Alicante, Spain
Alicante, Spain

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Alio J.L.,Vissum Corporation | Alio J.L.,University Miguel Hernández | Toffaha B.T.,Vissum Corporation | Pena-Garcia P.,University Miguel Hernández | Sadaba L.M.,Clinica Universitaria de Navarra
Journal of Refractive Surgery | Year: 2015

PURPOSE: To describe the main causes of explantation of phakic intraocular lenses (PIOLs) according to the anatomical site of implantation (angle supported, iris fixated, or posterior chamber). METHODS: This multicentric, retrospective, and consecutive study sponsored by the Spanish Ministry of Health comprised a total of 240 eyes (226 patients) explanted due to PIOL complications. Clinical data of 144 angle-supported lenses, 24 iris-fixated lenses, and 72 posterior chamber lenses explanted were recorded preoperatively and postoperatively. RESULTS: Mean age of the patients at explantation was 46.30 ± 11.84 years (range: 25 to 80 years). The mean time between implantation and explantation was 381.14 ± 293.55 weeks (range: 0.00 to 1,551.17 weeks). It was 422.33 ± 287.81 weeks for the angle-supported group, 488.03 ± 351.95 weeks for the iris-fixated group, and 234.11 ± 4,221.60 weeks for the posterior chamber group. It was 8.10 ± 5.52 years for the angle-supported group, 9.36 ± 6.75 years for the iris-fixated group, and 4.49 ± 4.25 years for the posterior chamber group. This period of time was significantly shorter in the posterior chamber group (P <.001). Overall, the main causes of explantation were cataract formation (132 eyes, 55%), endothelial cell loss (26 eyes, 10.83%), corneal decompensation (22 eyes, 9.17%), PIOL dislocation/decentration (16 eyes, 6.67%), inadequate PIOL size or power (12 eyes, 5%), and pupil ovalization (10 cases, 4.17%). Cataract development was the cause of explantation in 51.39% of angle-supported cases, 45.83% of iris-fixated cases, and 65.28% of posterior chamber cases. Endothelial cell loss was the cause of explanation in 15.97% of angle-supported PIOLs, 8.33% of iris-fixated PIOLs, and 1.39% of posterior chamber PIOLs. CONCLUSIONS: Cataract is the main cause of PIOL explanation, especially in posterior chamber PIOLs. In the angle-supported group, endothelial cell loss was the second cause of explanation.


Alio J.L.,VISSUM Corporation | Alio J.L.,University Miguel Hernández | Arnalich-Montiel F.,VISSUM Corporation
Current Pharmaceutical Biotechnology | Year: 2012

Blood derived products have demonstrated their capacity to enhance healing and stimulate the regeneration of different tissues and this enhancing effect is attributed to the growth factors and bioactive proteins that are synthesized and present in blood. Eye platelet rich plasma (E-PRP) provides higher concentration of essential growth factors and cell adhesion molecules by concentrating platelets in a small volume of plasma as compared with autologous serum, the latter being used widely in ophthalmology for epithelial wound healing of the cornea for the last two decades. These growth factors and cell adhesion molecules have a major role in wound healing and enhance the physiological process at the site of the injury/surgery via eye drops or clot. E-PRP has been used more recently, and has achieved successful outcomes in peer-review articles in the treatment of dormant ulcers (epithelial defects of the cornea that fail to heal), moderate to severe dry eye syndrome, ocular surface syndrome post Laser In Situ Keratomileusis (LASIK), and for surface reconstruction after corneal perforation associated with amniotic membrane transplantation. Preparation of E-PRP in the two available formulations, eyedrops and clot, is inexpensive and easy although it requires following strict sterility conditions using sterile and disposable materials and operating inside a laminar flow hood. No serious adverse effects have been described with the use of these products, and it is generally well tolerated. In summary, Platelet enriched plasma in the form obtained in ophthalmology, E-PRP, is a reliable and effective therapeutic tool to enhance epithelial wound healing in ocular surface disease. © 2012 Bentham Science Publishers.


Alio J.L.,VISSUM Corporacion Oftalmologica | Alio J.L.,University Miguel Hernández | Rodriguez A.E.,VISSUM Corporation | WrobelDudzinska D.,VISSUM Corporation
Current Opinion in Ophthalmology | Year: 2015

Purpose of review: Blood-derived products [autologous serum, eye platelet-rich plasma (E-PRP), plasma rich in growth factors] are successful therapies for ocular surface disorders, which compromise the integrity of the cornea surface and conjunctiva. Recent findings: The most noteworthy and recent research has been directed towards hemoderivatives that include platelets. PRP for ophthalmologic use (E-PRP) has achieved successful outcomes as reported in the peer-review literature in the treatment of dry eye, post-laser in-situ keratomileusis ocular surface syndrome, dormant ulcers, and for ocular surface surgical reconstruction after corneal perforation associated to amniotic membrane transplantation, bovine pericardium membrane transplantation, or autologous fibrin membrane combined with solid PRP clot. Summary: PRP is a portion of the patient's own blood having a platelet concentration above baseline. The main advantage of PRP over other products is the presence of the platelets and associated with this the prolonged release of growth factors that are involved in the wound healing process of the cornea and conjunctival surface. E-PRP seems to be a reliable and effective therapeutic approach to enhance epithelial wound healing and promote ocular surface regeneration in different pathological conditions.


Alio J.L.,Vissum Corporation | Alio J.L.,University Miguel Hernández | Plaza-Puche A.B.,Vissum Corporation | Javaloy J.,Vissum Corporation | And 2 more authors.
Journal of Refractive Surgery | Year: 2012

PURPOSE: To compare the visual outcomes and intraocular optical quality observed postoperatively in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL) and an apodized diffractive multifocal IOL. METHODS: Seventy-four consecutive eyes of 40 cataract patients (age range: 36 to 79 years) were divided into two groups: zonal refractive group, 39 eyes implanted with a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 IOL, Oculentis GmbH); and diffractive group, 35 eyes implanted with an apodized diffractive multifocal IOL (ReSTOR SN6AD3, Alcon Laboratories Inc). Distance and near visual acuity outcomes, contrast sensitivity, intraocular optical quality, and defocus curves were evaluated during 3-month follow-up. Calculation of the intraocular aberrations was performed by subtracting corneal aberrations from total ocular aberrations. RESULTS: Uncorrected near visual acuity and distance-corrected near visual acuity were better in the diffractive group than in the zonal refractive group (P=.01), whereas intermediate visual acuity (defocus +1.00 and +1.50 diopters) was better in the zonal refractive group. Photopic contrast sensitivity was significantly better in the zonal refractive group (P=.04). Wavefront aberrations (total, higher order, tilt, primary coma) were significantly higher in the zonal refractive group than in the diffractive group (P=.02). CONCLUSIONS: Both multifocal IOLs are able to successfully restore visual function after cataract surgery. The zonal refractive multifocal IOL provides better results in contrast sensitivity and intermediate vision, whereas the diffractive multifocal IOL provides better near vision at a closer distance.


Alio J.L.,Vissum Corporation | Alio J.L.,University Miguel Hernández | Montalban R.,Vissum Corporation | Pena-Garcia P.,University Miguel Hernández | And 3 more authors.
Journal of Refractive Surgery | Year: 2013

PURPOSE: To evaluate the visual outcomes of patients with a new diffractive trifocal intraocular lens (IOL). METHODS: A trifocal diffractive Fine Vision IOL (Physiol, Liege, Belgium) was implanted after microincision cataract surgery (MICS) in 40 eyes of 20 patients with bilateral cataract. The monocular and binocular visual performance and the refractive status were assessed, as well as the defocus curve and contrast sensitivity at 1 and 6 months postoperatively. RESULTS: The monocular visual outcomes (logMAR) at 6 months postoperatively were uncorrected distance visual acuity 0.18 ± 0.13, uncorrected near visual acuity 0.26 ± 0.15, and uncorrected intermediate visual acuity 0.20 ± 0.11. With the best distance correction, the visual outcomes were 0.05 ± 0.06 for corrected distance visual acuity, 0.16 ± 0.13 for distance corrected near visual acuity, and 0.17 ± 0.09 for distance corrected intermediate visual acuity. Binocular defocus curve at 6 months shows a wide range of useful vision with 0.19 ± 0.08 (logMAR) at -1.50 diopter defocus. The monocular contrast sensitivity under scotopic conditions (3 cd/m2) was within normal range for a population older than 60 years. CONCLUSION: The trifocal Fine Vision IOL can restore vision at different distances after cataract surgery, specifically intermediate and near vision. Copyright © SLACK Incorporated.


Montalban R.,Vissum Corporation | Pinero D.P.,University of Alicante | Javaloy J.,Vissum Corporation | Javaloy J.,University Miguel Hernández | And 2 more authors.
Journal of Cataract and Refractive Surgery | Year: 2012

Purpose: To evaluate in normal healthy eyes the intrasubject repeatability of anterior and posterior corneal curvature measurements and other anatomic anterior segment measurements obtained with a new topography system combining Scheimpflug photography and Placido-disk technology. Setting: Vissum Corp., Alicante, Spain. Design: Evaluation of technology. Methods: All eyes received a comprehensive ophthalmologic examination including anterior segment analysis with the Sirius system. Three consecutive measurements were performed with the device to assess the intrasubject repeatability of the following parameters: anterior and posterior corneal curvature and shape factor, white-to-white (WTW) corneal diameter, central and minimum corneal thickness, and anterior chamber depth (ACD). The within-subject standard deviation (S w) and intraclass correlation coefficient (ICC) were calculated. Results: This study included 117 eyes of 117 subjects (mean age 42 years; range 7 to 80 years). For anterior and posterior corneal curvatures, the S w was 0.04 mm or lower and the ICC was higher than 0.990. For shape-factor measurements, the S w was below 0.08 in all cases and ICC values ranged between 0.909 and 0.994. Significantly larger S w values were found for the anterior and posterior shape factor calculated for 8.0 mm compared with 4.5 mm (P<.01). An S w value below 3 μm was observed for the central and minimum thickness, with ICC values close to 1. The mean S w for ACD and WTW was below 0.1 mm. Conclusion: In healthy eyes, the new topography system provided repeatable measurements of several anterior segment parameters, including anterior and posterior curvature and pachymetry. © 2012 ASCRS and ESCRS Published by Elsevier Inc.


Alio J.L.,Vissum Corporation | Alio J.L.,University of Alicante | Plaza-Puche A.B.,Vissum Corporation | Javaloy J.,Vissum Corporation | And 5 more authors.
Ophthalmology | Year: 2012

Purpose: To compare the visual acuity outcomes and ocular optical performance of eyes implanted with a multifocal refractive intraocular lens (IOL) with an inferior segmental near add or a diffractive multifocal IOL. Design: Prospective, comparative, nonrandomized, consecutive case series. Participants: Eighty-three consecutive eyes of 45 patients (age range, 3682 years) with cataract were divided into 2 groups: group A, 45 eyes implanted with Lentis Mplus LS-312 (Oculentis GmbH, Berlin, Germany); group B, 38 eyes implanted with diffractive IOL Acri.Lisa 366D (Zeiss, Oberkochen, Germany). Methods: All patients underwent phacoemulsification followed by IOL implantation in the capsular bag. Distance corrected, intermediate, and near with the distance correction visual acuity outcomes and contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively during a 3-month follow-up. Main Outcome Measures: Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected distance near and intermediate visual acuity (CDNVA), contrast sensitivity, intraocular aberrations, and defocus curve. Results: A significant improvement in UDVA, CDVA, and UNVA was observed in both groups after surgery (P≤0.04). Significantly better values of UNVA (P<0.01) and CDNVA (P<0.04) were found in group B. In the defocus curve, significantly better visual acuities were present in eyes in group A for intermediate vision levels of defocus (P≤0.04). Significantly higher amounts of postoperative intraocular primary coma and spherical aberrations were found in group A (P<0.01). In addition, significantly better values were observed in photopic contrast sensitivity for high spatial frequencies in group A (P≤0.04). Conclusions: The Lentis Mplus LS-312 and Acri.Lisa 366D IOLs are able to successfully restore visual function after cataract surgery. The Lentis Mplus LS-312 provided better intermediate vision and contrast sensitivity outcomes than the Acri.Lisa 366D. However, the Acri.Lisa design provided better distance and near visual outcomes and intraocular optical performance parameters. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.


Pinero D.P.,Vissum Corporation | Alio J.L.,Vissum Corporation | El Kady B.,Vissum Corporation | Pascual I.,Vissum Corporation
Journal of Cataract and Refractive Surgery | Year: 2010

Purpose: To evaluate and compare visual, refractive, and corneal aberrometric outcomes after implantation of 2 types of intrastromal corneal ring segments (ICRS) in eyes with early to moderate ectatic disease. Settings: Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain. Methods: This retrospective analysis comprised consecutive eyes with grade I or grade II corneal ectasia (keratoconus, pellucid marginal degeneration, ectasia after laser in situ keratomileusis) that had Intacs (Group I) or KeraRings (Group K) ICRS implantation using femtosecond technology. Visual, refractive, and corneal aberrometric outcomes were analyzed and compared between groups over a 6-month follow-up. Results: Group I had 17 eyes and Group K, 20 eyes. One month postoperatively, there was a statistically significant reduction in sphere in both groups (P≤.02). At 6 months, there was a statistically significant reduction in manifest cylinder in Group K that was consistent with the significant reduction in corneal astigmatic aberration (both P = .04). The uncorrected distance visual acuity increased significantly in Group K (P = .04) but not in Group I; 41.18% of eyes in Group I and 52.94% in Group K gained 1 or more lines of corrected distance visual acuity. Both groups had significant corneal flattening (P≤.02). At 1 month, the mean primary spherical aberration was -0.17 μm ± 0.52 (SD) in Group I and 0.40 ± 0.35 μm in Group K; the difference was statistically significant (P<.01). Conclusion: Astigmatism correction in early to moderate ectatic corneas was more limited with the Intacs ICRS, which induced negative primary spherical aberration in the initial postoperative period. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2010 ASCRS and ESCRS.


To evaluate the visual refractive and aberrometric outcomes of laser-assisted in situ keratomileusis (LASIK) surgery for the correction of high mixed astigmatism using a new-generation excimer laser and optimized aspherical profiles. Retrospective interventional case series. Fifty-two eyes of 36 patients (21-53 years) with primary mixed astigmatism over 3.0 diopters (D) were included. All cases underwent LASIK surgery using the sixth-generation excimer laser Amaris with cyclotorsion control and a femtosecond platform for flap creation. Visual, refractive, corneal topographic, and aberrometric outcomes were evaluated during a 3-month follow-up. Refractive astigmatic changes were analyzed by Alpins method. A significant reduction of refractive sphere and cylinder was observed 3 months postoperatively (P = .001), with an associated improvement of uncorrected distance visual acuity (P = .001). Best-corrected distance visual acuity (CDVA) remained unchanged in 31 eyes (59.6%), while 3 eyes (5.76%) lost 2 lines of CDVA. Fourteen eyes (26.9%) had spherical equivalent (SE) within ±0.5 D of emmetropia and 34 (65.3%) had SE within ±1.0 D of emmetropia. No significant difference was observed when comparing surgically induced and target astigmatism. A significant induction of higher-order aberration attributable to increase of spherical aberration was found (P = .003). Seven eyes (13.4%) required retreatment. LASIK for primary high mixed astigmatism using optimized aspherical profiles and a fast-repetition-rate excimer laser with cyclotorsion control is a safe, effective, and predictable procedure. Induction of higher-order aberrations is still present in the correction of the refraction error of the magnitude included in this study. Copyright © 2013 Elsevier Inc. All rights reserved.


Ortuno-Prados V.J.,VISSUM Corporation | Alio J.L.,VISSUM Corporation
Archivos de la Sociedad Espanola de Oftalmologia | Year: 2011

Case reports: We present the case of a patient with neurotrophic queratitis in the left eye treated with a Tutopatch® cover and platelet-rich plasma (PRP). Solid autologous PRP was placed in the bed of the ulcer and Tutopatch® was sutured to the conjunctiva. Discussion: We found this form of treatment very effective for progressive ulcers. Tutopatch® may constitute an alternative to amniotic membrane transplantation. © 2010 Sociedad Española de Oftalmología. Published by Elsevier España, S.L. All rights reserved.

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