Short term visual outcomes of a new trifocal intraocular lens

Background: Today, patients often expect to achieve spectacle independance after cataract surgery. New trifocal intraocular lenses have been developed to try and fullfill this demand. The purpose of this study is to report the short-term visual outcomes of a new trifocal intraocular lens (AcrySof PanOptix™). Methods: Consecutive adult patients undergoing cataract surgery with bilateral implantation of the study intraocular lens in a private practice clinic were considered for inclusion. Exclusion criteria were the presence of other ocular pathologies or preoperative astigmatism >1.5 diopters (D). Patients with intraoperative complications were excluded from analysis. One month after surgery patients underwent: monocular defocus curve; monocular and binocular uncorrected visual acuity in photopic and mesopic conditions, for far (4 m), intermediate (60 cm) and near (33 cm) distances and binocular contrast sensitivity. Patients completed a visual satisfaction questionnaire between 9 and 12 months after surgery. Results: One hundred and sixteen eyes of fifty-eight patients receiving bilateral implantation of the study intraocular lens were analysed. Mean binocular uncorrected visual acuity in photopic conditions was 0.03 LogMAR for far, 0.12 for intermediate and 0.02 for near distances. All patients achieved a binocular uncorrected visual acuity better than 0.3 LogMAR (20/40 Snellen equivalent) for distance and near vision and 94.8% of patients for intermediate vision. Mesopic binocular uncorrected visual acuity values were similar to photopic values. The monocular defocus curves showed that the best visual acuity was reached at a vergence of 0.00D. Visual acuity dropped slightly at −1.00D and peaked again at −2.00D. Visual acuities better than 0.2 LogMAR were maintained between −2.50D and +0.50D. Contrast sensitivity was high and similar in photopic and mesopic conditions. As regards patient-evaluated outcomes, only 2 patients (3.4%) were fairly dissatisfied with their sight after surgery. Three patients (5.1%) reported the need for spectacle correction for certain activities. All other patients (94.8%) reported never using spectacle correction. Conclusions: The PanOptix trifocal IOL provides good short-term visual outcomes, with good intermediate performance and excellent patient-reported satisfaction. The similar values achieved in mesopic and photopic conditions in binocular uncorrected visual acuity and contrast sensitivity suggest low pupillary dependence for light distribution. Trial registration number: ISRCTN60143265 , retrospectively registered on the 24th of April 2017

Analysis of vault prediction in phakic implantable phakic collamer lenses: manufacturer’s calculator vs theoretical formulae vs clinical practice

Background: Implantable collamer phakic (ICL) intraocular lens sizing calculations are necessary to avoid complications associated to inadequate sizing. Historically, Holladay R, Dougherty, Hernández-Matamoros, and other authors have tried to create new formulas that solve calculation problems and provide higher reliability. In addition, in recent years, the appearance of new equipment, parameters, and formulas have led to significant progress. This paper compares the sizing according to manufacturer’s method and other methods. Methods: Forty-three eyes of 24 patients with EVO ICL implanted, with at least 1 year of follow-up, were analysed. The analysed variables were white to white (WTW), anterior chamber depth (ACD), ACW (angle-to-angle), crystalline lens rise (CLR), ICL size, vault measured at 1 week and 1 year after surgery, ICL size, and vault predicted by Nakamura-2 as well as vault size predicted by Igarashi. Results: Sizing calculation with Online Calculation and Ordering System according to WTW and ACD is a good indicator with 86% success rate. The calculation with Nakamura 2 suggests larger ICL sizes in 32.5% of cases and smaller in 18.6% of cases, while the resulting Vault according to Igarashi obtains better results without significant differences. Conclusions: ICL sizing according WTW and ACD, using the manufacturer’s algorithm, seems to be the most predictable method compared to other algorithms using other variables. The surgeon’s expertise also has a high importance in the final ICL size election

Atlas electrónico de registros retinográficos y tomográficos: cribado, derivación, diagnóstico diferencial y seguimiento de afecciones retinianas Parte IV: Retinopatía del Prematuro

El objetivo de este proyecto es continuar con el Atlas retinográfico iniciado en las convocatorias anteriores con imágenes obtenidas con los principales y novedosos instrumentos utilizados en la actualidad para el diagnóstico de patologías retinianas. El Atlas presenta, además de las imágenes, una detallada descripción de los criterios cribado. Esta cuarta parte se centra en el diagnóstico por imagen de la retinopatía del prematuro, que se define como una vitreorretinopatía fibro y vasoproliferativa periférica que acontece en los recién nacidos inmaduros, generalmente sometidos a oxigenoterapia. El Atlas está constituido por una extensa relación de retinografías (fotografías del fondo de ojo–retina) y tomografías de coherencia óptica (imágenes de cortes histológicos de la retina en vivo), exponiendo casos reales de patologías comunes y poco comunes. Constituye una herramienta con triple función: por un lado, será un elemento didáctico para el aprendizaje de patologías retinianas y el método de diagnóstico por imagen; en segundo lugar, puede utilizarse para realizar autoevaluaciones y, en tercer lugar, constituye una completa base de datos de casos clínicos. En definitiva, se trata de una herramienta muy económica y de gran utilidad para un amplio grupo de profesionales sanitarios expertos y especialistas en sistema visual

Measurement of the Intraocular Pressure Elevation During Laser-Assisted In Situ Keratomileusis Flap Creation Using a Femtosecond Laser Platform

Purpose: The purpose of this study was to measure the intraocular pressure (IOP) elevation during laser assisted in situ keratomileusis (LASIK) flap creation using the WaveLight FS200 femtosecond (FS) laser platform. Methods: We conducted an ex vivo experimental study in an animal model. The WaveLight FS200 FS laser platform was used to perform the corneal LASIK flap in freshly enucleated porcine eyes. We measured the changes in IOP from the application of the suction ring (suctioning phase) through the creation of the lamellar corneal flap (cutting phase). The IOP was recorded using a manometric technique with direct cannulation to the anterior chamber. Results: Nine freshly enucleated porcine eyes were included in the study. The mean baseline IOP before the procedure was 20.33 ± 5.9 mm Hg. The mean IOP increase over baseline IOP was 32.33 ± 11.3 mm Hg at the suctioning phase, and 38.22 ± 11.3 mm Hg at the cutting phase. The total surgical time needed to complete the procedure was 29.5 ± 4.4 seconds. Conclusions: The WaveLight FS200 FS laser platform produces a low to moderate increase in IOP during LASIK flap creation. Translational Relevance: The WaveLight FS200 is a safe FS laser platform because it induces a low to moderate IOP increase during LASIK flap creation

Retinal protection from LED-backlit screen lights by short wavelength absorption filters

Background: Ocular exposure to intense light or long-time exposure to low-intensity short-wavelength lights may cause eye injury. Excessive levels of blue light induce photochemical damage to the retinal pigment and degeneration of photoreceptors of the outer segments. Currently, people spend a lot of time watching LED screens that emit high proportions of blue light. This study aims to assess the effects of light emitted by LED tablet screens on pigmented rat retinas with and without optical filters. Methods: Commercially available tablets were used for exposure experiments on three groups of rats. One was exposed to tablet screens, the other was exposed to the tablet screens with a selective filter and the other was a control group. Structure, gene expression (including life/death, extracellular matrix degradation, growth factors, and oxidative stress related genes), and immunohistochemistry in the retina were compared among groups. Results: There was a reduction of the thickness of the external nuclear layer and changes in the genes involved in cell survival and death, extracellular matrix turnover, growth factors, inflammation, and oxidative stress, leading decrease in cell density and retinal damage in the first group. Modulation of gene changes was observed when the LED light of screens was modified with an optical filter. Conclusions: The use of short-wavelength selective filters on the screens contribute to reduce LED light-induced damage in the rat retina

Atlas electrónico de registros retinográficos y tomográficos: cribado, derivación, diagnóstico diferencial y seguimiento de afecciones retinianas. Parte V: Distrofias retinianas

El objetivo de este proyecto es continuar con el Atlas retinográfico iniciado en las convocatorias anteriores con imágenes obtenidas con los principales y novedosos instrumentos utilizados en la actualidad para el diagnóstico de patologías retinianas. El Atlas presenta, además de las imágenes, una detallada descripción de los criterios cribado. Esta quinta parte se centra en el diagnóstico por imagen de distrofias retinianas, que son un grupo heterogéneo de enfermedades hereditarias de la retina, por lo general bilaterales y progresivas, que conducen a la pérdida de visión funcional hasta la ceguera. El Atlas está constituido por una extensa relación de retinografías (fotografías del fondo de ojo–retina) y tomografías de coherencia óptica (imágenes de cortes histológicos de la retina en vivo), exponiendo casos reales de patologías comunes y poco comunes. Constituye una herramienta con triple función: por un lado, será un elemento didáctico para el aprendizaje de patologías retinianas y el método de diagnóstico por imagen; en segundo lugar, puede utilizarse para realizar autoevaluaciones y, en tercer lugar, constituye una completa base de datos de casos clínicos. En definitiva, se trata de una herramienta muy económica y de gran utilidad para un amplio grupo de profesionales sanitarios expertos y especialistas en sistema visual

The Role of Social Support in Machismo and Acceptance of Violence Among Adolescents in Europe. Lights4Violence Baseline Results

Purpose To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries. Methods Cross-sectional design. We recruited 1,555 participants ages 13–16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence—dating violence, bullying, cyberbullying, abuse in childhood—and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex. Results Acceptance of violence was higher for those who had lower perceived social support from parents (βgirls = −154, p < .001; βboys = −.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (βgirls = .067, p = .035; βboys = .225, p < .001; (βgirls = .118, p < .001; βboys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys. Conclusions Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence

Implementación de la metodología aprendizaje-servicio (ApS) como medio generador de conocimiento y reflexión en los estudiantes de los grados de Educación Infantil y Educación Primaria

Memoria ID2019/045. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2019-2020