Biomedical subjects

J L Menezo

Publications and source records attributed to J L Menezo.

At least 19 recordsLinked to original sources

PubMed2005

[Contrast sensitivity to intraocular lens TECNIS Z-9000].

PURPOSE: To evaluate the increase in contrast sensitivity to intraocular lens TECNIS Z-9000 (Pfizer) compared with other intraocular lenses. METHOD: We implanted a TECNIS Z-9000 lens in 18 patients who had another type of intraocular lens implanted in their other eye. We then tested contrast sensitivity under both mesopic and photopic conditions using the VCTS (Vision Contrast Test System) provided by Vistech Consultants Inc. RESULTS: There was an improved contrast sensitivity at low and medium frequencies, following TECNIS-Z 9000 lens implantation, however this improvement did not reach statistical significance. There were significant differences at high frequencies, which are directly related to the quality of visual function. CONCLUSIONS: TECNIS Z-9000 lens implantation (with a modified anterior surface) achieves a significant improvement in contrast sensitivity, meaning in practice an increase in the quality of visual function.

Contrast Sensitivity↗

PubMed2003

Optic nerve alterations in apolipoprotein E deficient mice.

PURPOSE: To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for expression of the ApoE gene. METHODS: Eyeballs with the retrobulbar ON attached were obtained from 24-week-old mice. Using morphologic and morphometric techniques and light and transmission electron microscopy, the ON characteristics were determined in three groups of mice: 1) wild type mice as the controls (CG; n = 15), 2) knockout mice for the ApoE gene (ApoE-G; n = 15), and 3) knockout mice for the ApoE gene that were fed a cholesterol-supplemented diet (ApoED-G; n = 15). RESULTS: The ON cross-sectional area was significantly higher in the ApoE-G than in the CG (p < 0.001) mice, whereas no significant changes were noticed between the ApoE-G and ApoED-G mice. Significant differences were noticed between those groups regarding the myelination index. Higher density of intra-axonal degeneration and myelin sheath alterations were found in both ApoE groups in respect to the CG. CONCLUSIONS: These results suggest that ApoE knockout mice have changes in ON morphology and myelination.

Animals↗

PubMed2002

[Terson syndrome associated with a carotid-ophthalmic giant aneurysm].

UNLABELLED: PURPOSE/MATERIAL AND METHOD: A case of a 42 year-old woman presenting headache, vomiting and loss of consciousness of sudden onset. Upon testing right eye presented amaurosis while left eye showed a visual acuity of 20/50. RESULTS/CONCLUSION: Brain angiography showed a right sided giant carotid aneurysm at the ophthalmic artery area. Globe fundus in left eye showed vitreal and intra-retinal hemorrhage appearing in retinal posterior pole and periphery of the retina. Subarachnoidal hemorrhage accompanied by intra-vitreal bleeding is known as Terson's Syndrome. Peculiarities of this clinical case are discussed in this paper.

Adult↗

PubMed2001

[Conjunctival microbiological study in corneo-schleral prosthesis users].

PURPOSE: To evaluate conjunctival bacterial flora in carrier patients of corneo-schleral prosthesis, both in the affected and fellow eye. MATERIAL AND METHOD: Samples were obtained from twenty-six corneo-schleral prosthesis carriers and smear from both eyes were cultured. Samples were taken from 24 patients as controls. RESULTS: Significant growth of potentially pathogen bacteria was observed in the corneo-schleral prosthesis and fellow eyes compared to controls. CONCLUSION: Conjunctival bacterial flora showed variations in the eyes of controls, corneo-schleral prosthesis and fellow eyes groups.

Adult↗

PubMed2000

Multicenter study of the Artisan phakic intraocular lens.

PURPOSE: To assess the Artisan intraocular lens to correct myopia in phakic eyes. SETTING: European multicenter study sponsored by Ophtec BV, Groningen, The Netherlands. METHODS: In this prospective multicenter clinical study, the Artisan lens was implanted in 518 eyes between September 1991 and October 1999. The power of the lenses ranged from -5.0 to -20.0 diopters (D). Follow-up examinations were performed at 6 months and 1, 2, and 3 years. Follow-up ranged from 6 months (n = 454) to 3 years (n = 249). The preoperative uncorrected visual acuity (UCVA) was not recorded but was estimated to be worse than 0.1. The preoperative mean best spectacle-corrected visual acuity (BSCVA) was 0.67 +/- 0.26 (SD). Endothelial cell counts were done at 6 months and 1, 2, and 3 years in a subgroup of 129 eyes. RESULTS: A UCVA of 20/40 or better was observed in 76.8% of eyes regardless of the postoperative goal. A BSCVA of 20/40 or better was observed in 93.9% of eyes and remained stable throughout the follow-up. Of the eyes with extremely high myopia (>-15.0 D), 63.3% gained 2 or more lines of BSCVA; of those with moderate myopia (-5.0 to -10.0 D), 23.5% gained 2 or more lines. The mean endothelial cell density change was 4.8% at 6 months, 2.4% at 1 year, 1.7% at 2 years, and 0.7% at 3 years. The incidence of persistent adverse events at 3 years was relatively low. Secondary surgical interventions included repositioning of the lens because of poor initial placement and lens exchange because of preoperative power calculation errors. Glare and halo effects during night driving were noted and were related to large pupils in young patients. CONCLUSION: The Artisan lens is a safe, stable, efficacious, and predictable method to correct -5.0 to -20.0 D of myopia. This study suggests that the corneal endothelial cell loss is stabilized to the physiologically normal level after 3 years.

Adolescent↗

PubMed2000

Acute iridocyclitis in a patient with AIDS diagnosed as toxoplasmosis by PCR.

PURPOSE: To study the etiology of an acute iridocyclitis in a patient with AIDS using polymerase chain reaction (PCR) analysis of aqueous humor. METHODS: Case report describing a patient diagnosed with toxoplasmic retinochoroiditis in his left eye. He stopped his treatment after three weeks and subsequently developed an acute iridocyclitis without chorioretinitis in the fellow eye. Anterior chamber paracentesis was performed and aqueous humor was assayed by PCR. RESULTS: PCR of the aqueous humor showed positivity for Toxoplasma gondii. The iridocyclitis responded to topical dexamethasone and oral treatment with pyrimethamine and sulfadiazine. CONCLUSION: PCR is an effective method to diagnose toxoplasmic iridocyclitis in a patient with AIDS.

AIDS-Related Opportunistic Infections↗

PubMed2000

[Anterior pole ischemia and carotid stenosis].

PURPOSE/METHODS: We present the case of a 69 year-old male patient who developed an anterior pole ischemia syndrome in his right eye. He did not have any personal history of diabetes or previous ocular pathology. Indirect ophthalmoscopy did not show any pathological finding. RESULTS/CONCLUSIONS: Carotid Duplex scanning and Nuclear Magnetic Resonance detected a severe carotid stenosis on the same side, which explained the case. We reviewed different forms of presentation of venous stasis syndrome in carotid stenosis and present this uncommon case of anterior segment ischemia syndrome without posterior segment findings.

Aged↗

PubMed2000

[Amaurosis fugax as the early manifestation of orbital schwannoma].

PURPOSE/METHODS: We report a case of a 51-year-old woman who clinically presented amaurosis fugax in her left eye of four months' duration. RESULTS/CONCLUSIONS: Computed tomography showed a well defined intraconal mass suggestive of cavernous hemangioma. A left lateral orbitotomy was performed. A red and encapsulated mass was removed in its entirety without violation of its capsule. Microscopically, it was composed of areas of spindle-shaped cells disposed in form of palisade (Antoni type A) mixed with cystic areas where the cells were scattered in a loose myxoid matrix (Antoni type B). Some nuclei were large, hyperchromatic, pleomorphic and multilobulated. The diagnosis was made on the basis of the histopathologic findings.

Amaurosis Fugax↗

PubMed1998

Endothelial study of iris-claw phakic lens: four year follow-up.

PURPOSE: To study quantitative and morphometric endothelial changes in phakic eyes implanted with the Worst iris-claw lens to correct high myopia. SETTING: Department of Ophthalmology, University Hospital "La Fe", Valencia, Spain. MATERIAL AND METHODS: This retrospective study involved 111 phakic eyes (73 patients) implanted with the Worst iris-claw lens. Noncontact specular microscopy and computer-assisted analysis was performed preoperatively and 6 months and 1, 2, 3, and 4 years postoperatively. RESULTS: The mean cell loss was 3.85% at 6 months, 6.59% at 1 year, 9.22% at 2 years, 11.68% at 3 years, and 13.42% at 4 years. At 2 years, the hexagonality and coefficient variation in cell size were close to the preoperative levels. No major complications were seen; early postoperative corneal touch required intraocular lens (IOL) removal in 1 case (0.9%). Four eyes (3.6%) needed a reoperation because of poor IOL fixation (2 eyes), traumatic subluxation of the IOL (1 eye), and miscalculation of the IOL power (1 eye). CONCLUSIONS: Although there was a slight progressive cell loss after IOL implantation, the morphometric changes recovered and were close to the preoperative levels. This suggests that endothelial damage occurred primarily during the surgical procedure.

Adult↗

PubMed1998

Endophthalmitis following open-globe injuries.

Endophthalmitis following open-globe injuries is caused by a specific range of microorganisms, of which Bacillus sp. and coagulase-negative Staphylococcus are the most frequent. Risk factors include the presence of an intraocular foreign body, injury inflicted by organic material, delay in surgery, and the type of wound involved. Despite important advances in medical and surgical management, this type of endophthalmitis continues to pose a poor prognosis. In this sense, we consider prevention to be the best approach. We report our protocols for the prevention and treatment of endophthalmitis following open-globe injuries, based on recent experimental studies on the ocular pharmacokinetics of antibiotics and on multicenter studies of the treatment of endophthalmitis.

Anti-Bacterial Agents↗

PubMed1997

Diclofenac sodium and cyclosporin A inhibit human lens epithelial cell proliferation in culture.

PURPOSE: To investigate the effect of diclofenac sodium salt and cyclosporin A (CsA) on human lens epithelial cell (HLEC) growth in culture. METHODS: Cultures of HLEC were obtained from anterior capsules from extracapsular cataract surgery. Third-passage cells were seeded in 96-well plates in 0.1 ml culture medium. Cytotoxicity was estimated by the tetrazolium test in confluent monolayers after 24 h exposure to a wide range of concentrations of diclofenac and CsA. The effect of subcytotoxic concentrations of diclofenac and CsA on HLEC proliferation in subconfluent cultures was evaluated after 24 and 72 h of exposure. To investigate the relationship between PGE2 synthesis and the inhibitory effect of these drugs, after 24 h of exposure to diclofenac and CsA the production of PGE2 was measured by radioimmunoassay. We also tested the effect of exogenous PGE2 addition to diclofenac 72-h-treated cultures. RESULTS: Diclofenac and CsA (at concentrations > or = 65 microM and > or = 2.5 microM, respectively) inhibited the proliferation of subconfluent cultures of HLEC in a dose-dependent fashion. Diclofenac inhibits PGE2 synthesis, while CsA at high doses stimulates PGE2 synthesis of cultured HLEC. Exogenous PGE2 addition reversed in part the inhibitory effect of diclofenac. CONCLUSIONS: Diclofenac and CsA at appropriate doses are effective in inhibiting cultured HLEC proliferation. This could be of interest to prevent posterior capsule opacification. Further in vivo experimental studies seem worthwhile.

Aged↗

PubMed1997

Reproducibility of digital image analysis for measuring corneal haze after myopic photorefractive keratectomy.

PURPOSE: To evaluate the usefulness of digital image analysis for quantifying corneal haze by determining the reproducibility of its measurements at the corneal plane. METHODS: In a prospective study, 20 randomly selected eyes that had undergone myopic photorefractive keratectomy were photographed focusing the slit beam on their anterior corneal surface. Each photograph was examined using computer image analysis techniques that detect the edge of the reticular pattern of the image. Quantification of the difference between two areas, treated and adjacent untreated cornea, each containing 3,750 pixels with a resolution of 256 gray levels, was performed. Intra-analyzer variation was determined by evaluating the photographs obtained by two analyzers under standard conditions on four separate visits. Interanalyzer variation was calculated using one measurement and the mean of the four measurements. RESULTS: The pooled standard deviation of the measurements for the analyzers was 0.63 and 0.62 gray levels (coefficient of variation, 4.1% and 3.3%). An association between less severe haze measurements and higher reproducibility scores was found (r = .42; P = .007). The mean interanalyzer variation was smaller for the average of four measurements, 0.55 +/- 0.37 gray levels, than for one measurement, 0.94 +/- 0.73 gray levels (P = .014). CONCLUSIONS: Good reproducibility for haze measurements by digital image analysis of the differences between the treated and adjacent untreated corneal areas was obtained. When the average of four measurements was used instead of a single measurement, interanalyzer reproducibility increased significantly. This new technique may be used to quantify and analyze corneal haze after myopic photorefractive keratectomy.

Adult↗

PubMed1997

Endophthalmitis following penetrating eye injuries.

Postinjury endophthalmitis is the eye infection with the worst prognosis. A retrospective 9-year study was made of penetrating eye injuries, with an analysis of the incidence of infection and its relation to the type of wound and the presence of intraocular foreign bodies. There were 403 cases of penetrating eye injury; of these, 233 affected the cornea and 170 involved the posterior pole. Intraocular foreign bodies were present in 40 cases. Endophthalmitis developed in 4.2% of cases (17/403), and was more common in patients with posterior pole involvement (7%) than in purely corneal trauma (2.1%) (p = 0.03, Chi-square). Infection was in turn more frequent in the presence of intraocular foreign bodies (15%) (p = 0.17, Chi-square). Staphylococcus epidermidis was the most common cause (23.4%), while in three cases (17.6%) mixed infection was detected. The visual results were evisceration or non-perception of light in 82.3% of cases.

Adolescent↗

PubMed1996

Endothelial toxicity of ceftazidime in anterior chamber irrigation solution.

Due to the high toxicity of aminoglycoside antibiotics, many authors prefer to use third generation cephalosporines in the prophylaxis and treatment of intraocular infections. The aim of the present study was to determine safe ceftazidime levels in anterior chamber irrigation solution. Twenty-two eyes of 12 white New Zealand rabbits were divided into six groups of two animals each. Double paracentesis was performed in both eyes, irrigating the right eye with 250 ml of BSS-Plus (BSS+) solution, and the left eye with 250 ml of BSS+ solution with increasing concentrations of ceftazidime (2, 3, 4, 6 and 8 mg ml-1). Each rabbit was killed at the end of surgery, except the last group, which received BSS+ and BSS+ with 8 mg ml-1 of ceftazidime, respectively, in one eye, and were then killed 24 hr later. Endothelial lesions were assessed by silver nitrate staining. We considered lesions endothelial silver affinity ranging from minimal (1-2+) to intense (3-4+). 1-2+ silver affinity was found in 4 +/- 1.35% of endothelial cells in the controls; this percentage in turn increased with antibiotic concentration (6.1 +/- 1.13%, 6.7 +/- 0.4%, 7.2 +/- 1.36%, 7.3 +/- 1.93% and 7.5 +/- 1.83%, respectively). The percentage of 3-4+ silver affinity was 0.18 +/- 0.17% in the controls, and likewise increased with antibiotic concentration (0.22 +/- 0.11%, 0.37 +/- 0.09%, 2.8 +/- 0.63% and 3.1 +/- 0.46%, respectively). The increase in affinity was greatest up to the 4 mg ml-1 concentration. In the last group there were zones of endothelial alterations in morphology and size, with signs of attempted repair in the eye treated with antibiotic, but none in the case treated only with BSS+. Ceftazidime concentrations above 3 mg ml-1 in intraocular infusions induce endothelial cell toxicity.

Animals↗

PubMed1996

Direct objective quantification of corneal haze after excimer laser photorefractive keratectomy for high myopia.

PURPOSE: The purpose of the study is to measure regional distribution differences in corneal haze after excimer laser photorefractive keratectomy for high myopia. METHODS: The authors developed computerized gradient edge detectors with which were analyzed digitized anterior slit-lamp photographs of 40 eyes, an average of 21.0 plus or minus 14.5 weeks after photorefractive keratectomy for high myopia (-6 to -22 diopters). A treated area an adjacent untreated area on the anterior corneal surface, each containing six regions, were quantified, and the difference was correlated with various parameters. RESULTS: Mean differences between scarred and clear areas for haze grade 0.5, 1.0, 2.0, 3.0, and 4.0 were 16.9, 26.6, 42.6, 60.4, and 76.4 gray levels, respectively (rs = 0.96; P = 0.0001). A low but statistically significant correlation between the intended correction and postoperative corneal haze was found (r = 0.33; P = 0.037). The mean coefficient of variation of the amount of opacification within each treated area was 9.4%. This coefficient of variation increased with a longer follow-up time (r = 0.88; P = 0.0001). The difference in the intensity of haze between the center and more peripheral regions over the entrance pupil did not correlate with the attempted correction. However, a strong association between a relatively less severe central corneal haze with respect to more peripheral haze and longer follow-up time was found (r = -0.96; P = 0.0001). CONCLUSION: The amount of corneal haze showed a weak positive association with the attempted correction in excimer laser photorefractive keratectomy for high myopia. Corneal haze appeared fairly uniformly distributed within the ablation zone, but a more heterogeneous distribution was found with a longer follow-up time. Furthermore, later postoperative examinations disclosed a clear trend toward diminishing central opacification relative to peripheral regions over the entrance pupil.

Adult↗

PubMed1996

Goldmann applanation tonometry using sterile disposable silicone tonometer shields.

PURPOSE: Placement of a sterile single-use cover over the tonometer tip may be a convenient and safe alternative method to repeated chemical disinfection. This study was undertaken to evaluate the accuracy and performance of Goldmann applanation tonometry using a sterile disposable silicone tonometer shield over the biprism tip. METHODS: The same investigator measured intraocular pressure in 120 eyes with and without the shield. The eyes were tested randomly first with either the uncovered or the covered tonometer to control for the possible effects of repeated tonometry influencing measurement differences. Readings were recorded independently in a masked fashion. RESULTS: The intraocular pressure measurements evaluated with the silicone shield caused an average overestimation of the true intraocular pressure of 1.9 +/- 1.9 mmHg (P = 0.0001). Covered and uncovered readings correlated well (r = 0.91, P = 0.0001). The sensitivity and specificity of the covered tonometry in detection intraocular pressures of 21 mmHg or higher (as measured without the shield) were 96.3% and 68.8%, respectively. Minor distortions of the normal-appearing fluorescein bands were seen in 5% of the tonometries, and the shield had to be replaced because of bubbles or wrinkles on the applanating surface in 3.3% of the measurements, which means that care must be taken when fitting the shield. CONCLUSIONS: Although covered and uncovered tonometry readings correlated well, an overall trend for a slightly increased measured intraocular pressure as a result of using the silicone shield over the Goldmann tonometer tip was found. The outstanding sensitivity of this procedure in detecting increased intraocular pressure suggests that it can be useful in screening for ocular hypertension and glaucoma.

Adolescent↗

PubMed1996

Iris-fixated Worst claw versus sulcus-fixated posterior chamber lenses in the absence of capsular support.

PURPOSE: To evaluate visual outcomes and complications of iris-fixated intraocular lenses (IOLs) (lobster-claw) and sutured sulcus-fixated posterior chamber (PC) IOLs in primary and secondary implantation. SETTING: Eye Department, University Hospital "La Fe", Valencia, Spain. METHODS: This retrospective study reviewed 47 patients who had primary implantation of an iris-fixated (n = 34) or sulcus-fixated (n = 13) IOL and 54 patients who had secondary implantation of an iris-fixated (n = 41) or sulcus-fixated (n = 13) IOL. RESULTS: Visual acuity in the primary implantation group was similar with both lens types. Overall, 54.0% had a postoperative acuity of 20/40 or better. In eyes without pre-existing pathology, 60.0% with an iris-fixated IOL and 54.6% with a sutured PC IOL had this level of postoperative acuity (P = .768). In the secondary implantation group, the percentage of patients with a postoperative visual acuity of 20/40 or better was significantly higher in iris-fixated IOL eyes (78.0%) than in sulcus-fixated PC IOL eyes (46.2%) (P < .05). In eyes without pre-existing pathology, the difference was maintained. No intraoperative complications directly associated with iris-fixated lens implantation occurred. The incidence of postoperative complications common to either IOL type in primary and secondary implantation did not differ significantly. The incidence of retinal complications was higher in eyes that had primary implantation of either lens type, although the differences between both lenses in either primary or secondary implantation were not significant. CONCLUSION: The good visual outcomes and low incidence of intraoperative and postoperative complications in eyes with iris-fixated IOLs indicate that these lenses should be considered an alternative to sutured PC IOLs in eyes in which capsular support is inadequate or absent.

Adolescent↗

PubMed1996

Anterior chamber contamination following uncomplicated cataract surgery: comparative results using intravenous imipenem.

BACKGROUND AND OBJECTIVE: An attempt was made to establish the effect of an intravenous antibiotic on anterior chamber (AC) fluid contamination when administered before surgery. PATIENTS AND METHODS: A prospective study of AC contamination was conducted in 60 patients undergoing extracapsular cataract extraction (ECCE)/intraocular lens (IOL) implantation. The final 20 patients received 1 g of intravenous imipenem 1 hour before surgery. RESULTS: There were 4 positive AC cultures from the 20 patients in the imipenem group, and 13 positive AC cultures from the 40 control patients (P = .4, chi-square test). Of the 60 eyes, 17 had positive AC aspirate cultures and 23 had positive conjunctival smears. Only in one instance was the microorganism isolated from each case the same (1.7%). CONCLUSIONS: An insignificant decrease in AC contamination was observed when intravenous imipenem was used before surgery. The results also suggest that conjunctiva might not be the main source of contamination during surgery.

Anterior Chamber↗