Jorge L Alió

Minia University, Minya, Al Minyā, Egypt

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Publications (464)1101.85 Total impact

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    ABSTRACT: PURPOSE. To evaluate whether mouse adipose tissue mesothelial cells (ATMCs) share morphological and biochemical characteristics with mouse corneal endothelial cells (CECs) and to evaluate their capacity to adhere onto the decellularized basal membrane of human anterior lens capsules (HALCs) as a potential tissue engineered surrogate for corneal endothelium replacement. METHODS. ATMCs were isolated from the visceral adipose tissue of adult mice and their expression of several corneal endothelium markers was determined with qRT-PCR, immunofluorescence and Western blotting. ATMCs were shortly cultured in a Mesothelial Retaining Phenotype Media (MRPM) and further seeded and cultured on top of the decellularized basal membrane of HALCs. ATMCs-HALCs composites were evaluated by optical microscopy, immunofluorescence and transmission electron microscopy. RESULTS. MRPM cultured ATMCs express the corneal endothelium markers COL4A2, C0L8A2, SLC4A4, CAR2, Na+/K+-ATPase, β-catenin, Zona Occludens-1 and N-cadherin in a pattern similar to mouse CECs. Furthermore, ATMCs displayed strong adhesion capacity onto the basal membrane of HALCs and formed a confluent monolayer within 72 hours of culture in MRPM. Ultrastructural morphological and marker characteristics displayed by ATMCs monolayer onto HALCs clearly indicate that ATMCs retained their original phenotype of squamous epithelial-like cells. CONCLUSIONS. CECs and ATMCs share morphological (structural) and markers (functional) similarities. ATMCs adhered and formed structures mimicking focal adhesion complexes with the HALCs basal membrane. Monolayer structure and achieved density of ATMCs support the proposal of using adult human MCs as a possible surrogate of damaged corneal endothelium.
    Investigative ophthalmology & visual science. 08/2014;
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    ABSTRACT: Currently available keratoprosthesis models (non biological corneal substitutes) have a less than 75% graft survival rate at two years. We aimed at developing a model for keratoprosthesis based on the use of polyethyl acrylate (PEA)-based copolymers, extracellular matrix-protein coating and colonization with adipose-derived mesenchymal stem cells. Human adipose tissue derived mesenchymal stem cells (h-ADASC) colonization efficiency of seven PEA-based copolymers in combination with four extracellular matrix coatings were evaluated in vitro. Then, macroporous membranes composed of the optimal PEA subtypes and coating proteins were implanted inside rabbit cornea. After a three-month follow-up, the animals were euthanized, and the clinical and histological biointegration of the implanted material were assessed. h-ADASC adhered and survived when cultured in all PEA-based macroporous membranes. The addition of high hydrophilicity to PEA membranes decreased h-ADASC colonization in vitro. PEA based copolymer containing 10% hydroxyethyl acrylate (PEA-HEA10) or 10% acrylic acid (PEA-AAc10) monomeric units showed the best cellular colonization rates. Collagen plus keratan sulfate-coated polymers demonstrated enhanced cellular colonization respect to fibronectin, collagen or uncoated PEAs. In vivo implantation of membranes resulted in an extrusion rate of 72% for PEA, 50% for PEA-AAc10, but remarkably of 0% for PEA-HEA10. h-ADASC survival was demonstrated in all the membranes after three months follow-up. A slight reduction in the extrusion rate of h-ADASC colonized materials was observed. No significant differences between the groups with and without h-ADASC were detected respect to transparency or neovascularization. We propose PEA with low hydroxylation as a scaffold for the anchoring ring of future keratoprosthesis.
    Journal of Biomedical Materials Research Part A 06/2014; · 2.83 Impact Factor
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    ABSTRACT: To describe femtosecond laser cataract surgery and discuss the published peer-reviewed articles to have a fair evaluation of this new technology and its comparisons to conventional phacoemulsification surgery.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2014; 30(6):420-427. · 2.47 Impact Factor
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    ABSTRACT: To provide a review of the recent literature on the management of residual refractive error after cataract surgery.
    Current opinion in ophthalmology. 05/2014;
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    ABSTRACT: Cataract surgery in cases with previous corneal surgery can be a major challenge for the ophthalmologist as the visual and refractive outcome can be seriously affected. The surgeon has to preoperatively evaluate whether it is the cataract or the previous corneal surgery that most affects the visual acuity. The surgical procedure should be then carefully planned, to evaluate if a corneal graft surgery should be performed coincidentally to the cataract procedure or whether cataract surgery alone may sufficiently restore the best corrected vision of the patient. If phacoemulsification is possible, it is better to perform cataract surgery first to avoid risks which may occur with simultaneous surgery. Keratoplasty should be postponed to a later date. The refractive outcome of the case deserves special attention in the preoperative planning process and the reduction or elimination of the already existing astigmatism will be a desirable result. The authors will try to provide the practical cataract surgeon a review on this topic aiming to give guidelines for good clinical practice in the decision making process of these challenging and difficult cases.
    Expert Review of Ophthalmology 04/2014;
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    ABSTRACT: To describe the corneal appearance on confocal microscopy after AcuFocus KAMRA Inlay (AcuFocus, Inc., Irvine, CA) implantation and evaluate the visual acuity compared to the confocal microscopy data. Twelve eyes of 12 patients implanted with one of three models of the AcuFocus KAMRA Inlay (ACI 7000, 7000T, and 7000PDT) were prospectively evaluated by confocal microscopy 6 months after implantation. Additionally, 4 eyes of 4 patients explanted during the follow-up period were evaluated. Among the eyes implanted, mean epithelial thickness was 54.6 ± 22 μm. The subbasal nerve plexus was detected in 10 patients. The corneal nerves per unit area were 2.73 ± 2.1 sprouts/mm(2). The branch pattern was found in 8 patients. The mean keratocyte density value was 540 ± 210 cells/mm(2). A low grade of keratocyte activation was found in all patients. Among the eyes explanted, the mean wound healing opacity was 1,092.75 ± 1,877.35 μm/pixel. The corneal tolerance to the KAMRA Inlay appeared to be good. The inlay modified the normal structure of the corneal layer, but it was not associated with severe complications of the eye. Keratocyte activation was the finding most associated with a negative visual outcome. Confocal microscopy can be useful to evaluate the long-term evolution of the corneal layer changes following KAMRA Inlay implantation. [J Refract Surg. 2014;30(3):172-178.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 03/2014; 30(3):172-8. · 2.47 Impact Factor
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    ABSTRACT: Purpose: To demonstrate the surgical application of a new model of epidescemetic keratoprosthesis. Methods: A 53-year-old man was referred to our center with severe alkali burns in both eyes and was treated by a combined corneal graft associated with KeraKlear implantation assisted by femtosecond laser and cataract surgery with implantation of an intraocular lens. Results: After 1 month, visual acuity was 0.6 logMAR in both eyes with -2 sphere correction. Slit-lamp examination and anterior segment optical coherence tomography revealed that the device was centered in the pupil area with no infection. No sign of extrusion was detected. Conclusions: The advantage of this device is that it involves nonperforating surgery, thus reducing the postoperative risk of infection and necrosis of tissue around the prosthesis. Large-scale studies with a long follow-up period are required to evaluate the outcome of use of this device.
    European journal of ophthalmology 02/2014; · 0.91 Impact Factor
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    ABSTRACT: To evaluate the visual and refractive outcomes, predictability, and stability of phakic intraocular lens (pIOL) implantation in keratoconic eyes and compare the results of 2 pIOL models. Vissum Instituto Oftalmologico, Alicante, Spain. Retrospective case series. An iris-claw (Artiflex) or collagen copolymer posterior chamber pIOL (PC pIOL) (Implantable Collamer Lens) was implanted in eyes with stable keratoconus. The main outcome measures were postoperative changes from the preoperative manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, corneal topography, and endothelial cell count. Alpins vectorial analysis was performed. Twenty eyes received an iris-claw pIOL and 28 eyes, a PC pIOL. The mean spherical equivalent was -9.31 diopters (D) ± 4.20 (SD) (range -20.75 to -2.75) preoperatively and -0.46 ± 0.88 D (range -3.25 to 1.00 D) postoperatively (P<.001). No patient lost lines of CDVA. The mean decimal UDVA was 0.08 ± 0.09 preoperatively and 0.71 ± 0.26 postoperatively and the mean decimal CDVA, 0.77 ± 0.24 and 0.87 ± 0.98, respectively (P<.001). The mean efficacy index was 0.90 ± 0.26 and the mean safety index, 1.19 ± 0.29. The mean efficacy index was not statistically different between the PC pIOL (0.88 ± 0.28) and the iris-claw pIOL (0.96 ± 0.22) (P=.058). Refraction was stable during the follow-up. Phakic IOL implantation is a suitable refractive surgical option for stable keratoconus. It may be especially indicated for the management of high ametropia and showed good efficacy and safety. Refractive and keratometric stability was confirmed. No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 01/2014; · 2.75 Impact Factor
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    ABSTRACT: Purpose: Anterior segment optical coherence tomography (OCT) is a relevant diagnostic tool in the evaluation of corneal changes following corneal crosslinking (CXL) treatment in patients infected by a severe fungal corneal infection. Methods: Two patients with severe fungal keratitis that was unresponsive to medical treatment were treated with CXL. Corneal melting was present in all cases. Anterior segment OCT showed the preoperative depth and extension of the infiltrate and the modification during the follow-up. Results: Blockage of the melting was achieved in one patient and one patient developed a corneal perforation. Anterior segment OCT allowed control of the evolution of fungal infection and evaluation of the corneal tissue response to the CXL. It is also able to identify the extent and depth of the inflammation. This parameter seems more important than corneal pachymetry to ensure the safety of CXL procedures in infectious keratitis. Conclusions: The different behavior of inflamed tissue with respect to UVA irradiance could be the main point to understand the different postoperative outcome.
    European journal of ophthalmology 01/2014; · 0.91 Impact Factor
  • Pawel Klonowski, Robert Rejdak, Jorge L Alió
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    ABSTRACT: Microincision cataract surgery (MICS) is an approach to cataract surgery through incision less than 1.8 mm with the purpose of reducing surgical invasiveness, improving at the same time surgical outcomes. The main confirmed advantages of MICS are the control and avoidance of surgically induced corneal astigmatism and the decrease of postoperative corneal aberrations. MICS has been demonstrated to be minimally traumatic surgery, providing better postoperative outcomes than standard small incision phacoemulsification. High degree of surgical innovation, use of advanced phacoemulsification surgical platforms with pressurized fluidic control and new surgical instrumentation, allow doing very sophisticated cataract surgery. MICS favors the use of fluidics, reducing the use of phacoemulsification power. Bimanuality provides opportunity to do manipulation in anterior chamber area easily and much more comfortably than with standard coaxial technique. Today, surgery is performed through 1 mm incision. The use of the modern MICS intraocular lens (IOL) requires incisions of 1.8 mm. The increased availability of MICS IOLs allows to select the best IOL as per the demand of the patient. Long-term stability of the MICS outcomes and wide range of surgical capacity makes MICS the most modern and adequate approach to minimally invasive cataract surgery.
    Expert Review of Ophthalmology 01/2014; 8(4).
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    ABSTRACT: To investigate the visual and refractive outcomes, safety, efficacy and stability of cataract surgery in eyes with stable keratoconus. 17 eyes (10 patients) diagnosed as stable keratoconus, aged from 34 to 73 years (56.63±12.47), underwent micro-incision cataract surgery (MICS) followed by implantation of toric intraocular lens (IOL). Seven of them were operated bilaterally and three unilaterally. A complete ophthalmological examination was performed preoperatively and postoperatively. The main outcome measures were: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry and manifest refraction. Sphere changed from -1.77±6.57D (-11.00 to 7.00) preoperatively to 0.08±0.79D (-1.25 to 1.75) postoperatively (p=0.211), and cylinder changed from -2.95±1.71D (-7.00 to -0.75) to -1.40±1.13D (-3.25 to 0.00) (p=0.016). UDVA (logMAR) changed from 1.33±0.95 (0.40 to 2.77) to 0.32±0.38 (0.00 to 1.30) (p=0.008) and CDVA (logMAR) changed from 0.32±0.45 (0.01 to 1.77) to 0.20±0.36 (-0.03 to 1.30) (p=0.013). Efficacy and safety indexes were 1.38±0.58 and 1.17±0.66, respectively. Refraction and corneal topography were stable during the follow-up (9.10±5.54 months, 3-15) CONCLUSIONS: MICS surgery using corneal topography data and standard formulas for the calculation of the IOL power is a safe and effective procedure regarding keratometric stability, visual and refractive results.
    The British journal of ophthalmology 01/2014; · 2.92 Impact Factor
  • Jorge L Alio, Felipe Soria, Ahmed A Abdou
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    ABSTRACT: This review outlines the advantages and the differences of femtosecond laser-assisted cataract surgery (FLACS) following a coaxial or microincision cataract surgery phacoemulsification in the surgical outcome and greater control of cataract surgery. FLACS offers minimal tissue damage and extreme precision during corneal incision creation, continuous circular capsulorhexis (CCC) and nuclear fragmentation. It also allows diminishing the mean average ultrasound power to emulsify the nucleus followed by a coaxial or a biaxial procedure. The impact of reduced phacoemulsification energy on the corneal endothelium is an interesting topic that is being investigated. Despite its benefits, this technology has relevant financial issues and a high learning curve. FemtoMICS appears to be surgically and statistically more efficient than the FemtoCoaxial technique and Femtoincisions prove to be stable and do not change the corneal high order aberration significantly with favorable results of the triplanar configuration.
    Current opinion in ophthalmology 01/2014; 25(1):81-8. · 2.49 Impact Factor
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    ABSTRACT: To compare the efficacy and safety outcomes of bimanual microincision cataract surgery (MICS) versus 2.2-mm coaxial phacoemulsification assisted by Femtosecond LenSx (Alcon-LenSx Inc., Aliso Viejo, CA). This prospective, randomized, observational, comparative case series comprised 50 cataractous eyes of 50 patients receiving femtosecond laser refractive lens surgery followed by a bimanual MICS technique with two 1-mm incisions (25 patients) (FemtoMICS group) and a coaxial phacoemulsification technique with a 1-mm paracentesis and a 2.2-mm principal incision (25 patients) (FemtoCoaxial group). The main outcomes measures were: ultrasound power, effective phacoemulsification time, postoperative spherical equivalent, higher-order aberrations (corneal and internal), corneal thickness, endothelial cell count, macular thickness, and complications during and after surgery. Both groups were absolutely comparable for all variables preoperatively. Mean ultrasound power was 1.8% ± 0.9% for MICS and 14.7% ± 4.9% for 2.2-mm incisions (P < .001). Effective phacoemulsification time values for MICS and 2.2-mm incisions were 1.5 ± 0.9 and 4.5 ± 2.9 sec, respectively (P = .002). Mean postoperative spherical equivalent was -0.26 for FemtoMICS and -0.33 for FemtoCoaxial (P > .05). The efficacy index at 1 month postoperatively was 160.2% for FemtoMICS and 149% for FemtoCoaxial. No significant differences were found in corneal thickness, endothelial cell count, and macular thickness. Complications included posterior capsule rupture (4%) and anterior capsule rupture with no posterior capsule tear (4%) for FemtoMICS and bridges due to incomplete capsulorhexis (4%) for FemtoCoaxial. MICS and coaxial phacoemulsification techniques assisted by the Femtosecond LenSx achieved excellent safety and efficient outcomes. The FemtoMICS technique was surgically and statistically more efficient than the FemtoCoaxial technique. [J Refract Surg. 2014;30(1):34-40.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 01/2014; 30(1):34-40. · 2.47 Impact Factor
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    ABSTRACT: To evaluate refractive and visual parameters related to distance, intermediate, and near vision after cataract surgery and the optical quality of a new diffractive trifocal intraocular lens (IOL). Vissum Instituto Oftalmologico de Alicante, Alicante, Spain. Case series. Patients had bilateral refractive lens exchange and multifocal diffractive IOL (AT Lisa tri 839 MP) implantation. A complete ophthalmology examination was performed preoperatively and postoperatively. The follow-up was 6 months. The main outcome measures were uncorrected distance (UDVA) and corrected distance (CDVA), intermediate, and near visual acuities; keratometry; manifest refraction; and aberrations (total, corneal, internal). The study comprised 60 eyes of 30 patients (mean age 57.9 years ± 7.8 [SD]; range 42 to 76 years). There was significant improvement in UDVA, uncorrected intermediate visual acuity, uncorrected near visual acuity, CDVA, and distance-corrected intermediate and near visual acuity. The postoperative refractive status was within the range of +1.00 to -1.00 diopter. Total internal aberrations decreased significantly (P<.001). The trifocal IOL improved near, intermediate, and distance vision in presbyopic patients. The use of 3 foci provided significant intermediate visual results without sacrificing near or distance vision. No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 01/2014; 40(1):60-9. · 2.75 Impact Factor
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    ABSTRACT: This review evaluates the outcomes of intrastromal corneal ring segment (ICRS) implantation for the treatment of keratoconus considering a new grading system based on the preoperative visual impairment of the patient. Additionally, a five-year follow-up analysis of patients with stable and progressive keratoconus is performed in order to assess the long term stability of the surgical procedure. Corrected distance visual acuity decreased statistically significantly in patients with mild keratoconus (P < 0.01) but statistically significantly increased in all other grades (P < 0.05). The improvement in visual acuity and the decrease of keratometric and aberrometric values were stable throughout a long period of time in patients with stable keratoconus. In patients with progressive form keratoconus, a significant improvement was found immediately after the procedure, however clinically relevant regression greater than 3 D was observed at the end of the follow up period.
    Middle East African journal of ophthalmology 01/2014; 21(1):3-9.
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    ABSTRACT: Advances in small incision surgery have enabled cataract surgery to evolve from being concerned primarily with the safe removal of the opaque crystalline lens to a procedure refined to yield the best possible postoperative refractive result. As the outcomes of cataract surgery have improved, the use of lens surgery as a refractive modality in patients without cataracts (clear lens extraction) has increased in popularity. The removal of the crystalline lens for refractive purposes, or so called refractive lens exchange (RLE), offers distinct advantages over corneal refractive surgery in selected cases. nevertheless, in some middle-aged patients with high refractive errors, corneal refractive surgery can be a safe and effective treatment. In addition, the use of multifocal lenses offers an alternative for the correction of presbyopia. A further advantage of RLE is that it simultaneously eliminates the need for cataract surgery in the future. The keys for success in RLE are effectiveness and consistency in the refractive outcome, providing at the same time surgical and postoperative safety. To achieve these goals, adequate indications following strict risk/benefit criteria and refractive precision based on accurate preoperative protocols for IOL calculation and selection are mandatory, together with a appropriate choice of surgical procedure based on the surgeon´s skills, minimizing complications.
    Survey of Ophthalmology 01/2014; · 2.86 Impact Factor
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    ABSTRACT: IMPORTANCE This study confirmed the long-term outcomes of the ZB5M phakic intraocular lens (PIOL). OBJECTIVE To evaluate the potential long-term risk associated with ZB5M PIOL implantation. DESIGN, SETTING, AND PARTICIPANTS A retrospective, nonrandomized, consecutive cohort study of a total of 208 eyes implanted with ZB5M PIOLs at VISSUM Corporación Oftalmológica de Alicante between 1990 and 1996 identified through surgical records (208 eyes of 123 patients); 50 of these patients (97 eyes) had available records and follow-up. INTERVENTION ZB5M PIOL implantation. MAIN OUTCOMES AND MEASURES To evaluate the incidence and onset of each complication during the follow-up and risk factors and causes for loss of visual acuity. RESULTS Mean (SD) preoperative spherical equivalent refraction was -19.36 (6.7) diopters and at the end of follow-up, it was -1.4 (2.6) diopters. Mean (SD) best-corrected visual acuity at the preoperative visit was 0.35 (0.2) decimal and at the end of follow-up, 0.56 (0.3) decimal. Mean (SD) endothelial cell density preoperatively and at the end of follow-up was 2783 (787) cells/mm2 and 1921 (672) cells/mm2, respectively. The incidence of cataract during the follow-up was 0.010 eye-year (EY); cornea decompensation, 0.001 EY; ocular hypertension, 0.008 EY; pupil ovalization, 0.020 EY; uveitis, 0.001 EY; and retinal detachment, 0.002 EY. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study that describes the long-term outcomes and complications of ZB5M PIOLs and suggests increasing the postoperative follow-up examinations in patients older than 40 years, analyzing anterior chamber modifications, and recommends PIOL explantation in cases of an increase in the crystalline size.
    Jama Ophthalmology 11/2013; · 3.83 Impact Factor
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    ABSTRACT: To determine the effect of posterior capsulotomy on macular thickness, intraocular pressure and endothelial cell loss in pseudophakic patients with posterior capsule opacification using the other eye of every patient as a control. An observational prospective study was conducted on 31 pseudophakic patients with posterior capsular opacification in one eye, using the other eye as a control. Patients did not suffer any other ocular pathology. All patients were treated by posterior capsular opacification with Nd:YAG capsulotomy, and followed up for a three-month period. The ocular examination included, best corrected visual acuity (BCVA), intraocular pressure (IOP), macular optical coherence tomography (OCT), and endothelial cell assessment (including densitometry, cell size and coefficient of variation, hexagonal cell percentage and pachymetry), which were determined in both eyes before treatment, and one week, one month and 3 months after capsulotomy. Generalized estimating equations (GEE) were used to assess the capsulotomy effect adjusted by corresponding baseline measurements and time. No association was found between capsulotomy and IOP (P=.597), macular thickness (P=.085) or ECA (densitometry (P=.422), average size of cells (P=.299), variation coefficient (P=.495), hexagonal cell percent (P=.093) and corneal pachymetry (P=.423). A significant increase of 0.15 Snellen units in BCVA was found during the 3-month follow-up period (P<.001). This study shows that after Nd:YAG capsulotomy, BCVA improves significantly without any IOP, OCT or ECA changes during the three-month follow-up. Nd:YAG capsulotomy is a safe procedure in pseudophakic patients without any other ocular pathology.
    Archivos de la Sociedad Espanola de Oftalmologia 11/2013; 88(11):415-422.
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    ABSTRACT: To evaluate the visual outcomes of patients with a new diffractive trifocal intraocular lens (IOL). A trifocal diffractive Fine Vision IOL (Physiol, Liege, Belgium) was implanted after microincision cataract surgery (MICS) in 40 eyes of 20 patients with bilateral cataract. The monocular and binocular visual performance and the refractive status were assessed, as well as the defocus curve and contrast sensitivity at 1 and 6 months postoperatively. The monocular visual outcomes (logMAR) at 6 months postoperatively were uncorrected distance visual acuity 0.18 ± 0.13, uncorrected near visual acuity 0.26 ± 0.15, and uncorrected intermediate visual acuity 0.20 ± 0.11. With the best distance correction, the visual outcomes were 0.05 ± 0.06 for corrected distance visual acuity, 0.16 ± 0.13 for distance corrected near visual acuity, and 0.17 ± 0.09 for distance corrected intermediate visual acuity. Binocular defocus curve at 6 months shows a wide range of useful vision with 0.19 ± 0.08 (logMAR) at -1.50 diopter defocus. The monocular contrast sensitivity under scotopic conditions (3 cd/m(2)) was within normal range for a population older than 60 years. The trifocal Fine Vision IOL can restore vision at different distances after cataract surgery, specifically intermediate and near vision. [J Refract Surg. 2013;29(11):756-761.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2013; 29(11):756-61. · 2.47 Impact Factor
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    ABSTRACT: Purpose: To report a new quality of life questionnaire specifically designed to evaluate the outcomes of refractive surgical procedures. Methods: A total of 134 patients with ages ranging between 19-94 years were included in this study. 38.8% of patients underwent myopic refractive surgery and 61.2% underwent cataract surgery. The questionnaire consisted of 22 items that assessed the quality of life in patients undergoing refractive surgery. The VQOL questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the SF-36 Health Survey were completed by patients preoperatively and 3 months after surgery. Results: An index of 0.97 was found in the internal structure in the VQOL questionnaire. Four identified factors accounted for 78.5% of the total variance (Far vision 26.1%, social relationships 18.9%, near vision 17.5%, personal autonomy 16.0%). The internal consistency of these subscales was 0.96, 0.93, 0.90 and 0.89, respectively. Relations between the subscales of the VQOL and HAD, were observed between the VQOL in distance vision and personal autonomy with the Anxiety and Depression subscales (p<0.01). Relationships between VQOL and the SF-36 subscales were detected between the distance vision scale and the Body Pain, General Health, Vitality, Social Function and Mental Health subscales (p<0.05). Conclusions: A QOL questionnaire was developed to be a useful instrument for clinical practice. It was designed and validated for the Spanish population, in order to obtain reliable and valid measurements in refractive surgical procedures. Key words: Quality of life, questionnaire, refractive surgery, cataract surgery

Publication Stats

6k Citations
1,101.85 Total Impact Points


  • 2014
    • Minia University
      Minya, Al Minyā, Egypt
  • 1999–2014
    • Universidad Miguel Hernández de Elche
      Elche, Valencia, Spain
  • 1997–2014
    • VISSUM Instituto Oftalmológico de Alicante
      • Department of Research and Development
      Alicante, Valencia, Spain
  • 2012–2013
    • Universidad de Valladolid
      • Institute for Applied Ophthalmobiology (IOBA)
      Valladolid, Castille and León, Spain
    • Hospital Universitario de Getafe
      Madrid, Madrid, Spain
    • Hospital Universitario "Rio Hortega"
      Valladolid, Castille and León, Spain
  • 2009–2011
    • Universidad de Almería
      Unci, Andalusia, Spain
    • Universidad de Navarra
      • Oftalmología
      Pamplona, Navarre, Spain
    • University of Padova
      • Department of Neurosciences
      Padua, Veneto, Italy
  • 2007–2011
    • Hospital Virgen de los Lirios
      Alicante, Valencia, Spain
  • 1989–2011
    • University of Alicante
      • • Optics, Pharmacology and Anatomy
      • • Departamento de Ecología
      Alicante, Valencia, Spain
  • 2004–2008
    • University of Valencia
      • Departamento de Óptica
      Valencia, Valencia, Spain
  • 2005
    • University of Castilla-La Mancha
      Toledo, Castille-La Mancha, Spain
  • 1987–1988
    • Hospital Universitario de Salamanca
      Helmantica, Castille and León, Spain