Estudio morfológico y funcional del endotelio corneal tras la cirugía de la catarata

Tesis Univ. Complutense de Madrid, 1995Propósito: estudiar las alteraciones morfofuncionales inducidas en el endotelio corneal por la cirugía de la catarata con los principales métodos disponibles: paquimetría, fluorofotometría y microscopia especular.sujetos, material y metodos: Se ha estudiado una muestra homogénea de 98 pacientes con cataratas seniles no complicadas, realizando las determinaciones antes y tres meses después de la cirugía. Los pacientes se han clasificado en varios grupos atendiendo a la técnica quirúrgica (cirugía extracapsular con distintos tipos de capsulotomías: abrelatas, sonrisa y capsulorrexis y facoemulsificacion) y al grado de experiencia del cirujano. Resultados: existe una alteración significativa de la función de barrera endotelial a los 3 meses de la cirugía, así como una perdida celular media del 18'8+- 9'3%. Tanto la cirugía extracapsular como la facoemulsificación inducen un daño morfofuncional comparable, que es significativamente mayor en las intervenciones realizadas por cirujanos noveles. El mantenimiento de la cápsula anterior del cristalino en la capsulotomia en sonrisa hasta el final de la cirugía desempeña un papel de protección endotelial. No existe un incremento postoperatorio significativo del grosor corneal con ninguna de las técnicas.Depto. de Inmunología, Oftalmología y ORLFac. de MedicinaTRUEpu

Analysis of teachers´perceptions in the development of their professional work

En este estudio se analizan las creencias de autoeficacia de los y las docentes españoles y españolas, en el contexto de la Educación Primaria, Educación Secundaria Obligatoria (ESO) y Bachillerato, aplicando el cuestionario CACPD (Cuestionario de autoeficacia de las competencias profesionales del docente), en el curso escolar 2014-2015. Los resultados arrojan que las creencias sobre la propia eficacia docente, evaluada teniendo en cuenta las competencias docentes, depende del género, la etapa educativa, la titularidad del centro y las materias. No existiendo diferencias significativas en cuanto a los años de experiencia. El estudio concluye que en la formación inicial y continua del profesorado, sería posible llevar a cabo un trabajo centrado en el desarrollo de profesores líderes cuya relación con el alumno sea de reciprocidad, que sepan poner en práctica su capacidad creativa, con una actitud elevada hacia el esfuerzo, motivación y perseverancia en la adversidad, con buena práctica pedagógica y que desarrollen una capacidad de autoevaluación reflexionando y autorregulando su actuación docente, con mirada metacognitiva, cuya finalidad sea mejorar su propia actuación docenteIn this study we analyze Spanish teachers´ believes in Elementary, Middle and High School, applying the questionnaire CACPD (Questionnaire self-efficacy teachers´ believes), in the school course 2014-2015. The study show that the teachers´ believes evaluated efficiency in theirs competences depends on the kind, the educational stage, the ownership of the center and the matters. Not existing significant differences as for the years of experience. The study concludes that in the initial and continuous formation, we could be a work focuses on the development of leading teachers whose relation with the pupil will be of reciprocity, which they can put into practice his creative capacity, with an attitude raised towards the effort, motivation and perseverance in the adversity, with good pedagogic practice and that develop an individual teacher´s capacity of self-evaluation thinking over and self-regulation on their educational action, with metacognition, whose purpose is to improve his own educational actio

New poly(ester urea) derived from L-leucine: Electrospun scaffolds loaded with antibacterial drugs and enzymes

Electrospun scaffolds from an amino acid containing poly(ester urea) (PEU) were developed as promising materials in the biomedical field and specifically in tissue engineering applications. The selected poly(ester urea) was obtained with a high yield and molecular weight by reaction of phosgene with a bis(alpha-aminoacy1)-alpha,omega-dioldiester monomer. The polymer having L-Ieucine, 1,6-hexanediol and carbonic acid units had a semicrystalline character and relatively high glass transition and melting temperatures. Furthermore it was highly soluble in most organic solvents, an interesting feature that facilitated the electrospinning process and the effective incorporation of drugs with bactericidal activity (e.g. biguanide derivatives such as clorhexidine and polyhexamethylenebiguanide) and enzymes (e.g. alpha-chymotrypsin) that accelerated the degradation process. Continuous micro/nanofibers were obtained under a wide range of processing conditions, being diameters of electrospun fibers dependent on the drug and solvent used.; Poly(ester urea) samples were degradable in media containing lipases and proteinases but the degradation rate was highly dependent on the surface area, being specifically greater for scaffolds with respect to films. The high hydrophobicity of new scaffolds had repercussions on enzymatic degradability since different weight loss rates were found depending on how samples were exposed to the medium (e.g. forced or non-forced immersion). New scaffolds were biocompatible, as demonstrated by adhesion and proliferation assays performed with fibroblast and epithelial cells. (C) 2014 Elsevier B.V. All rights reserved.Peer ReviewedPostprint (published version

Purpureocillium lilacinum fungal keratitis: Confocal microscopy diagnosis and histopathology correlation

Disponible online el 1 de Diciembre de 2020. In Press, Corrected Proof.Unidad Docente de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaTRUEinpres

Ciliochoroidal detachment following pure sulfur hexafluoride injection in Descemet stripping automated endothelial keratoplasty

Received 29 October 2016, Accepted 6 March 2017, Available online 20 April 2017Unidad Docente de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaTRUEinpres

Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was months. Mean baseline IOP was  mmHg with medication and  mmHg after washout. Mean end-follow-up IOP was  mmHg, representing an IOP decrease of 36.92%,  mmHg (), from baseline washout IOP. The mean number of medications was significantly reduced from to (). 45% of patients were medication-free by the end of follow-up. Mean BCVA improved significantly from to (). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract

Agreement and clinical comparison between a new swept-source optical coherence tomography-based optical biometer and an optical low-coherence reflectometry biometer

Purpose To compare measurements taken using a swept-source optical coherence tomography-based optical biometer (IOLmaster 700) and an optical low-coherence reflectometry biometer (Lenstar 900), and to determine the clinical impacts of differences in their measurements on intraocular lens (IOL) power predictions. Methods Eighty eyes of 80 patients scheduled to undergo cataract surgery were examined with both biometers. The measurements made using each device were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW), and pupil diameter (PD). Holladay 2 and SRK/T formulas were used to calculate IOL power. Differences in measurement between the two biometers were determined using the paired t-test. Agreement was assessed through intraclass correlation coefficients (ICC) and Bland–Altman plots. Results Mean patient age was 76.3±6.8 years (range 59–89). Using the Lenstar, AL and PD could not be measured in 12.5 and 5.25% of eyes, respectively, while IOLMaster 700 took all measurements in all eyes. The variables CCT, AQD, LT, and MK varied significantly between the two biometers. According to ICCs, correlation between measurements made with both devices was excellent except for WTW and PD. Using the SRK/T formula, IOL power prediction based on the data from the two devices were statistically different, but differences were not clinically significant. Conclusions No clinically relevant differences were detected between the biometers in terms of their measurements and IOL power predictions. Using the IOLMaster 700, it was easier to obtain biometric measurements in eyes with less transparent ocular media or longer AL

Effect of pharmacological pupil dilation on measurements and iol power calculation made using the new swept-source optical coherence tomography-based optical biometer

Purpose: to determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). Procedures: eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results: mean patient age was 75.17 ± 7.54 years (range: 57–92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. Conclusions: the use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation

Increased Cortical Thickness and Caudate Volume Precede Atrophy in PSEN1 Mutation Carriers

Neuroimaging studies of familial Alzheimer's disease allow investigation of the disease process before clinical onset. We performed semi-automated MRI analysis to evaluate cortical thickness (CTh), grey matter (GM) volumes, and GM diffusivity indexes in PSEN1 mutation carriers (MC). We recruited 11 MC from 4 families with PSEN1 mutations (L286P, M139T, K239N) and 6 familial and 12 non-familial healthy controls. MC were classified as either asymptomatic (n=6) or symptomatic (n=5). Subjects underwent structural and diffusion-weighted 3-Tesla MRI scanning. CTh and GM volumes of subcortical structures and diffusivity indexes were calculated and group comparisons were performed. Structural images were reanalyzed with voxel-based morphometry methodology. Cerebrospinal fluid amyloid-β1-42 levels (Aβ) were measured. We found that symptomatic MC presented widespread cortical thinning, especially in precuneus and parietotemporal areas (p<0.01) and increased mean diffusivity (MD) in these areas compared to controls. Unexpectedly, asymptomatic MC, 9.9 years prior to the predicted age of disease onset, presented increased CTh in the precuneus and parietotemporal areas (p<0.01), increased caudate volumes (p<0.01), and decreased MD (p<0.05) in these areas compared to HC. In MC, CTh correlated with adjusted age. Aβ values were within normal limits in AMC. In conclusion, at early preclinical stages, CTh in the precuneus and parietotemporal regions and caudate volume increase in PSEN1 MC and decrease thereafter with disease progression. The different trends in MD in asymptomatic and symptomatic MC suggest that different microstructural changes underlie the contrasting morphometric findings. Reactive neuronal hypertrophy or/and inflammation may account for increased CTh and decreased MD in asymptomatic MC

Novel Insights into the Transmission of SARS-CoV-2 Through the Ocular Surface and its Detection in Tears and Conjunctival Secretions: A Review

SARS-CoV-2 is a highly transmissible virus that spreads mainly via person-to-person contact through respiratory droplets, or through contact with contaminated objects or surfaces from an infected person. At present we are passing through a phase of slow and painful understanding of the origin, epidemiological profile, clinical spectrum, and risk profile of the virus. To the best of our knowledge there is only limited and contradictory evidence concerning SARS-CoV-2 transmission through other routes. Importantly, the eye may constitute not only a potential site of virus replication but also an alternative transmission route of the virus from the ocular surface to the respiratory and gastrointestinal tract. It is therefore imperative to gain a better insight into the potential ophthalmological transmission route of the virus and establish directions on best practice and future models of care for ophthalmological patients. This review article critically evaluates available evidence on the ophthalmological mode of viral transmission and the value of earlier identification of the virus on the eye. More evidence is urgently needed to better evaluate the need for protective measures and reliable ocular diagnostic tests to diminish further pandemic spread