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Alicante, Spain

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. Source

Alio J.L.,Vissum Corporacion Oftalmologica | Alio J.L.,University Miguel Hernandez | Rodriguez A.E.,Vissum Corporation | WrobelDudzinska D.,Vissum Corporation
Current Opinion in Ophthalmology

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. Source

Ortuno-Prados V.J.,Vissum Corporation | Alio J.L.,Vissum Corporation
Archivos de la Sociedad Espanola de Oftalmologia

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. Source

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

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. Source

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

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. Source

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