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Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

Eye and Vision 2020年第1期7卷 328-335页

作者： Veronica Vargas jorge L.Alió Rafael I.Barraquer Justin Christopher D’Antin Cristina García Francisco Duch Joan Balgos jorge laliódel barrio Vissum Instituto Oftalmológico de Alicante AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain Institut Universitari Barraquer Universitat Autònoma de BarcelonaBarcelonaSpain Centro de Oftalmología Barraquer BarcelonaSpain Universitat Internacional de Catalunya BarcelonaSpain Clínica Real Vision MadridSpain Instituto Catalán de Retina(ICR)unidad de Cirugía Refractiva BarcelonaSpain

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy(phakic intraocular lens–pIOL–explantation with cataract surgery and pseudophakic intraocular lens implantation)in patients previously implanted with posterior chamber ***:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for posterior chamber pIOL with a follow up time of 12 *** uncorrected and best corrected distance visual acuities(UDVA,CDVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative ***:There was a statistically significant improvement in uncorrected and best corrected visual acuities after bilensectomy(p=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal *** endothelial cell count remained stable without a statistically significant change after surgery(p=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CDVA after surgery,73%of the patients were within±1 D(spherical equivalent)of the target *** complications were one posterior capsule rupture with the intraocular lens(IOL)implanted in the sulcus,and 3 eyes required the use of pupil expanders for adequate pupil ***,one eye developed retinal *** three pIOLs models explanted were the Implantable Collamer Lens(ICL),Implantable Phakic Contact Lens(IPCL)and the Phakic Refractive Lens(PRL).Conclusions:Good safety and visual outcomes were observed 1 year after bilensectomy for posterior chamber phakic intraocular lenses(PC pIOLs).There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.

关键词： Bilensectomy Posterior chamber phakic intraocular lenses Cataract Endothelial cell count Visual outcomes Postoperative complications Intraoperative complications

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Cellular therapy of the corneal stroma: a new type of corneal surgery for keratoconus and corneal dystrophies

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Eye and Vision 2018年第1期5卷 250-259页

作者： jorge L.Aliódel barrio jorge L.Alió Cornea Cataract and Refractive Surgery UnitVissum CorporaciónAlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain. Vissum Instituto Oftalmologico de AlicanteAvda de Denia s/n03016 AlicanteSpain

Cellular therapy of the corneal stroma,with either ocular or extraocular stem cells,has been gaining a lot of interest over the last *** publications from different research groups are showing its potential benefits in relation to its capacity to improve or alleviate corneal scars,improve corneal transparency in metabolic diseases by enhancing the catabolism of the accumulated molecules,generate new organized collagen within the host stroma,and its immunosuppressive and immunomodulatory *** extraocular stem cells do not require a healthy contralateral eye and they do not involve any ophthalmic procedures for their *** stem cells have been the most widely assayed and have the best potential to differentiate into functional adult keratocytes in vivo and in *** embryonic stem cells have been partially abandoned due to ethical implications,the discovery of the induced pluripotent stem cells(iPSC)has opened a new and very promising field for future research as they are pluripotent cells with the capacity to theoretically differentiate into any cell type,with the special advantage that they are obtained from adult differentiated *** delivery into the corneal stroma has been experimentally assayed in vivo in multiple ways:systemic versus local injections with or without a *** preliminary human clinical data is already available although still very limited,and further research is necessary in order to consolidate the clinical applications of this novel therapeutic line.

关键词： Stem cells Regenerative medicine Corneal transplant Decellularized cornea Cornea Corneal stroma Cellular therapy MSC Mesenchymal stem cells

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Accommodative intraocular lenses:where are we and where we are going

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Eye and Vision 2017年第1期4卷 81-92页

作者： jorge L.Alió jorge L.Aliódel barrio Alfredo Vega-Estrada Cornea Cataract and Refractive Surgery UnitVissum CorporaciónAvda de Denia s/nEdificio Vissum03016 AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain

Presbyopia still remains the last frontier of refractive *** surgical management is under constant evolution due to the limitations that exist today with respect to its management,which is probably in relation with the multifactorial basis in which presbyopia is clinically developed in the *** currently,virtually all surgical techniques that have been proposed for its correction are based on the induction of pseudoaccommodation in the presbyopic eye,including ***,the real restoration of accommodation is more complex,and it has been tried by the use of different,so called,“accommodative”pseudophakic intraocular lenses(AIOL).Overall,the reported results with these lenses by independent authors have been modest in relation with the restoration of the accommodative power of the eye and these modest benefits are usually lost with time due to the long term changes in the capsular *** fact made these lenses to be almost abandoned in the last few years,but there are currently other AIOL models being used with innovative mechanisms of action and different anatomical support outside the capsular bag that offer encouraging preliminary results that could bring a new potential of application to these types of *** this article,we will update the modern refractive surgeon about the fundamentals and provide updated information about the outcomes of AIOLs by reviewing the concept of accommodation,the different attempts that have been accomplished in the past,their demonstrated published results in human clinical trials,and the future alternatives that may arrive in the near future.

关键词： Accommodation Accommodative intraocular lens Presbyopia

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Retinal image quality with multifocal,EDoF,and accommodative intraocular lenses as studied by pyramidal aberrometry

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Eye and Vision 2021年第6期8卷 374-384页

作者： jorge L.Alio Francesco D’Oria Francesca Toto Joan Balgos Antonio Palazon Francesco Versaci jorge L.Alio del barrio Vissum Innovation AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezVissum Miranzac/Cabañal103016 AlicanteSpain Section of Ophthalmology Department of Basic Medical ScienceNeuroscience and Sense OrgansUniversity of BariBariItaly Department of Clinical Medicine Miguel Hernández UniversitySan Juan de AlicanteSpain R&D Department Costruzione Strumenti Oftalmici(CSO)FlorenceItaly

Background:To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function(PSF)Strehl ratio using a pyramidal wavefront sensor(PWS)-based ***:This study included 194 eyes implanted with:(a)19 AcrySof SA60AT(control group);(b)19 Miniwell;(c)24 LENTIS Mplus LS-313 MF30;(d)33 LENTIS Mplus LS-313 MF15;(e)17 AkkoLens Lumina;(f)31 AT LISA Tri 839MP;(g)20 Precizon Presbyopic;(h)20 AcrySof IQ PanOptix;(i)11 Tecnis *** outcome measures were PSF Strehl ratio,PSF Strehl ratio excluding second-order aberrations(PSFw2),total root mean square(RMS),low-order aberration(LOA)and high-order aberration(HOA)RMS measured by PWS ***:AT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0-and 4.0-mm pupil size(0.52±0.14 and 0.31±0.10;P<0.05),followed by SA60AT(0.41±0.11 and 0.28±0.07)and PanOptix(0.4±0.07 and 0.26±0.04).AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.004).Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.002).Total RMS,LOA RMS,HOA RMS,PSF Strehl ratio and PSFw2 varied significantly between the studied groups(P<0.001).Conclusions:Far distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted *** LISA Tri,SA60AT and PanOptix showed the highest values of far distance retinal image quality,while the lowest PSFw2 Strehl ratios were displayed by Miniwell,Mplus MF30 and Precizon Presbyopic.

关键词： Cataract surgery Pyramidal aberrometry Multifocal IOL Extended depth of focus Accommodative IOL

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Patients’dissatisfaction with multifocal intraocular lenses managed by exchange with other multifocal lenses of diferent optical profles

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Eye and Vision 2024年第1期10卷 31-40页

作者： Olena Al‑Shymali Colm McAlinden jorge L.Alio del barrio Mario Canto‑Cerdan jorge L.Alio Research&Development Department VISSUM Innovation and Department of Cornea Cataract and Refractive SurgeryVISSUM CorporationAlicanteSpain Department of Ophthalmology Singleton HospitalSwansea Bay University Health BoardSwanseaUK Division of Ophthalmology School of MedicineVISSUM AlicanteUniversidad Miguel HernándezCalle Cabañal 103016 AlicanteSpain Cornea Cataract and Refractive Surgery DepartmentVISSUM CorporationAlicanteSpain

Background:The aim of the study was to evaluate the outcomes of dissatisfed patients reporting poor visual quality following implantation of multifocal intraocular lenses(MF-IOLs),managed by IOL exchange with another multifocal optical ***:This is a retrospective series of ***-IOL exchange was done in 15 dissatisfed patients(30 eyes)with the perception of poor visual quality for far distance afected by neuroadaptation *** underwent a bilateral exchange of a MF-IOL with another MF-IOL of a diferent optical *** outcomes and complications were *** including Quality of Vision(QoV),Visual Function Index-14(VF-14)and its Rasch-revised version(VF-8R)and a satisfaction questionnaire were also used for outcome ***:The mean elapsed time from implantation to explantation-reimplantation was 11.8 *** QoV scores improved signifcantly across all the three *** function improved with a change in VF-14 score from 60.41±24.81 to 90.16±10.91(P<0.001).The VF-8R score improved as *** uncorrected distance visual acuity improved from 0.24 to 0.12 logMAR after exchange(P<0.001)and corrected distance visual acuity improved from 0.15 to 0.04 logMAR(P<0.001).Safety and efcacy indexes reached 1.46 and 1.16,*** patients’satisfaction following MF-IOL exchange,80%of the patients reported they would have the MF-IOL reimplantation procedure ***:Patient dissatisfaction with neuroadaptation failure following MF-IOL implantation can be managed in 80%of our cases by MF-IOL exchange with a diferent MF-IOL optical profle.

关键词： Multifocal intraocular lenses IOL exchange Visual acuity Neuroadaptation failure

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Corneal transplantation outcomes after the extrusion of an intrastromal keratoprosthesis:a pilot study

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Eye and Vision 2020年第2期7卷 250-254页

作者： Chiara Fariselli Ibrahim Toprak Olena Al-Shymali jorge L.Alio del barrio jorge L.Alio Research and Development Department Calle Cabañal1 Edificio Vissum03016 AlicanteSpain Department of Ophthalmology Pamukkale UniversityDenizliTurkey Cornea and Refractive Surgery Department Calle Cabañal1 Edificio Vissum03016 AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain

This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the eye after the extrusion of the non-perforating keratoprosthesis(Kpro)KeraKlear(KeraMed,USA).The non-perforating Kpro was extruded after a mean period of 21.4±21.8 months due to *** two cases,the keratoplasty was performed the same day of the non-perforating Kpro removal due to a severe melting,while in the other three cases it was performed one to 3 months *** eyes received a DALK,but in 3 eyes a macroscopic Descemet membrane perforation forced the conversion into a *** mean follow-up period after the keratoplasty was 16.8±6.6 *** cases of rejection were *** the 5 eyes achieved“anatomical success”(transparent graft,with no signs of infection or inflammation).Two eyes showed limited“functional success”because the achievement of the best visual potential was prevented by the development of glaucomatous optic atrophy during the follow-up *** conclusion,this short report presents an unexpected success of a keratoplasty performed with a tectonic purpose after the extrusion of the non-perforating Kpro because the corneal graft remained transparent,without neovascularization or scarring during the follow-up *** initial evidence shows some encouraging results regarding graft survival rate and the achievement of a useful visual rehabilitation with keratoplasty after a nonperforating Kpro failure instead of repeating the Kpro implantation.

关键词： Keratoprosthesis Extrusion Keratoplasty Corneal transplantation

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Small incision lenticule extraction(SMILE)in the correction of myopic astigmatism:outcomes and limitations-an update

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Eye and Vision 2017年第1期4卷 151-158页

作者： jorge L.Aliódel barrio Verónica Vargas Olena Al-Shymali jorge L.Alió Cornea Cataract and Refractive Surgery UnitVissum CorporaciónAlicanteSpain Division of Ophthalmology School of MedicineUniversidad Miguel HernándezAlicanteSpain

Small Incision Lenticule Extraction(SMILE)is a flap-free intrastromal technique for the correction of myopia and myopic *** date,this technique lacks automated centration and cyclotorsion control,so several concerns have been raised regarding its capability to correct moderate or high levels of *** objective of this paper is to review the reported SMILE outcomes for the correction of myopic astigmatism associated with a cylinder over 0.75 D,and its comparison with the outcomes reported with the excimer laser-based corneal refractive surgery techniques.A total of five studies clearly reporting SMILE astigmatic outcomes were *** shows acceptable outcomes for the correction of myopic astigmatism,although a general agreement exists about the superiority of the excimer laser-based techniques for low to moderate levels of *** correction of the static cyclotorsion should be adopted for any SMILE astigmatic correction over 0.75 D.

关键词： Small incision lenticule extraction SMILE Astigmatism Refractive surgery

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Simultaneous tectonic Descemet stripping endothelial keratoplasty and tectonic Bowman layer transplant for the management of corneal perforation

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International Journal of Ophthalmology(English edition) 2023年第9期16卷 1549-1554页

作者： Abdo Karim Tourkmani Colm McAlinden David F.Anderson jorge L.Alio del barrio jorge L.Alió Royal Gwent Hospital NewportWales NP202UBUK Ophthalmology Department Universidad Miguel HernándezAlicante 03202Spain Ulster University Northern IrelandBelfast BT151EDUK Southampton General Hospital Southampton SO166YDEnglandUK Cornea Cataract&Refractive Surgery UnitVissum(Miranza Group)Alicante 03106Spain

AIM:To report the outcomes of three cases of corneal perforation managed with simultaneous tectonic Descemet stripping endothelial keratoplasty(t-DSEK)and tectonic Bowman layer transplant(t-BLT)as an alternative to tectonic penetrating keratoplasty(t-PKP).METHODS:Three eyes of three patients receiving simultaneous t-DSEK and t-BLT for corneal perforation were *** technique for DSEK was modified depending on individual *** t-BLT technique was standardised using an 8 mm graft and fixated with a running *** was measured by the ability of this procedure to close a corneal ***:All three cases achieved tectonic eye globe restoration and remained stable during the minimum 3-month observation *** were relatively common:2 cases required amniotic membrane transplant for persistent epithelial *** case required DSEK *** case developed angle closure glaucoma requiring surgical peripheral ***:Simultaneous t-DSEK and t-BLT may be a useful strategy for the management of corneal perforation as an alternative management to t-PKP for selected cases.

关键词： tectonic corneal graft Descemet stripping endothelial keratoplasty Bowman layer transplant penetrating keratoplasty

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Clinical outcomes with a new design in multifocal intraocular lens:a pilot study

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Eye and Vision 2020年第5期7卷 366-374页

作者： jorge L.Alió Pilar Yébana Mario Cantó Ana B.Plaza Alfredo Vega jorge L.Aliódel barrio Francisco Lugo Vissum Corporation Avda de Denia s/nEdificio Vissum03016 AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain

Purpose:To evaluate the clinical and visual outcomes,quality of near vision and the influence of photic phenomena in patients bilaterally implanted with a new Precizon Presbyopic multifocal intraocular lens(IOL).Methods:In this prospective consecutive case series,20 eyes of 10 patients were included(mean age 63.80±12.55 years).Uncorrected and corrected visual acuity(far,intermediate and near),subjective refraction,binocular defocus curve,contrast sensitivity(CSV-1000)and quality of vision and satisfaction questionnaires were *** follow-up was 12 months after ***:At 12 months after surgery,uncorrected distance visual acuity(UDVA)improved with surgery(p=0.001)with a value of 0.08±0.08 *** near visual acuity(UNVA)was 0.22±0.12 logMAR and distance corrected near visual acuity(DCNVA)was 0.16±0.13 *** distance visual acuity(UIVA)was 0.22±0.10 *** sensitivity outcomes were similar to normal population in photopic conditions and slightly reduced in mesopic conditions of *** curve showed that this multifocal IOL was able to provide a visual acuity(VA)equal or better to 0.16 logMAR between defocus levels of+1.00 to−2.50 *** patient satisfaction was obtained in quality of vision and satisfaction questionnaires ***:The Precizon Presbyopic NVA IOL(OPHTEC BV)provides good visual *** multifocal IOL provides a high percentage of spectacle independence due to good VA at far,intermediate and near distances and satisfactory contrast *** patient satisfaction was observed in quality of vision and satisfaction questionnaires with a low percentage of patients manifesting photic phenomena.

关键词： Multifocal intraocular lens Near vision Photic phenomena Continuous transitional focus optic

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Corneal surgery in keratoconus: which type, which technique, which outcomes?

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Eye and Vision 2016年第1期3卷 8-21页

作者： Francisco Arnalich-Montiel jorge L.Aliodel barrio jorge L.Alio IRYCIS.Ophthalmology Department Ramon y Cajal University HospitalMadridSpain Cornea Unit Hospital Vissum MadridMadridSpain Cornea and External Diseases Service Moorfields Eye HospitalLondonUK Cornea Cataract and Refractive Surgery UnitVissum CorporacionAlicanteSpain Division of Ophthalmology Universidad Miguel HernandezAlicanteSpain

Keratoconus is a disease characterized by progressive thinning,bulging,and distortion of the *** cases usually present with loss of vision due to high irregular astigmatism.A majority of these cases require surgical *** review provides an update on the current treatment modalities of corneal surgery available for the management of advanced corneal ectasias.

关键词： Keratoconus Deep anterior lamellar keratoplasty Penetrating keratoplasty Corneal transplant Rejection

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