Archivos De La Sociedad Espanola De Oftalmologia[JOURNAL]
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200 papers
Extra-ocular muscle haematoma masquerading uveal prolapse post blunt trauma to the eye: A case report.
Bhutta Z, Joyce Burns S, Mudhar HS … +1 more , Khanam S
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jul · PMID 42392403 · Publisher ↗
This is a unique case of a 75-year-old lady who presented to eye emergency department with blunt trauma to the right orbit three days after a fall. Examination under anaesthesia revealed right globe subluxation, corneal...
This is a unique case of a 75-year-old lady who presented to eye emergency department with blunt trauma to the right orbit three days after a fall. Examination under anaesthesia revealed right globe subluxation, corneal ulceration with hypopyon, avulsion of extraocular muscles and a supero-lateral uveal prolapse. The eyeball was enucleated and sent for histopathology which revealed an intact globe with an avulsed lateral rectus muscle hematoma which was clinically masquerading as uvea, and displacement of the optic disc and pre-laminar optic nerve, causing extensive injury of optic nerve axons at the level of the lamina cribrosa, as shown by the accumulation of β-amyloid precursor protein (β-APP).The case highlights the importance of awareness of uncommon presentations and masquerades during the examination and management of ocular trauma.
Multifocal intraocular lenses in refractive lens exchange: Guidelines to optimize their use and indications.
Burkhard Dick H, Gerste RD, Taneri S
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jul · PMID 42392402 · Publisher ↗
INTRODUCTION AND OBJECTIVES: Refractive lens exchange (RLE) with presbyopia-correcting intraocular lenses (IOLs) can provide high levels of spectacle independence, but the procedure is unforgiving. Small residual refract...
INTRODUCTION AND OBJECTIVES: Refractive lens exchange (RLE) with presbyopia-correcting intraocular lenses (IOLs) can provide high levels of spectacle independence, but the procedure is unforgiving. Small residual refractive errors, ocular surface instability, undiagnosed corneal or macular disease, capsule-related IOL malposition, and mismatched expectations are common pathways to postoperative dissatisfaction. The literature on multifocal and extended-range optics is now complemented by consensus documents and functional classification frameworks that help standardize terminology and reduce "marketing-driven" decision making. MATERIALS AND METHODS: This narrative review aims to define practical indications for multifocal IOL use in RLE, clarify borderline cases, summarize the level of evidence supporting current recommendations, and present a staged algorithm for management of dissatisfaction. Priority was given to international consensus statements, systematic reviews/meta-analyses, randomized or comparative studies, large contemporary cohorts, and focused case series dealing with dissatisfaction, neuroadaptation failure, and IOL exchange. The literature was organized around the terms refractive lens exchange, refractive lensectomy, multifocal intraocular lens, trifocal, extended depth of focus, enhanced monofocal, dysphotopsia, neuroadaptation failure, and lens exchange, with emphasis on contemporary evidence available up to January 2026. RESULTS: The evidence can be translated into two clinic-ready workflows. The first is a preoperative selection pathway that starts with patient goals, prioritizes optical quality, treats astigmatism aggressively, and reserves range-first optics for eyes and expectations that can tolerate their trade-offs. The second is a symptom-first rescue pathway built on a strict reversible-first and YAG-last sequence. Borderline eyes are best handled with conservative category selection or deferred surgery. Contemporary exchange series show that persistent neuroadaptation failure may be successfully managed either by exchange to monofocal optics or by exchange to another multifocal platform with a different optical profile, provided that refraction, ocular surface disease, posterior-segment pathology, and IOL position have already been addressed. CONCLUSION: Multifocal IOLs remain valuable in RLE, but success depends more on indication discipline and rescue sequencing than on lens marketing labels. A structured algorithm, clear counseling, and explicit documentation of rescue options improve safety, readability, and everyday clinical usefulness.
The effect of pre- and perioperative anxiety on cardiovascular parameters and intraocular pressure of patients awaiting phacoemulsification surgery.
Dimitrova G, Gjorgjiovska A, Ljubic A … +1 more , Jordanovska SM
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42373077 · Publisher ↗
INTRODUCTION AND OBJECTIVES: To evaluate pre- and perioperative anxiety in patients scheduled for cataract surgery and to assess its correlation with cardiovascular parameters and intraocular pressure (IOP). PATIENTS OR...
INTRODUCTION AND OBJECTIVES: To evaluate pre- and perioperative anxiety in patients scheduled for cataract surgery and to assess its correlation with cardiovascular parameters and intraocular pressure (IOP). PATIENTS OR MATERIALS AND METHODS: Thirty cataract surgery patients were included. Exclusion criteria included previous ocular surgery, glaucoma, and ocular inflammation. Anxiety levels were assessed using a visual facial anxiety scale (VFAS). Systemic blood pressure (BP), heart rate (HR), and IOP were measured using a sphygmomanometer and an air-puff tonometer, with mean values calculated from three readings. VFAS, BP, HR, and IOP were recorded during the pre- and perioperative periods. A t-test compared parameters, and Pearson's coefficient was used to analyze correlations. RESULTS: Patients reported mild to moderate anxiety during both the pre- and perioperative periods. Cardiovascular parameters and IOP showed no significant differences between the two periods. IOP correlated significantly with HR perioperatively (R = 0.62, P < 0.001) and with systolic BP preoperatively (R = 0.47, P = 0.009). Preoperatively, patients with moderate to high anxiety had higher IOP (17.06 ± 1.69 mmHg) than those with no to mild/moderate anxiety (14.74 ± 2.41 mmHg; P = 0.006). CONCLUSIONS: Higher anxiety levels increase IOP preoperatively. Assessing BP, HR, and IOP, as well as alleviating anxiety may improve surgical outcomes and ensure stress-free procedures.
Management of central corneal opacities using manual and femtosecond laser-assisted rotational anterior lamellar autokeratoplasty: A descriptive case series.
Gegúndez-Fernández JA, Burgos-Blasco B, Ariño-Gutiérrez M … +3 more , Pérez-García P, Molero-Senosiain M, Díaz-Valle D
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42373076 · Publisher ↗
BACKGROUND AND OBJECTIVE: To describe the outcomes of rotational anterior lamellar autokeratoplasty (RALK) in central corneal opacities, assessing changes in visual acuity, astigmatism, and central corneal densitometry....
BACKGROUND AND OBJECTIVE: To describe the outcomes of rotational anterior lamellar autokeratoplasty (RALK) in central corneal opacities, assessing changes in visual acuity, astigmatism, and central corneal densitometry. PATIENTS AND METHODS: Retrospective descriptive case series of 9 eyes with central opacities and at least 4 mm of clear peripheral cornea, treated with manual RALK or femtosecond laser-assisted RALK. Demographic and clinical variables, leucoma characteristics, surgical parameters and postoperative evolution of best-corrected distance visual acuity (BCDVA), astigmatism, and central corneal densitometry (CCD) were analyzed. Pre- and postoperative values were compared, with statistical significance set at p < 0.05. RESULTS: Mean age was 44.9 years (5 women, 4 men) with a mean interval to surgery of 19.8 months. Mean leucoma area was 9.73 mm², with a depth of 268.4 μm and corneal thickness of 426.3 μm. Lamellar cut depth was 280.9 μm and graft diameter 7.9 mm. Median number of sutures was 4 (range 3-16). In 5 cases, the opacity was displaced to the superior cornea. BCDVA improved from 0.17 to 0.57 (decimal scale) at one year (p = 0.008). Astigmatism decreased from 7.7 to 5.9 D (p = 0.425), and CCD from 61.1% to 25.0% (p = 0.008). Mean follow-up was 2.4 years. One herpetic recurrence and two additional surgical procedures were recorded. CONCLUSIONS: RALK is an effective and safe technique for relocating central corneal opacities outside the visual axis and improving visual function in selected patients. Femtosecond laser assistance provides greater precision and edge congruency, which may facilitate earlier suture removal.
Evaluation of the anterior hyaloid using intraoperative optical coherence tomography: a key strategy in complex cataract surgery.
Cucurull Martí M, Babinska M, Bisbe López L
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42373075 · Publisher ↗
Cataract surgery in patients with high myopia and a history of multiple intravitreal injections carries an increased risk of complications. We report the case of a 57-year-old highly myopic patient with a phakic intraocu...
Cataract surgery in patients with high myopia and a history of multiple intravitreal injections carries an increased risk of complications. We report the case of a 57-year-old highly myopic patient with a phakic intraocular lens and a history of multiple intravitreal injections who experienced posterior capsular rupture during surgery. The use of intraoperative anterior segment optical coherence tomography enabled confirmation of the integrity of the anterior hyaloid, which proved crucial for adapting surgical maneuvers and avoiding anterior vitrectomy. This case underscores the value of intraoperative optical coherence tomography as a real-time diagnostic tool for tailoring surgical strategy and minimizing risk in complex cases. Its use may be particularly beneficial in highly myopic patients with prior intravitreal treatments, in whom careful assessment of the vitreolenticular interface is essential to maintain posterior segment stability.
Unilateral ocular hypertension secondary to frontal mucocele with orbital extension.
Moro-Muñiz M, Sanz Marco E, Salom Alonso D
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42373074 · Publisher ↗
We report the case of a 35-year-old man with no relevant past medical history who was referred for intermittent left-sided proptosis, self-limited blurred vision, and unilateral ocular hypertension. Examination showed pr...
We report the case of a 35-year-old man with no relevant past medical history who was referred for intermittent left-sided proptosis, self-limited blurred vision, and unilateral ocular hypertension. Examination showed preserved extraocular motility, mild left proptosis, and intraocular pressure of 19 mmHg in the right eye and up to 29 mmHg in the left eye, without structural glaucomatous damage on optical coherence tomography. Computed tomography demonstrated a large left frontal mucocele with remodeling and bony dehiscence of the orbital roof, causing extraconal mass effect on the left orbit. Topical hypotensive therapy was initiated, followed by endoscopic sinonasal surgery with left Draf IIb and right Draf I frontal sinusotomy technique. After surgery, proptosis resolved and intraocular pressure decreased to 14 mmHg in the left eye. This case highlights frontal mucocele with orbital extension as an uncommon and potentially reversible cause of unilateral ocular hypertension.
Cost-efficiency analysis of the Quixote® tele-ophthalmology programme at Hospital Universitario de Jerez.
Benitez-Del-Castillo J, Kosaka-Zanabria V, González-Del-Valle F … +3 more , Córdoba-Doña JA, Caraballo-Rodríguez G, Rodriguez-Herrera M
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42362183 · Publisher ↗
BACKGROUND AND OBJECTIVE: To calculate the cost per patient of ophthalmological care for patients referred from primary care under a telematic model (Quixote® project), compared with conventional face-to-face care at the...
BACKGROUND AND OBJECTIVE: To calculate the cost per patient of ophthalmological care for patients referred from primary care under a telematic model (Quixote® project), compared with conventional face-to-face care at the Hospital Universitario de Jerez, within the Jerez, Sierra de Cádiz, and Northwest Coast Health Area (Spain). MATERIAL AND METHODS: Comparative analysis of direct costs of telematic ophthalmological care versus the traditional face-to-face model, alongside a retrospective observational evaluation of efficiency after implementation of the Quixote® project. Outcomes included accessibility (mean waiting time in days for ophthalmological care, cumulative primary care waiting list) and patient satisfaction. RESULTS: The direct cost of complete care using the telematic model was €22.47 per patient compared with €32.5 per patient for the face-to-face model. Among 4288 patients evaluated in the Quixote® project at HUJ, 2659 patients (62%) required referral for face-to-face hospital assessment, while 1629 (37.9%) were discharged. The mean waiting time for patients referred from primary care decreased from 89 days to 39 days (-56.8%; 95%CI, 53.8%-58.5%; P < .0001). The cumulative waiting list decreased from 4606 to 1684 patients (-64%; 95%CI, 61.7%-66.3%; P < .0001). CONCLUSIONS: Implementation of the Quixote® tele-ophthalmology program is a cost-efficient strategy for delivering ophthalmological care. It improves patient throughput from primary care, reduces waiting lists, optimizes hospital resources, and facilitates early detection of relevant diseases.
Retinal occlusive event in a pediatric patient in the context of dengue infection: Case report.
Oliva Castillo NL
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42349551 · Publisher ↗
We report the case of a 3-year-old pediatric patient with serologically confirmed dengue infection who subsequently developed left exotropia and severe visual impairment. Ophthalmologic examination revealed diffuse retin...
We report the case of a 3-year-old pediatric patient with serologically confirmed dengue infection who subsequently developed left exotropia and severe visual impairment. Ophthalmologic examination revealed diffuse retinal and optic disc pallor, alterations of the retinal pigment epithelium, and macular fibrosis. B-mode ultrasonography ruled out intraocular malignancy, and optical coherence tomography demonstrated complete macular atrophy. The clinical findings were consistent with a previous retinal vascular occlusive event. However, the absence of angiographic studies and comprehensive systemic evaluation to exclude other etiologies limits the ability to establish a definitive causal relationship with dengue infection. This case highlights the importance of early ophthalmologic assessment in pediatric patients with recent viral infection and underscores the need for further studies to accurately characterize retinal vascular events.
Low-flow carotid-cavernous fistula associated with cavernous sinus thrombosis: An ophthalmic presentation.
Moro-Muniz M, Sanz Marco E, Salom Alonso D
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42349550 · Publisher ↗
A 70-year-old woman presented with 20 days of painless left-sided proptosis and ocular discomfort, without infectious symptoms. Examination revealed conjunctival chemosis and hyperemia, painless proptosis, ocular hyperte...
A 70-year-old woman presented with 20 days of painless left-sided proptosis and ocular discomfort, without infectious symptoms. Examination revealed conjunctival chemosis and hyperemia, painless proptosis, ocular hypertension (intraocular pressure, 35 mmHg), and mild limitation of abduction and elevation. Contrast-enhanced computed tomography and venous computed tomography angiography demonstrated left cavernous sinus thrombosis with proptosis and dilation of the superior ophthalmic vein. Dynamic magnetic resonance angiography suggested a low-flow carotid-cavernous fistula with partial cavernous sinus thrombosis and orbital venous hypertension. Orbital ultrasonography showed an arterialized superior ophthalmic vein with reversed flow. Conservative management with topical hypotensive agents and oral acetazolamide resulted in progressive clinical improvement. The 4-month follow-up magnetic resonance imaging demonstrated complete spontaneous resolution of the fistula and orbital venous congestion, with full clinical recovery.
Bacterial contamination map of high-touch surfaces in a hospital ophthalmology department: A cross-sectional study.
Asensio-Sánchez VM, Frontela A, Nebreda-Mayoral T … +1 more , Cuervo-Abarquero M
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42349549 · Publisher ↗
BACKGROUND AND OBJECTIVES: Bacterial contamination of high-touch surfaces can facilitate healthcare-associated infections, particularly in ophthalmology, where frequent contact with diagnostic devices occurs. The aim of...
BACKGROUND AND OBJECTIVES: Bacterial contamination of high-touch surfaces can facilitate healthcare-associated infections, particularly in ophthalmology, where frequent contact with diagnostic devices occurs. The aim of this study was to evaluate and characterize bacterial load on high-touch surfaces in a hospital ophthalmology department, identifying critical areas and predominant bacterial groups. MATERIAL AND METHODS: Cross-sectional observational study conducted in a tertiary hospital, sampling 150 surfaces across consultation rooms, emergency areas, waiting rooms, administrative areas, and critical points. Surfaces were sampled using sterile swabs and cultured on nutrient agar. After incubation at 37 °C for 48 h, bacterial load was quantified as colony-forming units per square centimeter (CFU/cm²). Bacterial identification was performed using Gram staining and conventional biochemical tests. Comparisons between areas were analyzed using ANOVA; P < .05. RESULTS: Significant differences in bacterial load were observed among areas; P < .001, with higher values in consultation rooms (104 ± 37 CFU/cm²) and critical points (118 ± 42 CFU/cm²). The most contaminated surfaces were slit-lamp chin rests, keyboards and mice, touch screens, and tonometer cones. Coagulase-negative staphylococci predominated (79%), followed by Staphylococcus aureus (14%) and Gram-negative bacilli (9%). CONCLUSIONS: Frequently touched surfaces in ophthalmology departments exhibit high bacterial loads, underscoring the need for differentiated cleaning protocols, periodic audits, and staff training to reduce cross-contamination and improve patient safety.
Blue light and melatonin: A critical review of scientific evidence and biohacker myths in ophthalmology.
Campo-Beamud C, Roig-Ferreruela G
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42349548 · Publisher ↗
Blue light is a physiological component of visible light, essential for daytime vision and circadian synchronization. There is no evidence supporting the routine use of blue-blocking glasses for preventive or therapeutic...
Blue light is a physiological component of visible light, essential for daytime vision and circadian synchronization. There is no evidence supporting the routine use of blue-blocking glasses for preventive or therapeutic purposes. The most effective strategies are based on light hygiene, reduction of nocturnal exposure, and patient education. Strengthening scientific communication is necessary to counter misinformation and maintain an evidence-based ophthalmological discourse. Blue light has been associated with potential effects on visual function, sleep, and circadian physiology, although clinical evidence remains heterogeneous. In recent years, dissemination of claims unsupported by clinical evidence regarding spectral filters for preventive purposes has increased. The aim of this review was to critically analyze the available scientific evidence on the visual, circadian, and systemic effects of blue light and contrast it with messages disseminated through media and social networks. A narrative review of the literature published between 2009 and 2025 was conducted using PubMed, Scopus, and the Cochrane Library, prioritizing human studies and institutional position statements relevant to ophthalmological practice. Available systematic reviews and controlled trials indicate that blue-filtering lenses do not provide clinically meaningful improvements in visual acuity or symptoms of digital eye strain, and show small and inconsistent effects on sleep-related outcomes. Under typical viewing conditions, screen light exposure remains well below levels associated with photochemical retinal damage in experimental models. Therefore, current evidence does not support the routine preventive or therapeutic use of blue-blocking glasses. The most effective strategies rely on light hygiene, reduction of nocturnal light exposure, and patient education.
Paracentral acute middle maculopathy vs acute macular neuroretinopathy: A 2-case report.
Ruiz Sáez P, García Torre M
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42349547 · Publisher ↗
Although the exact etiology of paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) remains uncertain, several characteristic features have been identified. Advances in multimodal imaging...
Although the exact etiology of paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) remains uncertain, several characteristic features have been identified. Advances in multimodal imaging have demonstrated a shared pathophysiological hallmark: retinal capillary ischemia. Both conditions involve impaired venous drainage, resulting in secondary ischemia localized to the deep capillary plexus. Although currently classified as distinct clinical entities, PAMM and AMN share significant similarities and may occasionally overlap or coexist. We report two clinical cases, one of PAMM and one of AMN, to highlight their principal similarities and differences.
Therapeutic applications of gene editing using CRISPR-Cas9 in the posterior segment: review of the literature.
Leon Agudelo JA, Martínez Vallejo H
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42285217 · Publisher ↗
CRISPR-Cas gene editing has become increasingly relevant in the treatment of several ophthalmic diseases. Its ability to make precise modifications at the DNA or RNA level has enabled targeted approaches for specific mut...
CRISPR-Cas gene editing has become increasingly relevant in the treatment of several ophthalmic diseases. Its ability to make precise modifications at the DNA or RNA level has enabled targeted approaches for specific mutations involved in conditions such as Leber congenital amaurosis type 10 (LCA10), certain forms of retinitis pigmentosa, and age-related macular degeneration. This article provides an organized overview of the biological basis of CRISPR-Cas technology and highlights key advances from preclinical studies and early clinical trials. Technical limitations and ongoing safety challenges are also discussed. Programs such as EDIT-101, EDIT-103, and HG202 stand out as important milestones in the evolution of ocular gene editing.
Optic disc oedema in a patient with POEMS syndrome associated with Castleman's disease.
López Herrero F, Sánchez-Vicente JL, Gámez-Jiménez EM … +3 more , González-Jáuregui López B, Portillo-Martínez M, Guijarro-Ambel JV
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42276248 · Publisher ↗
A case of POEMS syndrome associated with Castleman's disease is presented in a 36-year-old Caucasian patient, in whom papillary oedema was the neuro-ophthalmological manifestation. The patient presented with bilateral op...
A case of POEMS syndrome associated with Castleman's disease is presented in a 36-year-old Caucasian patient, in whom papillary oedema was the neuro-ophthalmological manifestation. The patient presented with bilateral optic disc oedema, which was confirmed by optical coherence tomography, showing thickening of the retinal nerve fibre layer. Fluorescein angiography demonstrated hyperfluorescence in the early phases with mild leakage in the late phases. Visual field testing using the central 24-2 threshold strategy revealed enlargement of the blind spot in both eyes, along with an inferior arcuate defect in the left eye. Papillary oedema represents the most common manifestation of POEMS syndrome, and its association with polyneuropathy and monoclonal proteins should prompt consideration of this diagnosis.
Anterior segment OCT, Schlemm's canal, and carotid-cavernous fistula: Reflections on a clinical case.
González Martín-Moro J, Altares Mateos V
Arch Soc Esp Oftalmol (Engl Ed) · 2026 Jun · PMID 42269965 · Publisher ↗
We rerport a 69-year-old man who presented with diplopia. He had a conjunctival injection with corkscrew-vessels, proptosis, and sixth cranial nerve palsy in his right eye (RE), and was diagnosed with a right carotid-cav...
We rerport a 69-year-old man who presented with diplopia. He had a conjunctival injection with corkscrew-vessels, proptosis, and sixth cranial nerve palsy in his right eye (RE), and was diagnosed with a right carotid-cavernous fistula (CCF). Intraocular pressure was within normal limits. Gonioscopic examination revealed a pinkish appearance of the trabecular meshwork, but the Schlemm's canal could not be identified on anterior segment optical coherence tomography (OCT). We discuss the potential usefulness and limitations of OCT in the assessment of the Schlemm's canal in CCF.
Redox-inflammation pathways in ocular disease: Targets for nutritional modulation.
Kavyasree PKV, Jayadevan K, Abdullah M … +1 more , Therayil A
Arch Soc Esp Oftalmol (Engl Ed) · 2026 May · PMID 42190948 · Publisher ↗
Visual impairment remains a major global health burden caused by diverse ocular diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, uveitis, and ocular surface disorders. Despite differi...
Visual impairment remains a major global health burden caused by diverse ocular diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, uveitis, and ocular surface disorders. Despite differing etiologies, growing evidence identifies oxidative stress and chronic inflammation as a shared pathogenic axis affecting both anterior and posterior ocular segments. High metabolic demand, sustained light exposure, dense mitochondrial content, and limited antioxidant defences render ocular tissues particularly susceptible to redox imbalance. Excess reactive oxygen species induce cellular injury and activate redox-sensitive inflammatory signalling, promoting neurodegeneration, microvascular dysfunction, immune-mediated damage, and progressive vision loss. This review summarises key mechanisms underlying redox-inflammatory crosstalk in ocular tissues, highlighting mitochondrial dysfunction, Nrf2-Keap1 antioxidant responses, NF-κB-driven inflammation, and MAPK and PI3K-Akt signalling as central molecular integrators. Tissue-specific responses in the retina, retinal pigment epithelium, trabecular meshwork, uveal tract, and ocular surface demonstrate how shared mechanisms generate distinct disease phenotypes. The modulatory potential of bioactive nutrients, including omega-3 fatty acids, carotenoids, and polyphenols, is critically discussed. Although preclinical evidence is strong, clinical outcomes remain variable, underscoring the need for precision nutrition strategies and mechanism-based clinical trial design.
Impact of bilateral graded inferior oblique recession on ocular torsion in patients with primary inferior oblique overaction: A prospective study.
Mallik KB, Singh A, Mittal SK … +2 more , Pandey PK, Kumar B
Arch Soc Esp Oftalmol (Engl Ed) · 2026 May · PMID 42190947 · Publisher ↗
INTRODUCTION AND OBJECTIVES: The impact of inferior oblique (IO) weakening on ocular torsion is well documented. This study aimed to evaluate objective and subjective torsional changes using fondo photography and the Dou...
INTRODUCTION AND OBJECTIVES: The impact of inferior oblique (IO) weakening on ocular torsion is well documented. This study aimed to evaluate objective and subjective torsional changes using fondo photography and the Double Maddox rod test (DMRT) after bilateral IO recession in cases of primary inferior oblique overaction. MATERIALS AND METHODS: This prospective, hospital-based observational cohort study included 82 eyes from 41 patients with primary inferior oblique overaction who underwent IO recession using the Apt and Call technique between December 2023 and March 2025. Pre- and postoperative subjective and objective torsion were analyzed using the DMRT and fundus photography to assess torsional changes at 1, 4, and 12 weeks. RESULTS: The mean age was 13.93 ± 8 years; 58.5% of patients were male. Preoperative DMRT showed no subjective torsion, with a mean objective torsion of 9.32 ± 5.25°. Mean IOOA grade and V-pattern were 2.74 ± 0.98 and 28.66 ± 9.08 prism diopters, respectively. Postoperatively, DMRT findings remained unchanged, whereas objective torsion decreased significantly to 5.82 ± 3.95, 5.51 ± 3.8, and 5.08 ± 3.77° at 1, 4, and 12 weeks, respectively. The overall change in torsion at 12 weeks was 4.24 ± 3.14°. Additionally, significant improvements in IOOA grading and V-pattern were observed at 12 weeks, with values of 0.09 ± 0.28 grades and 6.05 ± 2.95 prism diopters, respectively (P < .001). CONCLUSIONS: Bilateral graded IO recession significantly reduces objective ocular extorsion, without a corresponding change in subjective torsion as assessed by DMRT. The reduction in torsion was accompanied by significant improvements in IOOA grading and V-pattern deviation, confirming the functional efficacy of IO recession.
Use of exosomes as adjuvant therapy in the reconstruction of traumatic eyelid wounds: A case report.
Velasco Y Levy A
Arch Soc Esp Oftalmol (Engl Ed) · 2026 May · PMID 42190946 · Publisher ↗
Traumatic eyelid wounds with tissue loss pose a reconstructive challenge due to the risk of inflammation-driven fibrosis and functional impairment. Adipose-derived stem cell-derived exosomes have demonstrated regenerativ...
Traumatic eyelid wounds with tissue loss pose a reconstructive challenge due to the risk of inflammation-driven fibrosis and functional impairment. Adipose-derived stem cell-derived exosomes have demonstrated regenerative and antifibrotic effects in cutaneous wound-healing models. We report a case of high-energy periocular trauma in which standard oculoplastic reconstruction was supplemented with staged topical and microneedling-assisted exosome therapy. Accelerated epithelialization, favorable scar modulation, and preservation of eyelid contour and function were observed without adverse events. This case supports the feasibility of exosome-based therapy as an adjunct in complex eyelid wound reconstruction.
Improvement in quality of life and ocular surface symptoms after pterygium excision with conjunctival autograft and fibrin glue: a prospective study.
Alarcón García AD, Burgos-Blasco B, Robles Amor P … +3 more , Miranda Sánchez A, Pérez García P, Arriola Villalobos P
Arch Soc Esp Oftalmol (Engl Ed) · 2026 May · PMID 42190945 · Publisher ↗
INTRODUCTION AND OBJECTIVES: To evaluate changes in quality of life in patients with pterygium before and after pterygium excision with conjunctival autograft using standardized questionnaires. MATERIALS AND METHODS: A p...
INTRODUCTION AND OBJECTIVES: To evaluate changes in quality of life in patients with pterygium before and after pterygium excision with conjunctival autograft using standardized questionnaires. MATERIALS AND METHODS: A prospective observational study including patients scheduled for pterygium surgery was conducted. Patients completed the Ocular Surface Disease Index (OSDI) and the Visual Function Questionnaire 25 (NEI VFQ-25) before surgery and at 2 and 6 months postoperatively. Sex, age, prior treatments, visual acuity, and corneal and limbal pterygium extension were recorded. A standard surgical procedure was performed by experienced ocular surface surgeons under topical anaesthesia, consisting of pterygium excision via avulsion followed by superior conjunctival autograft fixation using tissue adhesive. RESULTS: Twenty eyes were included in this study: mean age 50.0 ± 11.5 years, and 12 patients (60%) were male. Visual acuity was 0.8 ± 0.2 (decimal scale), and the mean pterygium size was 3.3 ± 1.0 mm of corneal invasion and 3.3 ± 1.1 mm of limbal invasion. The mean preoperative OSDI score was 47.6 ± 20.6 (no differences between sexes; P = .650), which decreased significantly to 35.8 ± 18.1 at 2 months (11.8 [95%CI, 4.5-19.1]; P = .001) and to 29.0 ± 13.9 at 6 months postoperatively (18.6 [95%CI, 9.6-27.5]; P < .001). The mean preoperative NEI VFQ-25 score was 71.8 ± 6.8, with no significant differences between males and females (P = .928). Mean VFQ scores differed significantly across time points (F (1.5, 29.1) = 3.7; P = .047), although post hoc analysis showed no significant pairwise differences. CONCLUSIONS: Pterygium surgery significantly improves ocular symptomatology in most patients, with improvement observed within the first 6 months postoperatively.
Subretinal fluid resolution in the fellow eye after unilateral aflibercept injection in bilateral neovascular age-related macular degeneration: Coincidence or systemic effect?
Demirel R, Gültekin Irgat S, Bike HI
Arch Soc Esp Oftalmol (Engl Ed) · 2026 May · PMID 42190944 · Publisher ↗
We report a case of bilateral neovascular age-related macular degeneration (nAMD) in which a unilateral aflibercept injection led to complete resolution of subretinal fluid (SRF) in the untreated fellow eye. A 63-year-ol...
We report a case of bilateral neovascular age-related macular degeneration (nAMD) in which a unilateral aflibercept injection led to complete resolution of subretinal fluid (SRF) in the untreated fellow eye. A 63-year-old woman undergoing treat-and-extend therapy for the right eye developed new SRF in the left eye, which maintained good vision (best-corrected visual acuity, 0.8). To avoid injection-related risks in a high-vision eye, only the right eye was treated. Three weeks later, optical coherence tomography demonstrated complete SRF resolution in the left eye, which persisted for 8 weeks before recurrence. This case raises the possibility that systemic absorption of anti-vascular endothelial growth factor (anti-VEGF) may temporarily suppress choroidal neovascularisation activity in the fellow eye. However, this single observation cannot guide clinical practice and requires prospective validation.
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