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Biomedical subjects

A Maldonado-Bas

Publications and source records attributed to A Maldonado-Bas.

3 recordsLinked to original sources

Filtering glaucoma surgery using an excimer laser.

PURPOSE: To evaluate the results of excimer laser trabecular ablation in the treatment of open-angle glaucoma. SETTING: Clínica de Ojos Maldonado Bas Privada, Córdoba, Argentina. METHODS: This study comprised 32 eyes that had surgery for open-angle glaucoma between May 1997 and May 2000. The surgical procedure included topical anesthesia, a conjunctival incision, a lamellar scleral flap, and ablation of Schlemm's canal and the trabeculum with a scanning or diaphragm excimer laser system until a microperforation was produced in the underlying corneotrabecular tissue. The microperforation had no effect on the treatment and was used only as a sign that the ablation was deep enough and should be stopped. Schlemm's canal was unroofed, and its inner wall and the trabeculum were partially ablated. The scleral flap and conjunctiva were sutured. No antimetabolites were used. RESULTS: The mean intraocular pressure was 28.06 mm Hg +/- 9.82 (SD) preoperatively and 13.09 +/- 2.67 mm Hg postoperatively. Complications included hyphema (n = 3), choroidal detachment (n = 5), posterior synechias (n = 1), and posterior synechias and cataract (n = 1). CONCLUSION: Excimer laser ablation appears to be an effective option for the treatment of glaucoma that may be easier to perform than other procedures for many surgeons.

Adolescent↗

Results of laser in situ keratomileusis in different degrees of myopia.

PURPOSE: This study aimed to analyze the results of laser in situ keratomileusis (LASIK) in different degrees of myopia. MATERIAL AND METHODS: Three hundred consecutive eyes were divided into 4 groups according to their degree of preoperative myopia. Group I was between -3 and -6 diopters (D) (28 eyes), low myopia. Group II was between -6.25 and -10 D (138 eyes), moderate myopia. Group III was between -10.25 and -15 D (91 eyes), high myopia. Group IV was between -15.25 and -25.50 D (43 eyes), extremely high myopia. Patients were observed for 6 to 25 months. RESULTS: For group I, the preoperative spherical equivalent was -5.12 D +/- 0.81 standard deviation (SD), corrected visual acuity was 0.88 +/- 0.14 (SD), and keratometry was 44.09 D +/- 1.65 (SD). At the last check-up, the spherical equivalent was -0.42 D +/- 0.98 (SD), corrected visual acuity was 0.89 +/- 0.15 (SD), keratometry was 39.11 D +/- 1.61 (SD). For group II, preoperative spherical equivalent was -8.33 D +/- 1.24 (SD), corrected visual acuity was 0.72 +/- 0.22 (SD), keratometry was 44.34 D +/- 1.64 (SD). At last check-up, the spherical equivalent was -0.19 D +/- 1.22 (SD), corrected visual acuity was 0.76 +/- 0.17 (SD), keratometry was 37.56 D +/- 1.90 (SD). For group III, the preoperative spherical equivalent was -12.37 D +/- 1.49 (SD), corrected visual acuity was 0.58 +/- 0.23 (SD), and keratometry was 44.06 D +/- 1.63 (SD). At last check-up, spherical equivalent was -0.55 D +/- 1.63 (SD), corrected visual acuity was 0.61 +/- 0.18 (SD), and keratometry was 35.88 D +/- 2.18 (SD). For group IV, the preoperative spherical equivalent was -19.04 +/- 2.82 (SD), corrected visual acuity was 0.37 +/- 0.17 (SD), and keratometry was 44.02 D +/- 1.30 (SD). At last check-up, spherical equivalent was -1.49 D +/- 1.54 (SD), corrected visual acuity was 0.44 +/- 0.18 (SD), and keratometry was 33.94 D +/- 2.54 (SD). CONCLUSION: With some exceptions, LASIK results generally are acceptable and stable. Nevertheless, the scatter of some cases shows that there is room for improvement, even in the most sophisticated excimer software. The high regression of group I proves the need to sample multizone software to determine whether stability is improved. Although visual results are better in patients with lower myopia, the patients whose eyes had higher ametropia more often showed improvement in their visual acuity. This may be because of the greater postoperative size of the image on the macula.

Adolescent↗

Therapeutic alloplastic laser in situ keratomileusis for myopia.

BACKGROUND: A new technique, therapeutic alloplastic laser in situ keratomileusis to correct high myopia, is introduced. METHODS: Therapeutic alloplastic laser in situ keratomileusis consists of neutral homoplastic epikeratoplasty combined with superficial keratectomy performed with an excimer laser and/or a microkeratome. Indications for the technique are: myopia over 20 diopters (D), eyes with corneal scarring after photorefractive keratectomy (PRK), complications following keratomileusis, radial keratotomy complications with undercorrection, and keratoconus suspect myopic eyes. RESULTS: In all five eyes we achieved precise corneal lathing with the microkeratome or the excimer laser, and obtained a clear allograft. In all eyes, we maintained or improved the patient's spectacle-corrected visual acuity related to baseline values. We did not induce astigmatism, and corneal thickness was almost unchanged. CONCLUSIONS: Advantages of therapeutic alloplastic laser in situ keratomileusis are that it provides a Bowman's layer for the cornea following keratectomy, it is possible to lathe ablation diameters larger than 5 mm, it prevents the appearance of corneal haze, and reduces the need for corticosteroid treatment.

Adult↗