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Biomedical subjects

Javier Moreno-Montañés

Publications and source records attributed to Javier Moreno-Montañés.

14 recordsLinked to original sources
PubMed2007

Intraocular lens opacification after nonpenetrating glaucoma surgery with mitomycin-C.

A 58-year-old woman had successful phacoemulsification with intraocular lens (IOL) implantation in January 2001. Two years later, nonpenetrating glaucoma surgery with mitomycin-C (MMC) 0.02% was performed for uncontrolled glaucoma. Two months later, opacification of the anterior IOL surface was observed. The IOL was removed and a hydrophobic acrylic AcrySof IOL (Alcon) implanted. The opacified IOL was studied by flame atomic absorption spectrometry, which showed the presence of calcium carbonate. A new IOL of the same model was placed in an aqueous solution with calcium carbonate and basic pH, and the same opacification developed. We hypothesize that the change in aqueous humor pH after glaucoma surgery and the characteristics of the IOL precipitated deposition of calcium.

Antibiotics, Antineoplastic↗
PubMed2005

Surgical treatment of a dislocated intraocular lens-capsular bag-capsular tension ring complex.

We describe a surgical technique for managing late dislocation of an intraocular lens-capsular bag-capsular tension ring (IOL-CB-CTR) complex. Two 10-0 polypropylene sutures are placed transsclerally over and under the CTR through the anterior and posterior capsules to capture the CTR, which then is retracted and sutured through the sclera. The same maneuver is performed 180 degrees away. This simple, easy, effective procedure can be performed with a small corneal incision and does not require extraction of the IOL-CB complex. Although the CTR does not completely prevent IOL-CB dislocation, it provides the possibility of suturing the IOL-CB to the sulcus without replacing the IOL.

Aged↗
PubMed2005

Objective quantification of posterior capsule opacification after cataract surgery, with optical coherence tomography.

PURPOSE: To evaluate posterior capsule opacification (PCO) in humans after cataract surgery with intraocular lens (IOL) implantation, by using optical coherence tomography (OCT-1). METHODS: Sixty-six eyes with PCO and 20 eyes with a normal posterior capsule were analyzed. A 3-mm-long horizontal scan of the posterior capsule was obtained. Measurements at three points and their average were recorded. Intraoperator and interoperator reliabilities were assessed. Investigated was peak intensity (PI) and posterior capsule thickening (PCT), with PCT indicating the distance between two reflectivity spikes, with an approximate axial resolution of 10 microm. Results were compared with visual acuity (VA) and PCO type. RESULTS: Intraoperator reliability was 0.59 and 0.97 for average PI and PCT, respectively. The interoperator concordance correlation coefficient was 0.70 and 0.82 for average PI and PCT, respectively. Median (interquartile range) intensities of the reflectivity spike were 16.88 (dB) (range, 12.88-20.41) and 11.9 (8.58-14.28), respectively, in the PCO and control eyes (P = 0.001). PCT was found in PCO eyes (median: 86.13 microm; range, 46.33-115.33), whereas no second spike appeared in control eyes (P = 0.001). The area under the receiver operating characteristic curve of the average PCT for differentiating pearl-type from fibrosis-type PCO was 0.87 (P = 0.001). For a cutoff point of 55.3 microm, the sensitivity was 97.5%, and the specificity was 69%. Worse VA correlated significantly only with larger PCT (r(o) = 0.66; P = 0.01). CONCLUSIONS: OCT-1 appears useful to quantitate PCO. In addition, this system seems to discriminate between different types of PCO. PCT may be a previously unrecognized factor in VA degradation.

Adolescent↗
PubMed2004

Extraction of endocapsular tension ring after phacoemulsification in eyes with pseudoexfoliation.

PURPOSE: To describe an easy and effective surgical technique for removing the endocapsular tension ring (CTR) after phacoemulsification. DESIGN: New surgical technique. METHODS: One 10-0 polypropylene suture needle is passed through the hole at one end of the CTR. Then, the CTR is introduced into the capsular bag before phacoemulsification. If the posterior capsule ruptures, the CTR can be removed by pulling the suture toward the corneal incision and rotating the CTR to remove it. RESULTS: We performed this technique in 23 cases with a risk of zonular damage and did not encounter complications at any point in the procedure. CONCLUSIONS: We recommend this procedure in eyes with risk of zonular dialysis and posterior capsule rupture, especially in advanced pseudoexfoliative cataracts or if the surgeon has limited experience with these cases.

Device Removal↗
PubMed2003

Intraoperative and postoperative complications of Cionni endocapsular ring implantation.

PURPOSE: To analyze the intraoperative and postoperative complications of Cionni ring implantation in eyes with a subluxated lens or zonular weakness. SETTING: Departamento de Oftalmología, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona, Spain. METHODS: This case series comprised 7 eyes of 5 patients with a subluxated lens or zonular weakness secondary to Marfan's syndrome (n = 2), traumatic cataract (n = 2), or megalocornea (n = 1) or of unknown etiology (n = 2). An AcrySof (Alcon) foldable intraocular lens (IOL) was implanted in all eyes. A 2-eyelet Cionni ring was implanted in 1 eye and a 1-eyelet Cionni ring, in 6 eyes. The Cionni ring was secured in position with a transscleral suture knotted to the ring's hook, avoiding peripheral perforation of the capsular bag. RESULTS: In 1 eye, corectopia was inadvertently produced by passing the suture needle through the iris root; lens subluxation temporarily increased during ring rotation and implantation. However, after the transscleral suture was tightened, capsular bag centration was excellent. In the eye with megalocornea, traction from the 2 hooks tore the edge of the anterior capsule rim. The most frequent postoperative complication was posterior capsule opacification, which occurred in 5 eyes, 2 of which required a neodymium:YAG posterior capsulotomy. After 1 year, the Cionni ring continued to provide excellent stability and capsular bag and IOL positioning in all cases. CONCLUSIONS: Results indicate that Cionni ring implantation is an acceptable procedure to correct limited lens subluxation, preserves the capsular bag, and has few significant complications.

Acrylic Resins↗
PubMed2003

Clinical factors related to the frequency and intensity of glistenings in AcrySof intraocular lenses.

PURPOSE: To assess the frequency of glistenings in eyes that had phacoemulsification and implantation of AcrySof intraocular lenses (IOLs) (Alcon) and to evaluate the clinical factors related to the glistenings. SETTING: Departamento de Oftalmología, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain. METHODS: A consecutive series of 129 eyes of 94 patients was prospectively evaluated. All patients had cataract surgery and implantation of an MA30BA AcrySof IOL by the same surgeon using the same technique. The operating surgeon examined patients for the presence of glistenings. The frequency and intensity of glistenings were assessed in relation to 14 clinical factors. The effect of glistenings on postoperative Snellen best corrected visual acuity (BCVA) was also evaluated. RESULTS: Glistenings, which occurred in 38 cases (29.5%), were slight in 15 eyes, moderate in 18, and intense in 5. The frequency of the glistenings was related to the time between surgery and evaluation (P =.0001), the IOL dioptric power (P =.01), postoperative inflammation (P =.01), and phacotrabeculectomy (P =.01). The intensity of the glistenings was related to the time after surgery (P =.01) and presence of postoperative inflammation (P =.004). No relation between glistenings and Snellen BCVA was found. CONCLUSIONS: The frequency and intensity of glistenings in AcrySof IOLs increased with time after surgery and were higher when postoperative inflammation was present. Glistenings developed more frequently in cases of phacotrabeculectomy but not after combined phacoemulsification and deep sclerectomy. Glistenings did not result in decreased Snellen BCVA.

Acrylic Resins↗
PubMed2003

Bleeding during gonioscopy after deep sclerectomy.

PURPOSE: To show a new complication after deep sclerectomy (DS). METHODS: We described two eyes of two patients with open-angle glaucoma and cataract who were operated on of an uneventful phacoemulsification and DS with SK-gel implantation. RESULTS: Bleeding during gonioscopic examination occurred in both eyes 7 and 8 months after combined surgery. The blood originated from the vessels around the Descemet window, and was probably due to manipulation or rocking of the goniolens. Pressure was immediately applied to the gonioscopic lens and the hyphema was interrupted. CONCLUSION: These cases show the presence of new vessels around the Descemet window after DS with SK-gel. Bleeding from the Descemet window vessels can occur during gonioscopy even months after DS. We recommend conducting a careful gonioscopic examination in patients who have undergone DS to avoid this complication.

Aged↗
PubMed2002

Complete anterior capsule contraction after phacoemulsification with acrylic intraocular lens and endocapsular ring implantation.

A 69-year-old man with pseudoexfoliation syndrome and bilateral cataract had phacoemulsification with continuous curvilinear capsulorhexis and implantation of a morcher endocapsular ring and AcrySof acrylic intraocular lens (IOL) (Alcon). Two months later, the patient had vision loss in the left eye with a visual acuity of 20/500. He presented with anterior capsule fibrosis in both eyes, with complete occlusion of the capsule opening in the left eye and mild occlusion in the right eye. After a neodymium:YAG laser anterior capsulotomy in the left eye, visual acuity was 20/20. This case shows that endocapsular ring implantation does not prevent anterior capsule contraction syndrome but can prevent IOL decentration.

Acrylic Resins↗
PubMed2002

Extensive corneal epithelial defect associated with internal hordeolum after uneventful laser in situ keratomileusis.

This report illustrates a retrospective case review in which extensive corneal epithelial ulceration occurred concomitantly with an internal hordeolum in the inferior forniceal conjunctiva 24 hours after an uneventful laser in situ keratomileusis. The internal hordeolum and epithelial defect were successfully managed using a bandage soft contact lens, a course of topical dexamethasone and tobramycin, and generous lubrication.

Administration, Topical↗
PubMed2002

Retinal thickness study with optical coherence tomography in patients with diabetes.

PURPOSE: To quantitatively assess retinal thickness by optical coherence tomography (OCT) in normal subjects and patients with diabetes. This study was intended to determine which retinal thickness value measured with OCT best discriminates between diabetic eyes, with and without macular edema. METHODS: OCT retinal thickness was measured by a manual technique in a total of 26 healthy volunteers (44 control eyes) and 85 patients with diabetes (148 eyes) with the clinical diagnosis of no diabetic retinopathy (45 eyes), nonproliferative diabetic retinopathy without clinically significant macular edema (CSME; 54 eyes), proliferative diabetic retinopathy without CSME (21 eyes), and 28 eyes with diabetic retinopathy with CSME. Independent predictors of the presence of CSME were quantified by using univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were generated to evaluate and compare the predictor variables. The correlation of retinal thickness measurements and visual acuity was calculated. RESULTS: There were statistically significant differences in foveal thickness between control eyes and all the other eye groups (P = 0.001). Diabetic eyes with CSME had a statistically significant greater thickness in each of the areas compared with the other groups. In a multivariate logistic regression model, foveal thickness was a strong and independent predictor of CSME (odds ratio [OR], 1.037; 95% confidence interval [CI] 1.02-1.05). The area under the ROC curve of this predictor variable was 0.94 (P = 0.001). For a cutoff point of 180 microm, the sensitivity was 93%, and specificity was 75%. Foveal thickness correlated with visual acuity in a log minimum angle of resolution (logMAR) scale (Spearman's rho = 0.9, P = 0.001). CONCLUSIONS: These results suggest that foveal thickening over 180 microm measured by OCT may be useful for the early detection of macular thickening and may be an indicator for a closer follow-up of the patient with diabetes.

Adult↗