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Biomedical subjects

Jairo E Hoyos

Publications and source records attributed to Jairo E Hoyos.

4 recordsLinked to original sources

Hyperopic laser in situ keratomileusis for refractive accommodative esotropia.

PURPOSE: To assess the efficacy of hyperopic laser in situ keratomileusis (LASIK) in creating orthophoria without optical correction in adult patients with refractive accommodative esotropia (RAE). SETTING: Instituto Oftalmológico de Sabadell, Sabadell, Barcelona, Spain. METHODS: This prospective single-center clinical trial studied 9 eyes (18 patients) with RAE having hyperopic LASIK. The mean follow-up was 20 months (range 12 to 24 months). The mean preoperative refraction was +5.01 diopters (D) and the mean deviation angle without optical correction, 36 prism diopters. The intervention was hyperopic LASIK using the Automated Corneal Shaper microkeratome (Bausch & Lomb) and the Apollo broad-beam excimer laser using a 5.5 mm optical zone and an 8.0 mm transition zone; astigmatism was treated by steepening the flattest meridian. RESULTS: All patients achieved orthophoria or the preoperative microtropia without optical correction immediately after surgery. This was maintained throughout the follow-up. Fifty-six percent of all cases were within +/-0.5 D of emmetropia, and 89% were within +/-1.0 D. The uncorrected visual acuity improved significantly (P <.005), especially at near, and the mean best corrected visual acuity (BCVA) was maintained, although 4 eyes (22%) lost 1 line of BCVA. There were no significant complications. CONCLUSIONS: In adult patients with RAE, treatment of the refractive error using hyperopic LASIK was safe and effective and corrected the esodeviation. Further studies in younger patients will help determine the age at which this intervention may be indicated.

Accommodation, Ocular↗

Phakic refractive lens experience in Spain.

PURPOSE: To evaluate the efficacy, predictability, and safety of a phakic refractive lens (PRL) for high myopia and hyperopia. SETTING: Instituto Oftalmológico Hoyos, Barcelona, Spain. METHODS: A PRL was implanted in 31 eyes (17 myopic, 14 hyperopic) with a mean preoperative spherical equivalent (SE) of -18.46 diopters (D) (range -11.85 to -26.00 D) for myopia and +7.77 D (range +5.25 to +11.00 D) for hyperopia. All eyes had a thorough ophthalmologic examination before and after surgery. The follow-up was at least 12 months. RESULTS: At 1 year, the mean postoperative SE in the myopic group was -0.22 D +/- 0.87 (SD) and 82% were within +/-1.00 D of the desired refraction. The mean postoperative SE in the hyperopic group was -0.38 +/- 0.82 D, and 79% were within +/-1.00 D. Snellen lines of visual acuity were gained in 65% of the myopic eyes (8 eyes gained 1 line, 3 eyes gained 2 lines), and no eye lost lines. In the hyperopic group, 1 eye gained 1 line of acuity and 1 eye lost 1 line. In the hyperopic group, complications included pupillary block in 2 eyes and pigment dispersion signs without intraocular hypertension in 1 eye. In the myopic group, 1 eye had a corticosteroid-induced intraocular pressure rise, 1 eye had a spot of anterior cortical lens opacity immediately after surgery that did not progress, and 3 eyes with the PRL model 100 had decentration that required replacement of the lens. Four patients (2 myopic, 2 hyperopic) reported night halos in both eyes. CONCLUSIONS: Results indicate that PRL implantation to correct high myopia and hyperopia is a relatively rapid, safe, predictable, and stable method that in many cases also improves the best corrected visual acuity. Complications such as visually significant progressive cataract and pigmentary glaucoma were not observed.

Adult↗

Zonular dehiscence two years after phakic refractive lens (PRL) implantation.

PURPOSE: To report two cases of zonular dehiscence two years after phakic refractive lens (PRL) implantation. METHODS: In case 1, a 31-year-old myopic patient with refraction of -12.75 diopters (D) in the right eye and -20.50 D in the left eye, a 12-mm white-to-white measurement, and anterior chamber depth (ACD) of 3.7 mm underwent implantation of a -11.0 D and a -15.5 D PRL-101. Two years after surgery, a temporal-superior PRL decentration was observed in the left eye. In case 2, a 48-year-old pseudophakic patient with refraction of +8 -2.5 x 20 degrees underwent implantation of a piggyback PRL-200. Two years after surgery, an inferior PRL decentration was observed. RESULTS: The PRL was explanted in both cases. A zonular dehiscence was found--temporal-superior in case 1 and inferior in case 2. CONCLUSIONS: We have stopped implanting PRLs for the present time as the cause of this complication has yet to be determined.

Adult↗