Paola Valente

Ospedale Pediatrico Bambino Gesù, Roma, Latium, Italy

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Publications (22)57.77 Total impact

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    ABSTRACT: Background Retinoblastoma (RB) is the most common malignant childhood tumor of the eye and results from inactivation of both alleles of the RB1 gene. Nowadays RB genetic diagnosis requires classical chromosome investigations, Multiplex Ligation-dependent Probe Amplification analysis (MLPA) and Sanger sequencing. Nevertheless, these techniques show some limitations. We report our experience on a cohort of RB patients using a combined approach of Next-Generation Sequencing (NGS) and RB1 custom array-Comparative Genomic Hybridization (aCGH). Methods A total of 65 patients with retinoblastoma were studied: 29 cases of bilateral RB and 36 cases of unilateral RB. All patients were previously tested with conventional cytogenetics and MLPA techniques. Fifty-three samples were then analysed using NGS. Eleven cases were analysed by RB1 custom aCGH. One last case was studied only by classic cytogenetics. Finally, it has been tested, in a lab sensitivity assay, the capability of NGS to detect artificial mosaicism series in previously recognized samples prepared at 3 different mosaicism frequencies: 10, 5, 1 %. Results Of the 29 cases of bilateral RB, 28 resulted positive (96.5 %) to the genetic investigation: 22 point mutations and 6 genomic rearrangements (four intragenic and two macrodeletion). A novel germline intragenic duplication, from exon18 to exon 23, was identified in a proband with bilateral RB. Of the 36 available cases of unilateral RB, 8 patients resulted positive (22 %) to the genetic investigation: 3 patients showed point mutations while 5 carried large deletion. Finally, we successfully validated, in a lab sensitivity assay, the capability of NGS to accurately measure level of artificial mosaicism down to 1 %. Conclusions NGS and RB1-custom aCGH have demonstrated to be an effective combined approach in order to optimize the overall diagnostic procedures of RB. Custom aCGH is able to accurately detect genomic rearrangements allowing the characterization of their extension. NGS is extremely accurate in detecting single nucleotide variants, relatively simple to perform, cost savings and efficient and has confirmed a high sensitivity and accuracy in identifying low levels of artificial mosaicisms.
    BMC Cancer 11/2015; 15(1). DOI:10.1186/s12885-015-1854-0 · 3.36 Impact Factor

  • Pediatric Blood & Cancer 07/2015; 62(12). DOI:10.1002/pbc.25636 · 2.39 Impact Factor
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    ABSTRACT: To report the results 15 months after transepithelial corneal cross-linking by iontophoresis of riboflavin performed in pediatric patients affected by keratoconus. Fourteen eyes of 14 pediatric patients [mean age 13 ± 2.4 (SD) years; range, 10-18 years] were treated. Riboflavin solution was administered by iontophoresis for 5 minutes, and then UVA irradiation (10 mW/cm) was performed for 9 minutes. The corrected distance visual acuity measured as decimal number, spherical equivalent, refractive astigmatism, simulated K, corneal coma, spherical aberration, and high-order aberrations for 5.0-mm pupil and the thinnest point were measured preoperatively and 3, 6, 12, and 15 months postoperatively. The endothelial cell density was evaluated. The paired Student t test was used to compare data during the follow-up. Fifteen months after the procedure, the corrected distance visual acuity improved from 0.7 ± 1.7 to 0.8 ± 1.8 (P = 0.005). Spherical equivalent and refractive astigmatism as well as topographic and aberrometric data did not show significant changes. Also, the mean thinnest point and the endothelial cell density remained unchanged. The optical coherence tomography showed a nonhomogeneous but deep hyperreflective band with a fading effect extending through the anterior 180 μm of the cornea. No side effects were recorded. Transepithelial collagen cross-linking by iontophoresis, unlike other transepithelial techniques, seems to halt pediatric keratoconus progression over 15 months. However, we did not record significant improvement in higher-order aberrations and topographic indices.
    Cornea 03/2015; 34(5). DOI:10.1097/ICO.0000000000000410 · 2.04 Impact Factor
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    ABSTRACT: Laser assisted keratoplasty is nowadays largely used to perform minimally invasive surgery and partial thickness keratoplasty [1-3]. The use of the femtosecond laser enables to perform a customized surgery, solving the specific problem of the single patient, designing new graft profiles and partial thickness keratoplasty (PTK). The common characteristics of the PTKs and that make them eligible respect to the standard penetrating keratoplasty, are: the preservation of eyeball integrity, a reduced risk of graft rejection, a controlled postoperative astigmatism. On the other hand, the optimal surgical results after these PTKs are related to a correct comprehension of the deep stroma layers morphology, which can help in the identification of the correct cleavage plane during surgeries. In the last years some studies were published, giving new insights about the posterior stroma morphology in adult subjects [4,5]. In this work we present a study performed on two groups of tissues: one group is from 20 adult subjects aged 59 ± 18 y.o., and the other group is from 15 young subjects, aged 12±5 y.o. The samples were from tissues not suitable for transplant in patients. Confocal microscopy and Environmental Scanning Electron Microscopy (ESEM) were used for the analysis of the deep stroma. The preliminary results of this analysis show the main differences in between young and adult tissues, enabling to improve the knowledge of the morphology and of the biomechanical properties of human cornea, in order to improve the surgical results in partial thickness keratoplasty.
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    ABSTRACT: Background: The prevalence of childhood obesity is increasing worldwide. Studies in adult populations show that retinal microvascular changes are associated with obesity and components of the metabolic syndrome. In our study we have assessed the effect of body mass index (BMI), metabolic parameters, and adiposity on the retinal microvasculature in children. Methods: Fifty-four consecutive children with biopsy-proven NAFLD were enrolled in this study. Anthropometric and laboratory parameters were obtained using standardized protocols. Retinal caliber was quantified from digital retinal images using well-known computer-based programs. Twenty-four-hour ambulatory blood pressure monitoring was measured using a standard protocol. Results: In our population, the prevalence of retinopathy was of 53 % (13 males). The 29 patients with retinopathy (mean age 10.91 ± 3.10) showed significantly higher values of triglycerides (mg/day) (105.57 vs. 90.20, p = 0.04), basal insulin (mUI/ml) (17.20 vs. 12.97, p = 0.02), and HOMA-IR (3.37 vs. 2.76, p = 0.04). The patients with a HOMA-IR >2.5 (OR = 3.34, p = 0.02; 95 % IC, 1.07-10.39), and systolic non-dipping (OR 4.16, p = 0.028, 95 % IC, 1.11-13.67), have an increased risk of retinopathy. Moreover, the study of correlation between all stages of liver biopsy (CRN criteria) and the grade of retinopathy showed a positive correlation with fibrosis (r = 0.31) and an NAS score (r = 0.28). Conclusions: We found an association between metabolic parameters and nocturnal blood pressure on the retinal microvasculature among the obese children with NAFLD. Furthermore, for the first time, we report the positive relationship between hepatic fibrosis in pediatric NAFLD patients and the degree of retinopathy signs.
    Journal of Gastroenterology 12/2014; 50(8). DOI:10.1007/s00535-014-1024-1 · 4.52 Impact Factor
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    ABSTRACT: Trilateral retinoblastoma (TRB) is a rare disease associating bilateral retinoblastoma (RB) with primitive intracranial neuroblastic tumor. To verify the occurrence of TRB in a single-Center case series and point out the clinical relevance of a baseline brain magnetic resonance imaging (MRI) in RB, focusing on pineal gland lesions. Baseline MRI was routinely performed in all cases of RB from 1999. All MRIs were reviewed for this study and the RB database was checked in order to identify patients characteristics, treatments and follow-up. A total of 107 patients with RB were diagnosed between 1999 and 2012. Sixty-two patients had unilateral RB and 45 bilateral RB. MRI revealed the presence of pineal gland lesions in 10 patients (9%); seven were considered pineal benign cysts (6.5%), while in three patients (2.8%), TRB was suspected. All patients with TRB presented hereditary RB. In one patient, the suspected TRB was metachronous and in the other two patients was synchronous. Biopsy was not performed. Cerobrospinal fluid (CSF) was negative in all patients. The MRI modification, before treatment in the first case and later in the second case, confirmed the TRB diagnosis. The third patient died due to progressive Central Nervous System (CNS) disease that clearly confirmed the TRB diagnosis. None of the three patients had received prior chemotherapeutic treatment. TRB represents a rare condition in this series, occurring in three (2.8%) out of all patients with RB. A synchronous presentation with small lesion seems more frequent when a baseline MRI is performed. When a histologically-proven diagnosis is not available, a suspected diagnosis should be considered with caution and only follow-up will confirm the diagnosis. A wait-and-see approach should be considered. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
    Anticancer research 12/2014; 34(12):7449-54. · 1.83 Impact Factor

  • The Journal of pediatrics 12/2013; 164(3). DOI:10.1016/j.jpeds.2013.10.045 · 3.79 Impact Factor
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    ABSTRACT: To evaluate the efficacy of diode laser welding to close corneal wounds in penetrating keratoplasty (PKP) and cataract surgery in pediatric patients. Ophthalmology Department, Bambino Gesù Children's Hospital, Rome, Italy. Prospective observational study. Patients had surgery for congenital cataract (Group 1) or femtosecond laser-assisted PKP (Group 2). The surgery was followed by corneal wound closure using diode laser welding of the stroma. In Group 1, no standard suturing was used. In Group 2, the donor button was sutured onto the recipient using 8 single nylon sutures or a 10-0 nylon running suture (12 passages). Laser welding was then used as an adjunct to the traditional suturing procedure. Group 1 comprised 7 eyes (7 patients; mean age 8.1 years ± 5.3 [SD], range 1 to 15 years) and Group 2, 5 eyes (5 patients; mean age 10.6 ± 3.3 years, range 6 to 15 years). The adhesion of the laser-welded tissues was perfect; there were no collateral effects, and restoration of the treated tissues was optimum. Seidel testing showed no wound leakage during the follow-up. Postoperative astigmatism did not change significantly from the first day after cataract surgery and shifted moderately 3 months after PKP. Laser welding of corneal tissue appeared to be safe and effective in children for whom a sutureless surgical procedure is important to reduce the use of anesthesia for suture management, prevent endophthalmitis, and improve the antiamblyopic effect. No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 10/2013; 39(12). DOI:10.1016/j.jcrs.2013.05.046 · 2.72 Impact Factor
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    ABSTRACT: Diode laser welding of ocular tissues is a procedure that enables minimally invasive closure of a corneal wound. This procedure is based on a photothermal effect: a water solution of Indocyanine Green (ICG) is inserted in the surgical wound, in order to stain the corneal tissue walls. The stained tissue is then irradiated with a low power infrared diode laser, delivering laser light through a 300-μm core diameter optical fiber. This procedure enables an immediate closure of the wounds: it is thus possible to reduce or to substitute the use of surgical threads. This is of particular interest in children, because the immediate closure improves refractive outcome and anti-amblyopic effect; moreover this procedure avoids several general anaesthesia for suture management. In this work, we present the first use of diode laser welding procedure in paediatric patients. 5 selected patients underwent cataract surgery (Group 1), while 4 underwent fs-laserassisted penetrating keratoplasty (Group 2). In Group 1 the conventional surgery procedure was performed, while no stitches were used for the closure of the surgical wounds: these were laser welded and immediately closed. In Group 2 the donor button was sutured upon the recipient by 8 single stitches, instead of 16 single stitches or a running suture. The laser welding procedure was performed in order to join the donor tissue to the recipient bed. Objective observations in the follow up study evidenced a perfect adhesion of the laser welded tissues, no collateral effects and an optimal restoration of the treated tissues.
    Ophthalmic Technologies XXIII; 02/2013
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    ABSTRACT: To report the long-term therapeutic results for patients with conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma who were treated with intralesional injections of interferon-α (IFN-α). Prospective, nonrandomized, interventional case series. Twenty eyes of 16 patients with histologically proven conjunctival MALT lymphoma in the absence of systemic disease. Patients were given 1,500,000 international units (IU) of IFN-α (Roferon-A; Roche s.p.a., Milano, Italy) subconjunctivally inside the lesion 3 times weekly for 4 weeks. If there was even a minimal response, a further cycle of 1,000,000 IU 3 times weekly for 4 weeks was administered. Patients were followed up clinically using slit-lamp examination to determine evidence of tumor disappearance or recurrence. In 10 eyes, an incisional biopsy was performed 6 months after therapy to verify the histologic absence of the lesion. A complete response was obtained in 15 eyes (75%) at the end of first cycle treatment, and in 5 eyes (25%) after further cycles. Seventeen eyes (85%) showed no local recurrence after a median follow-up of 65 months (range, 15-136 months). Three eyes (15%) demonstrated recurrence at variable points after treatment. One patient with stage IIA lymphoma exhibited systemic lymphoma progression. Local immunotherapy with IFN-α seems to be an effective and lasting treatment method and provides an alternative to radiotherapy for conjunctival MALT lymphomas. Very few transient side effects were detected.
    Ophthalmology 03/2012; 119(3):494-500. DOI:10.1016/j.ophtha.2011.09.008 · 6.14 Impact Factor
  • Luca Buzzonetti · Gianni Petrocelli · Paola Valente ·
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    ABSTRACT: To report the early results of big-bubble deep anterior lamellar keratoplasty assisted by femtosecond laser in children. Five eyes of 5 pediatric patients were enrolled in the study; 3 had keratoconus and 2 corneal opacities. An IntraLase 60 KHz femtosecond laser (Abbott Medical Optics, Inc) was used to create mushroom incisions on both donor and recipient corneas. All patients were evaluated for best-corrected visual acuity, spherical equivalent, refractive astigmatism, keratometric astigmatism, mean K value, and corneal thinnest point. The big bubble was always achieved, and all eyes were treated successfully without intraoperative complications. The follow-up was of 10 months. At 10 months (at least 3 months after complete suture removal), the mean postoperative best-corrected visual acuity was 20/30 (range, 20/25 to 20/30), mean spherical equivalent was -1.8 ± 1.2 diopters (D) (range, -0.25 to 1.25 D), mean refractive astigmatism was 1.8 ± 1.4 D (range, 0 to 4.0 D), mean keratometric astigmatism was 5.1 ± 2.1 D (range, 3.5 to 8.59 D), mean K value was 46.2 ± 0.8D, and mean corneal thinnest point was 581 ± 46 μm (range, 511-638 μm). Our early findings suggest that the big-bubble technique in deep anterior lamellar keratoplasty assisted by femtosecond laser is safe and effective also in pediatric patients in the attempt to decrease the rejection percentage, improve the refractive outcome, and then provide an antiamblyopic effect.
    Cornea 02/2012; 31(9):1083-6. DOI:10.1097/ICO.0b013e31823f8efc · 2.04 Impact Factor
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    Luca Buzzonetti · Gianni Petrocelli · Paola Valente ·
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    ABSTRACT: Purpose. To report the 12-month follow-up after big-bubble deep anterior lamellar keratoplasty (DALK) assisted by femtosecond laser that we have called IntraBubble. Methods. A 60 kHz IntraLase femtosecond laser (Abbott Medical Optics) firstly created a 30° angled intrastromal channel to insert the air injection cannula, 50 μ above the thinnest corneal site measured by Sirius Scheimpflug camera (CSO, Firenze, Italy), then performed a full lamellar cut 100 μ above the thinnest corneal point, and from the same corneal depth, created a mushroom incision. The lamella was removed, and the smooth cannula of Fogla was inserted into the stromal channel and air was injected to achieve a big bubble. The follow up is 12 months, and sutures were removed by the 10th postoperative month in all patients. Best Corrected Visual Acuity (BCVA), spherical equivalent and, by Sirius Scheimpflug camera (CSO, Firenze, Italy) keratometric astigmatism were evaluated. Results. All procedures were completed as DALK except 2 converted to PK because an inadvertent intraoperative macroperforation occurred. Mean postoperative BCVA was 0.8, mean spherical equivalent was -3.5 ± 1.7 D, and mean keratometric astigmatism was 4.8 ± 3.1 D. Conclusion. The femtosecond laser could standardize the big-bubble technique in DALK, reducing the risk of intraoperative complications and allowing good refractive outcomes.
    Journal of Ophthalmology 02/2012; 2012(2090-004X):264590. DOI:10.1155/2012/264590 · 1.43 Impact Factor
  • Luca Buzzonetti · Gianni Petrocelli · Paola Valente ·
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    ABSTRACT: To evaluate the efficacy of amniotic membrane transplantation in lamella melting after anterior lamellar keratoplasty (ALK) assisted by femtosecond laser in a pediatric patient. An 11-year-old girl with progressive keratoconus underwent ALK assisted by femtosecond laser on the right eye. The surgical procedure was performed under general anesthesia. The 60-KHz IntraLase femtosecond laser (Abbott Medical Optics) created both the donor (thickness 350 µm; diameter 8.1 mm; side cut 70°) and recipient (thickness 260 µm; diameter 8.0 mm; side cut 70°) lamellae. The recipient lamella was then gently removed and donor was fitted into place and sutured using 4 interrupted sutures added to a running suture in nylon 10-0. The surgery was uneventful. Two months after surgery, a lamella melting was observed. One month after topical steroid treatment, amniotic membrane transplantation was performed. When lamella melting was observed, the best-corrected visual acuity (BCVA) was 0.1 and 0.5 with foramen and no inflammatory reaction in the anterior chamber was reported. Eleven months after amniotic membrane transplantation, BCVA was 0.9 and no visual acuity increase was recorded with foramen. Our findings show that amniotic membrane transplantation could be considered in lamella melting after ALK assisted by femtosecond laser in children.
    European journal of ophthalmology 10/2011; 22(3):477-80. DOI:10.5301/ejo.5000061 · 1.07 Impact Factor
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    ABSTRACT: To evaluate the long-term efficacy of verteporfin photodynamic therapy (PDT) as the primary treatment for symptomatic circumscribed choroidal hemangioma (CCH). Prospective consecutive, 2-centered, noncomparative, interventional case series. Twenty-five subjects with symptomatic CCH. All patients had recent onset of visual symptoms and evidence of exudative macular changes on fluorescein angiography (FA) and optical coherence tomography (OCT). Verteporfin 6 mg/m(2) body surface area was administered intravenously over a 10-minute interval. Five minutes after infusion, a 689 nm laser was applied with a light dose of 50 J/cm(2) for the first 3 patients and a light dose of 100 J/cm(2) for all the other patients. Retreatments were performed in case of persistent exudation found on OCT. Evaluation of best-corrected visual acuity (BCVA) using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria, FA, indocyanine green angiography (ICGA), OCT, and ultrasound were performed before PDT and on follow-up examinations. All patients were followed for at least 5 years. Primary outcome measures were changes in BCVA and foveal center thickness (FCT) between baseline and month 60. Secondary measures were tumor thickness decrease, absence of leakage on FA, and adverse events. Twenty-two patients received 1 PDT session at 100 J/cm(2), and no recurrences were detected. Three eyes, treated with 50 J/cm(2), received a second PDT session at 100 J/cm(2) 1 month after the first session. After a follow-up of 60 months, BCVA improved an average of 18.5 ETDRS letters (P<0.001); BCVA improved by > or =2 lines in 19 eyes (76%). The FCT decreased from a mean of 386.20 microm to 179.2 microm, and OCT showed the complete resolution of macular exudation in all cases. All tumors responded with a reduction in size. No treatment-related adverse events or complications were identified. The 5-year results of PDT in treating symptomatic CCH support treatment with a light dose of 100 J/cm(2) after slow intravenous infusion of verteporfin to stabilize or improve visual acuity and resolution of macular exudation.
    Ophthalmology 04/2010; 117(8):1630-7. DOI:10.1016/j.ophtha.2009.12.033 · 6.14 Impact Factor
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    ABSTRACT: To evaluate the refractive and keratometric effect of arcuate keratotomy performed using the IntraLase femtosecond laser (Abbott Medical Optics) in patients with high postoperative keratoplasty astigmatism. Nine eyes of nine patients (mean age 45 +/- 7.5 years; mean spherical equivalent refraction -2.50 +/- 3.60 diopters [D]) who had undergone a penetrating keratoplasty were considered. The subjective refraction was measured, and corneal thickness and keratometric parameters were calculated by the Pentacam (Oculus Optikgeräte). All uncomplicated surgeries were performed with the IntraLase femtosecond laser. Paired 70 degrees arc length incisions were performed at 80% depth of the corneal thickness. The mean optical zone was 5.9 mm. The side cut was 90 degrees. All incisions were performed in the graft itself. Mean change in best spectacle-corrected visual acuity (BSCVA), refractive and keratometric astigmatism, and spherical equivalent refraction was evaluated. Follow-up was 3 months. Refractive and keratometric data were analyzed using vector analysis as described by Alpins. A paired Student t test was used to compare preoperative and 3-month postoperative data. A P value <.05 was considered significant. Mean preoperative BSCVA was 20/30, increasing to 20/25 postoperatively (P > .05). The mean refractive astigmatism decreased by 6.00 D (P < .05), whereas the mean keratometric value decreased by 4.60 D (P < .05). The mean spherical equivalent refraction did not change significantly. The surgical vectors in the refractive and keratometric analysis were calculated, showing good predictability. Arcuate keratotomy performed with the IntraLase femtosecond laser could be an effective, safe, and relatively predictable treatment of high postoperative keratoplasty astigmatism.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 09/2009; 25(8):709-14. DOI:10.3928/1081597X-20090707-05 · 3.47 Impact Factor
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    ABSTRACT: To evaluate epithelial healing, postoperative pain, and best spectacle-corrected visual acuity (BSCVA) after transepithelial photorefractive keratectomy (PRK) performed with a new phototherapeutic keratectomy (PTK) mode using the NIDEK CXIII excimer laser. Fifteen eyes from 10 patients with myopia underwent transepithelial PRK using a multistage program to perform PTK followed by PRK. The PTK incorporated Flex Scan, which accounts for the loss of radial ablation efficiency on the peripheral cornea. The epithelium was removed with the excimer laser by monitoring the disappearance of blue fluorescence during the ablation. Epithelial healing was evaluated by taking slit-lamp photographs every 24 hours until complete reepithelialization. Postoperative pain was measured according to the Faces Pain Rating Scale. All outcomes are reported for 3 months postoperatively. Haze was graded by two ophthalmologists, each masked to the other's result. Mean reepithelialization took 3.50+/-0.85 days, mean pain score was 3.00+/-1.20, and BSCVA was 20/20 for 9 eyes, 20/30 for 3 eyes, and 20/40 for 3 eyes. All patients had haze below grade 2. The outcomes of the preliminary study show that the incorporation of the Flex Scan algorithm in the PTK mode is as safe and effective as conventional PTK algorithms. The primary advantage of this new PTK mode may be more consistent epithelial removal. Additional studies are needed to determine long-term outcomes.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 02/2009; 25(1 Suppl):S122-4. · 3.47 Impact Factor

    Acta ophthalmologica 09/2008; 86:0-0. DOI:10.1111/j.1755-3768.2008.6362.x · 2.84 Impact Factor
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    ABSTRACT: To compare corneal aberration changes 1 year after myopic laser in situ keratomileusis (LASIK) performed with a mechanical microkeratome and IntraLase femtosecond laser. Twenty four eyes of 15 patients underwent LASIK with the Hansatome microkeratome, and 23 eyes of 13 patients underwent LASIK with the IntraLase femtosecond laser. A standard ablation was performed with the Bausch & Lomb Technolas 217 excimer laser. Topography data were used to calculate corneal aberrations with a 3.0 mm and 5.00 mm pupil, before and 12 months after surgery. The increasing factor (IF), defined as the ratio between the postoperative and preoperative mean value of the optical aberration, was calculated. The method of Mulhern et al was used to evaluate the centration of ablation. The comalike aberration was correlated with the decentration of ablation. The Student t test was used for the statistical anaylsis. The postoperative mean decentration of ablation was <0.5 mm. The comalike aberration appeared to be positively correlated with the decentration of ablation in both groups with a 5.0-mm pupil (P < 0.05). With a 3.00-mm pupil, the comalike aberration changed in the Hansatome group, whereas with a 5.00-mm pupil, all aberrations statistically significantly changed in both groups (P < 0.05). The IF similarly increased in 2 groups for spherical-like aberration, whereas IF greatly increased for total and comalike aberrations in the Hansatome group. Wavefront corneal aberrations change significantly 1 year after myopic LASIK performed with the Hansatome microkeratome as well as with IntraLase femtosecond lasers. Both of the procedures induce higher-order aberrations in the anterior corneal surface, but the amount of comalike aberration increases more with the Hansatome mechanical microkeratome.
    Cornea 03/2008; 27(2):174-9. DOI:10.1097/ICO.0b013e31815a50bf · 2.04 Impact Factor
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    ABSTRACT: To assess the efficacy and safety of LASIK in patients with high myopic anisometropia and to provide specific screening guidelines for anisometropic patients undergoing refractive surgery. Twenty-six eyes of 16 patients with high myopic anisometropia (>3.0 diopters) were enrolled in this study. Complete pre- and postoperative ophthalmologic and orthoptic examinations were performed. The preoperative orthoptic examination was done with glasses and contact lenses. Twenty-two eyes of 13 patients underwent uncomplicated LASIK; the second eye was treated 2 weeks after the first eye. Patients were examined 1 day, 7 days, and 1, 3, 6, and 12 months after surgery. Thirteen patients obtaining good results at red glass bar test (RGB) underwent LASIK without postoperative diplopia; four showed an improvement of the sensorial assessment. Three patients were excluded from surgery because of diplopia with RGB values <4 to 5. LASIK temporarily induced diplopia in the suppressed eye of one patient; however, the diplopia disappeared after surgery of the fixating eye. Patients with high myopic anisometropia and a weak sensorial state who undergo refractive surgery may be at risk for postoperative diplopia. We suggest clinical guidelines to reduce the occurrence of this complication.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2006; 22(5):461-6. · 3.47 Impact Factor
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    ABSTRACT: To evaluate retinal thickness at the posterior pole of the fundus in ocular hypertension (OHT) and open-angle glaucoma (OAG), and to correlate morphometric findings with visual sensitivity as determined by automated perimetry. One randomly selected eye from 41 patients with clinical diagnosis of OHT (n = 25) or early to moderate OAG (n = 16) and 16 age-matched normal controls was examined. Retinal thickness was measured by Retinal Thickness Analyzer (RTA), acquiring 5 pre-defined scans covering the central 20 degrees of the fundus. RTA average thickness and thickness profile data, including hemispheric asymmetries calculated as relative (superior/inferior and nasal/temporal) or absolute (vertical and horizontal, ie, independent of which hemisphere was thinner) parameters, were calculated. For each eye, white-on-white Humphrey 30-2 visual field results were analyzed, in addition to standard global indices, by quantifying perimetric sensitivities for regions of the posterior pole corresponding to those sampled by the RTA. On average, central retinal thickness was reduced (P < 0.05) in OAG compared with OHT or normal control eyes. Vertical hemispheric absolute thickness asymmetry was increased (P < or = 0.01) in OAG eyes compared with the other groups. Horizontal hemispheric absolute thickness asymmetry was increased (P < 0.01) in both OHT and OAG eyes, compared with control eyes. At least one of the RTA parameters was altered in 13 of 25 OHT (52%) and 12 of 16 OAG eyes (75%), most frequently involving thickness asymmetries. In OAG, but not OHT eyes, superior/inferior asymmetry was positively (r = 0.69, P < 0.01) correlated with the corresponding asymmetry in perimetric sensitivity. The RTA can reveal increased hemispheric thickness asymmetries in both OHT and OAG eyes. In OAG eyes thickness asymmetries are associated with corresponding perimetric asymmetries. The findings in OHT eyes suggest that localized anatomic and functional damage to inner retina may not develop in parallel early in the disease process.
    Journal of Glaucoma 11/2005; 14(5):375-83. DOI:10.1097/01.ijg.0000176933.14229.fc · 2.11 Impact Factor

Publication Stats

181 Citations
57.77 Total Impact Points


  • 2011-2014
    • Ospedale Pediatrico Bambino Gesù
      • Department of Ophthalmology
      Roma, Latium, Italy
  • 2012
    • Catholic University of the Sacred Heart
      • School of Ophthalmology
      Milano, Lombardy, Italy
  • 2004-2008
    • The Catholic University of America
      Washington, Washington, D.C., United States