Archivos De La Sociedad Espanola De Oftalmologia最新文献

{"title":"Mejorar habilidades en gonioscopia: una necesidad","authors":"C. Burgueño-Montañes, J. Galvez-Olortegui, T. Galvez-Olortegui","doi":"10.1016/j.oftal.2026.502474","DOIUrl":"10.1016/j.oftal.2026.502474","url":null,"abstract":"","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502474"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signo de la semiluna blanca en la implantación del iStent inject® W, mediante lente de gonioscopía de Swan-Jacob","authors":"J.E. Muñoz de Escalona Rojas","doi":"10.1016/j.oftal.2026.502533","DOIUrl":"10.1016/j.oftal.2026.502533","url":null,"abstract":"<div><div>To describe the value of the «white crescent sign» as a gonioscopic reference for accurate implantation of the iStent inject® W device. The ab interno surgical technique using the Swan-Jacob direct gonioscopy lens is described. Optical principles of coaxial visualization and the effects of peripheral aberrations and parallax in minimally invasive glaucoma surgery are analyzed. Central and coaxial visualization with the Swan-Jacob lens produces a bright reflection over the trabecular meshwork, termed the «white crescent sign». This sign confirms appropriate alignment, minimizes distortion, and enables identification of the optimal anatomical implantation zone (the thickest portion of the crescent), thereby reducing parallax error. The white crescent sign is a reliable intraoperative marker that enhances anatomical precision during iStent inject® W implantation and may reduce surgical error.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502533"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148545601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implante de acetónido de fluocinolona en la uveítis no infecciosa: interpretación de los resultados a largo plazo","authors":"A. Maduri,&nbsp;R. Saxena,&nbsp;V. Vadhithala,&nbsp;S. Kumar","doi":"10.1016/j.oftal.2026.502565","DOIUrl":"10.1016/j.oftal.2026.502565","url":null,"abstract":"","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502565"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148545600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infiltración corneal por perforación endotelial tardía por un segmento de anillo intraestromal","authors":"P. Puy,&nbsp;D. Carrascosa,&nbsp;E. Redondo,&nbsp;M.I. Gabarrón,&nbsp;N. Toledano","doi":"10.1016/j.oftal.2026.502504","DOIUrl":"10.1016/j.oftal.2026.502504","url":null,"abstract":"<div><div>Intrastromal rings have a high safety profile, with late complications being rare.</div><div>A clinical case is presented a patient who attended the emergency department due to photophobia and redness in the right eye with a two-day onset. A relevant medical history includes the implantation of an intrastromal corneal ring segment for keratoconus 11 years earlier.</div><div>Examination revealed a deep whitish stromal infiltration around the ring. After several weeks of antibiotic treatment, the decision was made to explant the ring. Preoperative optical coherence tomography demonstrated endothelial perforation at the site of the inf</div><div>iltration. Aqueous humour leakage was observed upon removal of the ring segment.</div><div>The patient reported notable symptomatic improvement following surgery.</div><div>We present a rare complication following the implantation of an intrastromal ring, initially suspected to be a stromal infiltration, which turned out to be an unusually late endothelial perforation.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502504"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resultado anatómico y recuperación visual tras retinopexia neumática: análisis de factores predictivos en una cohorte que incluye criterios no estándar","authors":"A. Márquez Falcón,&nbsp;L. Cabanes Goy,&nbsp;Y. Ramos Ravelo,&nbsp;G. Castillo Bermúdez","doi":"10.1016/j.oftal.2026.502551","DOIUrl":"10.1016/j.oftal.2026.502551","url":null,"abstract":"<div><h3>Background and objective</h3><div>Pneumatic retinopexy is a treatment for rhegmatogenous retinal detachment with standard selection criteria. There is growing interest in evaluating its outcomes in broader clinical profiles. This study aimed to evaluate anatomical outcomes and visual recovery after pneumatic retinopexy in a cohort including non-standard criteria, and to identify independent predictive factors for anatomical failure and reduced visual recovery.</div></div><div><h3>Materials and methods</h3><div>A prospective cohort study of 92 eyes (92 patients), stratified into standard (<em>n</em> <!-->=<!--> <!-->57) and non-standard (<em>n</em> <!-->=<!--> <!-->35) criteria. Over 12 months of follow-up, primary reattachment survival was assessed using Kaplan-Meier curves and predictive factors were analyzed with multivariate regression models.</div></div><div><h3>Results</h3><div>The primary anatomical success rate was 82.5% in the standard criteria group and 85.7% in the non-standard group (<em>P</em> <!-->=<!--> <!-->0.777), with a cumulative survival at 12 months<!--> <!-->&gt; 95% in both groups (log-rank, <em>P</em> <!--> <!-->=<!--> <!-->0.754). Final anatomical success exceeded 97%. Final best-corrected visual acuity improved significantly (<em>P</em> &lt;<!--> <!-->0.001) with no differences between groups (<em>P</em> <!-->=<!--> <!-->0.343). Greater detachment extent was an independent predictor of anatomical failure in multivariate model (OR<!--> <!-->=<!--> <!-->3.23 per additional quadrant, <em>P</em> <!-->=<!--> <!-->0.044). Longer detachment duration (β = 0.021 logMAR/day; <em>P</em> &lt;<!--> <!-->0.001) and older age (β = 0.006 logMAR/year; <em>P</em> &lt;<!--> <!-->0.001) were independent predictors of reduced visual recovery.</div></div><div><h3>Conclusions</h3><div>Pneumatic retinopexy suggests a high survival rate of primary retinal reattachment and provides significant visual improvement in patients meeting both standard and non-standard criteria. Detachment extent, symptom duration, and age are key independent predictive factors for optimizing candidate selection and anticipating functional outcomes.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502551"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competencias profesionales en atención visual en España y la Unión Europea: oftalmólogos, ópticos y los riesgos de la «expansión competencial»","authors":"J.A. Gegúndez-Fernández,&nbsp;J. García-Feijóo","doi":"10.1016/j.oftal.2026.502557","DOIUrl":"10.1016/j.oftal.2026.502557","url":null,"abstract":"<div><div>This article examines the delineation of professional competencies in visual health care in Spain and the European Union, comparing the continental European model with the British, USA and Canada models. In Spain and most European countries, the diagnosis and treatment of eye diseases is the exclusive responsibility of ophthalmologists, supported by extensive medical training and strict regulation. Optometrists play a complementary role, focused on detecting refractive anomalies and adapting optical aids, without legal authority for medical diagnosis or treatment prescription. The article warns of the risks of expanding optometrists’ competencies without appropriate legal and educational reform, as this could compromise patient safety. It emphasizes that Anglo-Saxon models are not directly applicable to the Spanish context due to structural differences. The article advocates for clear interprofessional collaboration, well-defined referral protocols, and regular legal updates, always prioritizing patient safety.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502557"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuritis óptica bilateral secundaria a pembrolizumab. Un evento adverso infrecuente secundario a la administración de inhibidores del check-point: a propósito de un caso","authors":"P.M. Espacio Santos,&nbsp;F. Rabadán Márquez,&nbsp;P. Tejada Calvo,&nbsp;J. Venegas Cruz,&nbsp;J.M. Rodríguez García,&nbsp;R.M. Bayon Porras","doi":"10.1016/j.oftal.2026.502503","DOIUrl":"10.1016/j.oftal.2026.502503","url":null,"abstract":"<div><div>Toxicity secondary to checkpoint inhibitors (ICP) can affect numerous parts of the body, with varying frequency. We present a case of bilateral optic neuritis secondary to the use of pembrolizumab (an anti-PD-1), which has been described in the literature in less than 1% of cases associated with the use of anti-PD-1/PD-L1 and anti-CTLA4 (ICP).</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502503"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encuesta sobre la situación actual de la terapia intravítrea en España","authors":"G. Garay-Aramburu,&nbsp;J. Zarranz-Ventura,&nbsp;J.J. Escobar-Barranco,&nbsp;A. García-Layana,&nbsp;E. Rodríguez Neila,&nbsp;J. Donate-López,&nbsp;E. Cervera-Taulet,&nbsp;P. Calvo-Pérez,&nbsp;M. Gómez-Resa,&nbsp;M. López-Gálvez,&nbsp;F. Gómez-Ulla,&nbsp;M.J. Abraldes","doi":"10.1016/j.oftal.2026.502532","DOIUrl":"10.1016/j.oftal.2026.502532","url":null,"abstract":"<div><h3>Background and objective</h3><div>Intravitreal injections are the most frequently performed intraocular procedure in ophthalmology; however, limited data exist regarding their organizational implementation in Spain. This study evaluated the current status of intravitreal therapy in Spanish hospitals and clinics.</div></div><div><h3>Methods</h3><div>A structured national survey comprising 46 questions grouped into nine thematic sections was conducted. The survey was voluntarily distributed using a nonprobability sampling strategy through professional networks across Spain. Duplicate responses were excluded.</div></div><div><h3>Results</h3><div>A total of 172 responses were received, of which 129 unique responses were analyzed. Most centers (89.84%) lacked formal agreements with primary care. However, 64.34% reported having referral protocols from outpatient clinics, and 66% had written protocols for managing macular diseases. Only 39.53% had a dedicated intravitreal therapy unit, whereas an additional 33% reported nursing or administrative coordination specifically assigned to intravitreal therapy. Only 27.81% had an efficient system for reviewing clinical outcomes of intravitreal injections, and 6% used artificial intelligence systems for optical coherence tomography analysis. Patient safety was a shared concern, and most centers reported safety incidents.</div></div><div><h3>Conclusions</h3><div>Intravitreal therapy delivery in Spain demonstrates substantial organizational variability. No relevant differences were observed between public and private sectors. Areas for improvement include coordination with primary care, implementation of standardized protocols, and equitable access to resources.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 7","pages":"Article 502532"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Características y resultados de la cirugía de la esotropía residual","authors":"P. Merino Sanz ,&nbsp;B. Zahonero ,&nbsp;A. Fuentes Zamora ,&nbsp;P. Gómez de Liaño Sánchez ,&nbsp;J. Yáñez-Merino","doi":"10.1016/j.oftal.2026.502502","DOIUrl":"10.1016/j.oftal.2026.502502","url":null,"abstract":"<div><h3>Background</h3><div>Residual esotropia (RE) is a postoperative complication with a prevalence of 20% after surgery for childhood esotropia.</div></div><div><h3>Objective</h3><div>To study the characteristics and efficacy of different surgical techniques in reoperations on subjects with residual esotropia.</div></div><div><h3>Materials and methods</h3><div>Retrospective study of 34 cases with residual esotropia between 2017-2024. The mean age was 33.12<!--> <!-->years, 52.94% women. The mean time between initial surgery and reoperation was 16.3<!--> <!-->years. Data were collected from the alternating prism cover test, TNO and Worth tests, limitations in ductions, and alphabetical pattern. Success was considered a residual deviation &lt;<!--> <!-->10 prism diopters without diplopia. The mean follow-up time was the period from the first surgery to data collection: 18.26<!--> <!-->years.</div></div><div><h3>Results</h3><div>A total of 46 surgeries were performed: re-recession of the medial rectus (19.15%), lateral rectus resection (44.68%), or both techniques combined (36.17%), uni- or bilaterally. The mean number of reoperations was 1.38 (range: 1-3), with one case requiring three surgeries. The surgical technique with the best outcome was the re-recession of the medial rectus muscles (87.5%), followed by combined surgery (64.7%) and resection of the lateral rectus muscles (52.4%). No statistically significant differences were found between the surgical techniques analyzed.</div></div><div><h3>Conclusions</h3><div>Medial rectus re-recession was the most effective technique for correcting residual esotropia compared to lateral rectus resection or a combination of both. No predictors of surgical success were found.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 6","pages":"Article 502502"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio transversal para la cuantificación de los residuos y la huella de carbono de la terapia médica antiglaucomatosa en España: el coste real de los fármacos hipotensores en monodosis sin conservantes","authors":"J. González-Martín-Moro ,&nbsp;V. Altares-Mateos ,&nbsp;J. Zarallo-Gallardo ,&nbsp;J. Pascual-Prieto","doi":"10.1016/j.oftal.2026.502550","DOIUrl":"10.1016/j.oftal.2026.502550","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The healthcare system is responsible for around 5% of global CO₂ emissions. Glaucoma is one of the most common chronic diseases. The aim of this work is to quantify the ecological impact of anti-glaucoma medical therapy packaging in Spain, assessing its carbon footprint and waste generation.</div></div><div><h3>Material and methods</h3><div>This cross-sectional study analyzed the ecological impact of glaucoma medical treatment packaging. Packaging materials from 33 drug presentations were classified, and weighed. Their carbon footprint was calculated using emission factors from Ecoinvent v3.10. Drug presentations were classified as multi-dose or single-dose, and the Mann-Whitney U test was used to compare the amount of waste and carbon footprint of each type.</div></div><div><h3>Results</h3><div>The total amount of annual waste was more than 5 times higher in single-dose than in multi-dose treatments (median: 713.1; interquartile range [648.1-806.8] g vs. median: 136.5; interquartile range [118.3-153.9] g). The carbon footprint was 9 times higher with single-dose treatment than with multi-dose treatment (median: 2.23; interquartile range [1.77-2.49] kg CO₂e vs. median: 0.24; interquartile range [0.20-0.28] kg CO₂e) in multi-dose treatments.</div></div><div><h3>Conclusions</h3><div>The use of single-dose containers significantly increases plastic waste. The increase in carbon footprint is even higher due to plastic and aluminum content. Future studies should clarify their benefits to help balance ecological impact and patient safety.</div></div>","PeriodicalId":8348,"journal":{"name":"Archivos De La Sociedad Espanola De Oftalmologia","volume":"101 6","pages":"Article 502550"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148060093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}