Browsing by Author "Miotto Montesinos, Giuseppe Cornelio"

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Clinical-surgical Characteristics of Patients with Macular Hole. Exilaser Ophthalmological Center. Cuenca, Ecuador. 2015-2019
(2023) Miotto Montesinos, Giuseppe Cornelio
Background: The macular hole (MH) is one of the least studied ophthalmological pathologies; satisfactory treatment has been achieved through the implementation of surgical techniques a few years ago and the study and analysis of its clinical-surgical characteristics are of vital importance to assess the success of surgery with intrinsic and extrinsic factors. Objective: Describe the clinical-surgical characteristics of patients diagnosed with a macular hole at the EXILASER Ophthalmological Center in Cuenca in the period 2015-2019. Methods: Descriptive, retrospective study. The study universe corresponds to 75 patients who attended the EXILASER Ophthalmological Center and were diagnosed with MH between January-2015 and December-2019. Results: 76.0% of the patients are women; 81.3% are between 60 and 79 years old; 96.0% reside in urban areas; 34.7% are dedicated to housework; 24.0% report cataracts; 26.7% have arterial hypertension; 84.0% presented loss of central vision; 80.0% had decreased visual acuity. 50.7% presented affection only in the right eye; 53.3% had a chronic evolution greater than one year; 33.3% presented grade III MH. 44.0% had surgery; 93.9% had anatomical surgical closure. The relationship between the degree of MH, time of evolution, and closure of the MH was not significant (p> 0.05). Conclusion: The success rate of MH closure after surgical intervention is greater than 90% with improvement in postoperative visual acuity. No significant association was found between the grade of the MH, time of evolution, and the closure of the MH.
Conventional PRK versus single-step transPRK in corneal refractive surgery with excimer laser
(2021) Miotto Montesinos, Giuseppe Cornelio; Rojas Alvarez, Eduardo; Torres Piedra, Diego Manolo; Torres Palacios, Nataly Carolina
Objective: To compare conventional alcohol-assisted PRK (aaPRK) and single-step transPRK in terms of clinical-refractive and surgical variables. Method: An observational, prospective, longitudinal study was carried out in 72 patients who were candidates for corneal refractive surgery with the excimer laser, with a diagnosis of compound myopic astigmatism, at the Exilaser Ophthalmological Center, Cuenca, Ecuador, from September to December 2019. Patients underwent surface surgery (transPRK or aaPRK). Data processing was performed with the SPSS program, version 21.0. For data comparison between both surgical techniques, the chi-square test was used, where P < 0.05 was considered statistically significant. Results: The average spherical equivalent was obtained for aaPRK (−0.14) and transPRK (−0.11) 3 months after the procedure (p = 0.34). UCVA average was 0.93 in aaPRK and 0.96 in transPRK, without statistically significant differences (p = 0.63). Surgical time was shorter in transPRK (720.31 s) compared to aaPRK (1080.85 s), with a statistically significant difference (p < 0.001). In transPRK there was less pain immediately after surgery, compared to aaPRK (p <0.05). Epithelial closure was achieved on day 6.27 for aaPRK and in day 3.62 for transPRK (average values; p = 0.02). conclusions: Single-step transepithelial PRK and aaPRK in patients who are candidates for refractive surgery showed very similar results 3 months after surgery in terms of uncorrected visual acuity, spherical equivalent and with minimal postoperative complications. TransPRK offers greater advantages to the patient regarding shorter surgical time, rapid epithelial closure and less pain in the immediate postoperative period.
Corneal indices determined with pentacam in possible candidates for corneal refractive surgery
(2020) Rojas Alvarez, Eduardo; Miotto Montesinos, Giuseppe Cornelio; Torres Piedra, Diego Manolo; Torres Palacios, Nataly Carolina; Fosado Tellez, Osvaldo Alberto
Objective: To describe the level of correlation of clinical refractive variables with corneal indices in Pentacam Scheimpflug tomography, demonstrate the usefulness of the study of corneal indices in the diagnosis of keratoconus (KC), and identify the corneal indexes with the greatest influence on the diagnosis of KC. Methods: A descriptive, retrospective, and cross-sectional study was conducted in 69 patients (138 eyes) with refractive disorders, possible candidates for corneal refractive surgery, at the Exilaser Ophthalmological Center, Cuenca, Ecuador, from March to August 2019. Corneal indices were studied using Pentacam. Statistical correlation methods, Levene’s test, Fisher’s exact test, Cramérs’ V coefficient, and multiple correspondence analyses were used. Results: The variables refractive cylinder and central keratometry had a direct correlation with the corneal indices (p<0.001). An inverse correlation was obtained between central pachymetry and corneal indices (p<0.001). A high level of dependence on central KC index (CKI) (Cramér V = 0.785) and KC index (KI) (Cramér V = 0.775) was obtained with the diagnosis of KC. Conclusions: Pentacam is a valuable tool in the analysis of corneal indices for the diagnosis of KC, given its high level of correlation with clinical refractive variables. The selection of candidates for refractive surgery, even when there is no diagnosis of KC, is strengthened with the analysis of the corneal indices. The indices with the most intense level of dependence with the diagnosis of KC are, in order, the following indices: CKI, KI, vertical asymmetry, minimum radius, and variation of the surface
Neurorretinitis atípica por toxoplasma con vítreo transparente
(2022) Fortún Campos, Abel
Purpose: Describe the clinical and tomographic findings of a case with atypical ocular toxoplasmosis. Case report: A 32-year-old male patient who began with decreased visual acuity in the left eye, with papillary edema and transparent vitreous, without a macular star. Presence of positive IgM for toxoplasmosis. Laboratory results, papillary optical coherence tomography and characteristics of the fibers of the optic nerve are shown. After treatment for toxoplasma was started, significant clinical improvement was obtained from the patient, verified with images of the fundus. Conclusions: Papillary edema due to toxoplasmosis with clean vitreous is not frequent in practice. However, it is a picture that must be taken into account in the differential diagnosis as an atypical presentation of ocular toxoplasmosis.