Person:
Santos Bueso, Enrique Miguel

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First Name
Enrique Miguel
Last Name
Santos Bueso
URI
https://hdl.handle.net/20.500.14352/79976
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Óptica y Optometría
Department
Inmunología, Oftalmología y ORL
Area
Oftalmología
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    Corneal aberrations in primary congenital glaucoma and its visual correlation
    (International Ophthalmology, 2024) Ly-Yang, Fernando; Morales Fernández, Laura; García Bella, Javier; Garcia Caride, Sara; Santos Bueso, Enrique Miguel; Saenz Frances, Federico; Fernández-Vigo López, José; García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María
    Primary congenital glaucoma (PCG) can cause permanent vision loss, and its prognosis is related to early detection and treatment. The main pathological defect consists of resistance to aqueous outflow through the trabecular meshwork due to abnormal development of tissue derived from the neural crest in the anterior chamber angle. Even after successful intraocular pressure (IOP) management in PCG poor visual outcomes still present a lifelong challenge. Vision loss in PCG is multifactorial, resulting from optic nerve damage, corneal scarring, and myopic astigmatism associated with anisometropic amblyopia. Although it is already known that children with PCG present with an altered corneal configuration, the knowledge of irregular astigmatism due to high-order aberrations (HOA) and due to the unequal expansion of the anterior segment, and its impact on visual outcomes, is not yet fully understood, to the best of our knowledge. Quality vision is influenced by the presence of aberrations in the eye's optical system, which can degrade the quality of the image projected onto the retina. Low-order aberrations (LOA), including myopia, hyperopia, and regular astigmatism, can be corrected by spectacles, while HOA cannot be corrected by ordinary means. Coma and spherical aberrations are the most visually significant HOAs, while trefoil and other HOAs have a lower impact on visual quality. The purpose of this article is to establish a quantitative correlation between HOA and visual acuity (VA) to measure the magnitude of the impact of the altered cornea on visual outcomes in PCG.
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    Corneal densitometry and biomechanical properties in patients with primary congenital glaucoma
    (Canadian Journal of Ophthalmology, 2021) Morales Fernández, Laura; Benito Pascual, Blanca; Pérez García, Pilar; Perucho González, Lucía; Sáenz Francés, Federico; Santos Bueso, Enrique Miguel; García Bella, Javier; Sánchez Jean, Rubén; García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María
    Objective: To describe corneal densitometry, topographic measurements, and biomechanical properties in patients with primary congenital glaucoma (PCG) and healthy patients. To examine correlations between variables and determine their glaucoma diagnostic capacity. Methods: This was a cross-sectional, case-control study conducted in 50 eyes of 50 patients with PCG (G1) and 40 eyes of 40 healthy patients (G2). The variables determined in each participant were: intraocular pressure, best corrected visual acuity (BCVA), corneal densitometry, topographic data using the Pentacam HR-Scheimpflug imaging system (Oculus Optikgerate GmbH, Wetzlar, Germany), and corneal hysteresis (CH) and corneal resistance factor (CRF) using the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Depew, NY). Results: Overall densitometry was significatively higher in the PCG group (G1: 17.94 ± 4.99 vs G2: 13.25 ± 1.96, p < 0.001). CH (G1: 8.02 ± 11.35 vs G2: 11.35 ± 1.42, p < 0.001) and CRF (G1: 9.48 ± 2.83 vs G2: 10.77 ± 1.34, p < 0.001) were lower in the glaucoma group. Mean posterior, central, and anterior elevation and mean keratometry were higher in G1 (p < 0.05). In the PCG group, overall densitometry showed significant correlation with CH (r = –0.321, p = 0.028) and with BCVA (r = −0.498, p = 0.002). AUCs (areas under the curve) for CH and overall densitometry were high (0.839 and 0.899 respectively) and the best overall densitometry; CH and CRF cutoffs were 14.0, 9.3 and 9.2 respectively. Conclusion: Densitometry is increased, and biomechanical corneal properties are decreased in patients with PCG. Densitometry and visual acuity showed a negative and significant correlation, so this measurement could be used as an indirect parameter of BCVA in the clinical practice.
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    Posterior chamber implantation of a Preserflo Microshunt in a patient with a compromised endothelium
    (Archivos de la Sociedad Española de Oftalmología, 2022) Martínez De La Casa Fernández-Borrella, José María; Sáenz Francés, Federico; Morales Fernández, Laura; García Feijoo, Julián; Santos Bueso, Enrique Miguel
    The objective of the present case is to describe a variation in the Preserflo Microshunt surgical technique, placing it in the posterior chamber to minimise the risk of endothelial cell loss in cases with a compromised endothelium. The patient was a 72-year-old pseudophakic woman, with granular dystrophy and a primary diagnosis of open-angle glaucoma presenting with a progressive visual field defect and an IOP of 26 mmHg with maximal medical therapy. The cornea had incipient stromal folds with an endothelial count of 700 cells/mm2. A Preserflo Microshunt was implanted in the posterior chamber to minimise the possibility of further damage to the corneal endothelium. Six months after surgery, the implant remains functional. The IOP is 9 mmHg without medications. As far as we know, this is the first Preserflo implanted in the posterior chamber described in the literature.