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Characterization, passive and active treatment in strabismic amblyopia: a narrative review

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International Journal of Ophthalmology(English edition) 2020年第7期13卷 1132-1147页

作者： Myriam Milla david p.pinero Department of Optometry OFTALVIST AlicanteAlicante 03016Spain Group of Optics and Visual perception Department of OpticsPharmacology and AnatomyUniversity of AlicanteSan Vicente del RaspeigAlicante 03690Spain

Strabismic amblyopia is characterized by a distorted spatial *** this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility *** inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of *** treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic *** researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic ***,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.

关键词： amblyopia strabismus occlusion vision therapy strabismic amblyopia penalization Bangerter foil

Adjustable muscle plication:a new surgical technique for strabismic patients with high risk for anterior segment ischemia

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International Journal of Ophthalmology(English edition) 2015年第4期8卷 839-842页

作者： Carlos Laria david p.pinero Department of Ophthalmology(OFTALMAR) Vithas Medimar International Hospital Foundation for the Visual Quality(FUNCAVIS Fundación para la Calidad Visual) Department of Optics Pharmacology and AnatomyUniversity of Alicante

INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior *** the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ***,we show the correction of the horizontal ocular deviation by means of an adjustable muscle

关键词： Figure a new surgical technique for strabismic patients with high risk for anterior segment ischemia high

profitability analysis of a femtosecond laser system for cataract surgery using a fuzzy logic approach

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International Journal of Ophthalmology(English edition) 2016年第7期9卷 1046-1050页

作者： Jose Antonio Trigueros david p pinero Mahmoud M Ismail Department of Financial Economic and Accounting Miguel Hernandez University Elche 03202 Alicante Spain Department of Optics Pharmacology and AnatomyUniversity of Alicante Crta San Vicente del RaspeigAlicante 03690 Spain Al-Azhar University Cairo 11651 Egypt

AIM：To define the financial and management conditions required to introduce a femtosecond laser system for cataract surgery in a clinic using a fuzzy logic ***：In the simulation performed in the current study,the costs associated to the acquisition and use of a commercially available femtosecond laser platform for cataract surgery（VICTUS,TECHNOLAS perfect Vision GmbH,Bausch ＆ Lomb,Munich,Germany） during a period of 5y were considered.A sensitivity analysis was performed considering such costs and the countable amortization of the system during this 5y ***,a fuzzy logic analysis was used to obtain an estimation of the money income associated to each femtosecond laser-assisted cataract surgery（G）. RESULTS：According to the sensitivity analysis,the femtosecond laser system under evaluation can be profitable if 1400 cataract surgeries are performed per year and if each surgery can be invoiced more than $*** contrast,the fuzzy logic analysis confirmed that the patient had to pay more per surgery,between $661.8 and $667.4 per surgery,without considering the cost of the intraocular lens（IOL）.CONCLUSION：A profitability of femtosecond laser systems for cataract surgery can be obtained after a detailed financial analysis,especially in those centers with large volumes of *** cost of the surgery for patients should be adapted to the real flow of patients with the ability of paying a reasonable range of cost.

关键词： cataract surgery femtosecond laser fuzzy logic femto-cataract victus profitability analysis

prevalence of visual impairment and refractive errors in an urban area of Mexico

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International Journal of Ophthalmology(English edition) 2019年第10期12卷 1612-1617页

作者： Isabel Signes-Soler david p pinero Milagro Ines Murillo Silvia Tablada University of Valencia 46100 BurjassotValenciaSpain Vision Without Border 03710 CalpAlicanteSpain Department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicante 03690Spain

AIM: To determine the distribution of refractive errors in a school-age population in Quintana Roo(Mexico) in the framework of an international cooperation campaign for the prevention of blindness. METHODS: A sample of 2647 school-age children(ranging from 5 to 14 years old) with a mean age of 9.1±1.9 years old were tested by trained volunteers for distance visual acuity(VA) and refractive errors. The first screening examination included uncorrected distance visual acuity(UDVA) and VA with a +2.00 D lens. Inclusion criteria for a second complete cycloplegic eye examination performed by an optometrist were UDVA plete eye examination. Mean logMAR UDVA was 0.035±0.094(range 1.00 to 0.00 logMAR) for the right eyes and 0.036±0.160(range 1.00 to 0.00 logMAR) for the left eyes. Bilateral amblyopia was found in 17 children(2.7% of refracted eyes;0.64% of the total). The main reason for visual impairment(VI) in the sample analyzed was found to be refractive errors. In 12 children(1.9% of refracted eyes;0.45% of the total) the VI was bilateral and 9(1.4% of refracted eyes;0.34% of the total) achieved a corrected distance visual acuity of 20/25 or better in both eyes. Mean magnitude of sphere and refractive cylinder was +0.20±0.96 D and-0.43±0.85 D in right eyes, and +0.24±1.08 and-0.43±0.83 D in left eyes. The proportion of myopic eyes [standard equivalent(SE) ≤-0.50 D] was 4.6% of the whole sample(5290 eyes). The mean magnitude of myopia was-0.84±3.44 D for the right eyes and-0.82±5.21 D for the left eyes. The proportion of hyperopic patients(SE≥+2.00 D) was 2.4%(15/633), which corresponded to 0.60% of the whole sample(32/5290 eyes). No statistically significant correlation of age to manifest sphere or cylinder was ***: VI due to uncorrected refractive errors can be easily corrected with glasses but it is still a burden to be treated.

关键词： myopia hyperopia refractive error blindness visual impairment

Comparative analysis of the efficacy of astigmatic correction after wavefront-guided and wavefront-optimized LASIK in low and moderate myopic eyes

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International Journal of Ophthalmology(English edition) 2017年第2期10卷 285-292页

作者： Mounir A.Khalifa Mahmoud F.Alsahn Mohamed Shafik Shaheen david p.pinero Ophthalmology Department Tanta UniversityTanta 31527Egypt Horus Vision Correction Center Alexandria 21311Egypt Alex LASIK Center Alexandria 21311Egypt Department of Ophthalmology University of AlexandriaAlexandria 21543Egypt Department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicante 03690Spain

AIM： To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis（LASIK） in eyes with myopic astigmatism using wavefront-guided（WFG） and wavefront-optimized（WFO） ablation ***： prospective study included 221 eyes undergoing LASIK： 99 and 122 eyes with low and moderate myopic astigmatism（low and moderate myopia groups）.Two subgroups were differentiated in each group according to the ablation profile： WFG subgroup,109 eyes（45/64,low/moderate myopia groups） treated using the Advanced Custom Vue platform（Abbott Medical Optics Inc.）,and WFO subgroup,112 eyes（54/58,low/moderate myopia groups） treated using the EX-500 platform（Alcon）.Clinical outcomes were evaluated during a 6-month follow-up,including a vector analysis of astigmatic ***： Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group（p≤0.041）.postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups（p≤0.003）.In moderate myopia group,a higher percentage of eyes with a postoperative cylinder ≤0.25 D was found in the WFG subgroup（90.6% vs 65.5%,p=0.002）.In low and moderate myopia groups,the difference vector was significantly higher in the WFO subgroup compared to WFG（p〈0.001）.In moderate myopia group,the magnitude（p=0.008） and angle of error（p〈0.001） were also significantly higher in the WFO *** induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups（p≤0.006）.CONCLUSION： A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK.

关键词： myopia wavefront-guided LASIK wavefront-optimized LASIK astigmatism

Visual function alterations in essential tremor: A case report

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Journal of Innovative Optical Health Sciences 2015年第5期8卷 94-98页

作者： david p.pinero Begona Monllor Vicenta Moncho Vicent J.Camps Dolores de Fez Grupo de Optica y percepcion Visual(GOpV)Department of Optics Pharmacology and Anatomy University of AlicanteSpain Department of Ophthalmology(OFTALMAR)Medimar International Hospital AlicanteSpain Foundation for the Visual Quality(Fundacion para la Calidad Visual FUNCAVIS)

Our purpose is to report alterations in contrast sensitivity function(CSF)and in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter in case of an essential tremor(ET).A complete evaluation of the visual function was performed in a 69-year old patient,including the analysis of the chromatic discrimination by the Fansworth–Munsell 100 hue test,the measurement of the CSF by the CSV-1000E test,and the detection of potential alteration patterns in the magno,parvo and koniocellular visual pathways by means of a multichannel *** acuity and intraocular pressure(IOp)were within the ranges of normality in both *** abnormalities were detected in the fundoscopic examination and in the optical coherence tomography(OCT)*** results of the color vision examination were also within the ranges of normality.A signi¯cant decrease in the achromatic CSFs for right eye(RE)and left eye(LE)was detected for all spatial *** statistical global values provided by the multichannel perimeter confirms that there were significant absolute sensitivity losses compared to the normal pattern in *** the LE,only a statistically significant decrease in sensitivity was detected for the blue-yellow(BY)*** pattern standard deviation(pSD)values obtained in our patient indicated that there were significant localized losses compared to the normality pattern in the achromatic channel of the RE and in the red-green(RG)channel of the *** color vision alterations may be present in ET that cannot be detected with conventional color vision tests,such as the FM 100 Hue.

关键词： Multichannel perimetry essential tremor color vision visual pathways contrast sensitivity

Interchangeability of corneal curvature and asphericity measurements provided by three different devices

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International Journal of Ophthalmology(English edition) 2019年第3期12卷 412-416页

作者： david p.pinero Roberto Soto-Negro pedro Ruiz-Fortes Rafael J pérez-Cambrodí Hideki Fukumitsu Department of Optics Pharmacology and AnatomyUniversity of AlicanteSan Vicente del Raspeig 03690 Department of Ophthalmology(OFTALMAR) Vithas Medimar International Hospital Department of Ophthalmology Marina Baixa Hospital

AIM: To evaluate the interchangeability of keratometric and asphericity measurements provided by three measurement systems based on different optical ***: A total of 40 eyes of 40 patients with a mean age of 34.1 y were included. In all cases, a corneal curvature analysis was performed with IOL-Master(IOLM), iDesign 2(ID2), and Sirius systems(SIR). Differences between instruments for flattest(K1) and steepest(K2) keratometric readings, as well as for magnitude and axis of corneal astigmatism were analyzed. Likewise, differences in asphericity(Q) between SIR and ID2 were also evaluated. RESULTS: Mean differences between devices for K1 were 0.20±0.21(pp=0.046) and-0.32±0.36 D(pparisons IOLM-SIR, IOLM-ID2 and SIR-ID2, respectively. The ranges of agreement for these comparisons between instruments were 0.41, 0.70, and 0.70 D. For K2, mean differences were 0.31±0.33(pp=0.265) and-0.39±0.38 D(pp=0.011; 0.55 D, p=0.386; 0.43 D, p=0.05). In contrast, ranges of agreement were clinically relevant for astigmatic axis(26.68o, 33.83o and 18.37o, p≥0.121) and for Q between SIR and ID2(0.16, ppower, astigmatic axis and asphericity measurements provideby the three systems evaluated cannot be considered as interchangeable, whereas measurements of corneal astigmatism obtained with SIR and ID2 can be considered as interchangeable for clinical purposes.

关键词： astigmatism corneal topography keratometry corneal asphericity

Clinical comparative analysis of the outcomes with a yellow- and a violet-tinted intraocular lens

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International Journal of Ophthalmology(English edition) 2016年第1期9卷 166-169页

作者： peter Mojzis Zdenek Bombera Sarka Vesela Daniela Klapuchova peter Ziak david p.pinero premium Clinic Teplice 41501 Czech Republic Eye Department of Regional Hospital in Havlickuv Brod Havlickuv Brod 58001 Czech Republic Eye Clinic of Jessenius Faculty of Medicine Martin 03601Czech Republic Department of Optics Pharmacology and AnatomyUniversity of Alicante San Vicente del Raspeig 03690Alicante Spain

Dear Sir,I am Dr. peter Mojzis from premium Clinic in Teplice （Czech Republic）. I write to present the results of a comparative study of clinical outcomes obtained with two different types of tinted intraocular lenses （IOLs）, yellow-vs violet-tinted IOLs. IOLs containing a yellow chromophore that filters simultaneously ultra violet （UV） and blue light were developed several years ago in the attempt of avoiding that blue and violet visible light reached the retina in the pseudophakic eye.

关键词： IOL and a violet-tinted intraocular lens Clinical comparative analysis of the outcomes with a yellow

potential of video games for the promotion of neuroadaptation to multifocal intraocular lenses: a narrative review

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International Journal of Ophthalmology(English edition) 2019年第11期12卷 1782-1787页

作者： Maria Begona Coco-Martin pedro LValenzuela Miguel JMaldonado-López Alejandro Santos-Lozano Ainhoa Molina-Martin david p pinero Research Unit Hospital Clínico Universitario de Valladolid.ICSCYLValladolid 47003Spain Grupo de Cirugía Refractivay Rehabilitación Visual.Instituto Universitario de Oftalmobiología Aplicada(IOBA) Universidad de ValladolidValladolid 47011Spain physiology Unit Systems Biology DepartmentUniversity of AlcaláMadrid 28801Spain Grupo de Investigación i+Health Departamento de Ciencias de la SaludUniversidad Europea Miguel de CervantesValladolid 47012Spain Department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicante 03690Spain Department of Ophthalmology(IMQO-Oftalmar) Vithas Medimar International HospitalAlicante 03016Spain

Multifocal intraocular lenses(IOLs) are currently usually implanted for the treatment of cataracts because they have been proved to be superior to monofocal IOLs with respect to spectacle independence. In turn, they are associated with a higher prevalence of dysphotopsia symptoms that is one of the most common causes of patient dissatisfaction. Neuroadaptation seems to play a major role in the optimal adaptation to multifocal IOLs. In this context, the development of strategies that facilitate the neuroadaptation process to multifocality might be an effective strategy to reduce patients' dissatisfaction. Video games have been proved to be effective for the improvement of visual acuity and for the promotion of neuroplasticity in elderly subjects and other populations with cortical-related visual impairment. This narrative review highlights the physiological potential of video games as a perceptual strategy to improve visual acuity and promote neuroplasticity in patients using multifocalIOLs, although research is still needed to confirm these benefits in this specific population, with only one comparative study to this date providing evidence of them.

关键词： multifocal intraocular lens dysphotopsia photic phenomena halos video games neuroadaptation neuroplasticity