. Mean follow-up after RLE was 7.89 ± 6.61 months. Mean preoperative sphere was -5.25 ± 6.40 diopters (D), and mean postoperative sphere was 0.22 ± 1.01 D (P<.001). Mean preoperative cylinder was 3.95 ± 1.30 D, which decreased to 1.36 ± 1.17 D postoperatively (P<.001). Mean pre- and postoperative spherical equivalent refractions were -7.10 ± 6.41 D and -0.46 ± 1.12 D, respectively (P<.001). Preoperative mean UDVA was 1.35 ± 0.36 D (20/447 Snellen) and postoperative mean UDVA was 0.29 ± 0.23 D (20/39 Snellen) (P<.001). CONCLUSIONS Toric IOL implantation may be an effective therapeutic option in the optical rehabilitation of patients with stable and nonprogressive keratoconus.
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Affiliation(s)
- Martha Jaimes
- Department of Cornea and Refractive Surgery, Institute of Opthalmology, Conde de Valenciana, Mexico City, Mexico
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Navas A, Muñoz-Ocampo M, Graue-Hernández EO, Gómez-Bastar A, Ramirez-Luquín T. Spontaneous Rotation of a Toric Implantable Collamer Lens. Case Rep Ophthalmol 2010; 1:99-104. [PMID: 21151633 PMCID: PMC2999733 DOI: 10.1159/000322819] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We present a case of toric implantable collamer lens (TICL) spontaneous rotation in a patient with myopic astigmatism. A 23-year-old female underwent TICL implantation. Preoperative uncorrected visual acuity (UCVA) was 20/800 and 20/1200, respectively, with -7.75 -4.25 × 0° and -8.25 -5.25 × 180°. The left eye achieved an UCVA of 20/30. After 3 months of successful implantation of TICL in the left eye, the patient presented with a sudden decrease in visual acuity in the left eye. UCVA was 20/100 with a refraction of +2.50 -4.50 × 165°. We observed the toric marks with a 30° rotation from the original position and decided to reposition the TICL, obtaining a final UCVA of 20/25, which remained stable at 6 months' follow-up. TICL can present a considerable rotation that compromises visual acuity. The relocation of TICL is a safe and effective procedure to recover visual acuity due to significant spontaneous TICL rotation.
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Affiliation(s)
- Alejandro Navas
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology 'Conde de Valenciana', Mexico City, Mexico
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