Prophylaxis of Macular Edema with Intravitreal Ranibizumab in Patients with Diabetic Retinopathy after Cataract Surgery: A Pilot Study

The purpose of this study was to evaluate the effectiveness of intravitreal ranibizumab (Lucentis, Genentech, South San Francisco, Calif, USA) combined with cataract surgery for the prevention of clinically significant macular edema (CSME) in patients with diabetic retinopathy (DR). This prospective interventional case series included fifty-four eyes of 54 patients with a previous diagnosis of nonproliferative diabetic retinopathy (NPDR) without macular edema preoperatively. Subjects were assigned in a 1 : 1 ratio to receive an intraoperative intravitreal ranibizumab injection (n = 27) or not (control group, n = 27) associated with standardised phacoemulsification surgery. The main outcome measure was the incidence of CSME one and three months after surgery. One month after surgery the incidence of CSME in the control group was 25.92% and 3.70% in the treatment group and at three months was 22.22% and 3.70%, respectively. Short-term results suggest that intravitreal ranibizumab immediately after phacoemulsification prevents CS ME in patients with NPDR

Acute endothelial failure after cosmetic iris implants (NewIris®)

We report a case of an acute endothelial failure after the implantation of a new cosmetic, colored, artificial iris diaphragm implant called NewIris®. A 21-year-old woman came to us complaining of progressive loss of vision and pain after NewIris lenses had been implanted. Decreased visual acuity, corneal edema, and increased intraocular pressure in both eyes appeared only 3 weeks after the surgery. The lenses were removed as soon as possible but had already severely affected the endothelial cell count. NewIris implants are an alternative to cosmetic contact lenses, but they are not as safe as other phakic anterior chamber intraocular lenses, nor are they a good option for the patient

Diffractive Corneal Inlays: A New Concept for Correction of Presbyopia

A new class of corneal inlays for treatment of presbyopia is described, which uses diffraction as the working principle. The inlay consists of an opaque disk with a small central aperture surrounded by an array of micro-holes that are distributed following the order of a given Fresnel zone plate having N zones. In this way, the central hole of the disk produces an extension of the depth of focus of the eye for distance vision and contributes to the zero order of diffraction, and the light diffracted by the micro-holes in the periphery produces a real focus for near vision. In our general design, the number of zones and the diameter of the central hole are free parameters that can be used to design customized devices with different addition power and near-focus intensity. Two different designs are analyzed to show this property. In the analysis, we employed a ray tracing software to study the performance of the new inlays in the two different model eyes. The results are compared with those obtained with a model of the small-aperture inlay that is currently in the market. The different merit functions used in the comparison and the image simulations performed with the inlays in the model eyes show the excellent performance of our proposal

A new trifocal corneal inlay for presbyopia

[EN] Corneal inlays (CIs) are the most recent surgical procedure for the treatment of presbyopia in patients who want complete independence from the use of glasses or contact lenses. Although refractive surgery in presbyopic patients is mostly performed in combination with cataract surgery, when the implantation of an intraocular lens is not necessary, the option of CIs has the advantage of being minimally invasive. Current designs of CIs are, either: small aperture devices, or refractive devices, however, both methods do not have good performance simultaneously at intermediate and near distances in eyes that are unable to accommodate. In the present study, we propose the first design of a trifocal CI, allowing good vision, at the same time, at far, intermediate and near vision in presbyopic eyes. We first demonstrate the good performance of the new inlay in comparison with a commercially available CI by using optical design software. We next confirm experimentally the image forming capabilities of our proposal employing an adaptive optics based optical simulator. This new design also has a number of parameters that can be varied to make personalized trifocal CI, opening up a new avenue for the treatment of presbyopia.This work was supported by Ministerio de Ciencia e Innovacion, Spain (Grant PID2019-107391RB-I00) and by Generalitat Valenciana, Spain, (Grant PROMETEO/2019/048). D. Montagud-Martinez and V. Ferrando acknowledge the financial support from the Universitat Politecnica de Valencia, Spain (fellowships FPI-2016 and PAID-10-18, respectively)Furlan, WD.; Montagud-Martínez, D.; Ferrando, V.; Garcia-Delpech, S.; Monsoriu Serra, JA. (2021). A new trifocal corneal inlay for presbyopia. Scientific Reports. 11(1):1-8. https://doi.org/10.1038/s41598-021-86005-8S1811

Bleeding Follicular Conjunctivitis due to Influenza H1N1 Virus

Influenza H1N1 or A virus is a new virus serotype capable of human-to-human transmission. This infection causes a flu syndrome similar to that of seasonal influenza, with only one case of conjunctivitis described and no clinical details or microbiological confirmation. Its diagnosis is performed by PCR of pharyngeal smear of the patients affected. We report the first well-documented case in the medical literature of conjunctivitis by H1N1 virus

Aqueous humor neutrophil gelatinase-associated lipocalin levels in patients with idiopathic acute anterior uveitis

Purpose: The purpose of this study was to evaluate the levels of neutrophil gelatinase-associated lipocalin (NGAL) in the aqueous humor in eyes with idiopathic acute anterior uveitis (AAU). Methods: A comparative control study. Aqueous humor was collected from 20 eyes of 20 patients with idiopathic AAU. The control group included 20 aqueous samples from 20 patients about to undergo cataract surgery and without any other ocular or systemic diseases. The level of NGAL was determined with a commercially available ELISA kit. Results: The concentration of NGAL in aqueous humor was markedly higher in patients with idiopathic AAU than in control subjects (Mann–Whitney U test, p<0.001). The level of NGAL was 139,197.38±183,426.36 (mean±SD) pg/ml in eyes with AAU and 3,169.96±1,595.78 pg/ml in the eyes of the control group. Conclusions: The aqueous humor NGAL level is increased in eyes with idiopathic AAU. These results imply that NGAL is associated with the regulation of inflammation in patients with AAU and could be used as a biomarker of ocular inflammation and immunomodulatory treatment response.Medicin

In Vitro Chromatic Performance of Three Presbyopia-Correcting Intraocular Lenses with Different Optical Designs

Most of the new premium models of intraocular lenses for presbyopia correction use diffractive optics in their optical design. The presence of multiple foci and the difference of the diffractive efficiency for different wavelengths have a great impact in the lens optical performance. In this context, there is a limited information available for clinicians to understand the optical principles that differentiate each design and their potential influence on clinical outcomes. Optical bench studies with polychromatic light are necessary to solve this limitation. In this work, a custom made optical bench was employed to assess with polychromatic light the through the focus optical quality of three different IOL designs: trifocal, EDOF effect; and enhanced monofocal. By using different and complimentary approaches: images of the USAF test, axial PSFs and TF-MTFs, each design revealed its intrinsic features, which were not previously reported for these IOLs models in a comparative way. It was found that the chromatic aberration plays a very important role in the performance of each IOL. Our results could help clinicians to understand the optical principle of each lens and also provide useful information for choosing the lens that best suits the needs of the individual patient