Person:
Martínez De La Casa Fernández-Borrella, José María

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First Name
José María
Last Name
Martínez De La Casa Fernández-Borrella
URI
https://hdl.handle.net/20.500.14352/79989
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Óptica y Optometría
Department
Inmunología, Oftalmología y ORL
Area
Oftalmología
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    Additional Guidance on the Use of the PRESERFLO™ MicroShunt in the Treatment of Glaucoma: Insights from a Second Delphi Consensus Panel
    (Ophthalmology and Therapy, 2024) Khawaja, Anthony P.; Abegão Pinto, Luís; Stalmans, Ingeborg; Aptel, Florent; Barkander, Anna; Barton, Keith; Beckers, Henny; Iliev, Milko; Klink, Thomas; Marchini, Giorgio; Martínez De La Casa Fernández-Borrella, José María; Pillunat, Karin R; Simonsen, Jan H; Vass, Clemens
    Introduction: The PRESERFLO™ MicroShunt (PMS) has been proven to significantly lower intraocular pressure (IOP) in patients with glaucoma and has been available for use since 2019. With increasing published evidence and growing experience of glaucoma surgeons, the aim of this modified Delphi panel was to build on the findings of a previous Delphi panel conducted in 2021 and provide further guidance on the role of the PMS to treat patients with glaucoma in Europe. Methods: Thirteen European glaucoma surgeons experienced in the PMS procedure participated in a 3-round modified Delphi panel. A targeted literature review and expert steering committee guided Round 1 questionnaire development. Consensus was pre-defined at a threshold of ≥ 70% of panellists selecting 'strongly agree'/'agree' or 'strongly disagree'/'disagree' for 6-point Likert scale questions or ≥ 70% selecting the same option for multiple or single-choice questions. Questions not reaching consensus were restated/revised for the next round, following guidance from free-text responses/scoping questions. Results: In total, 28% (n = 9/32), 52% (n = 16/31) and 91% (n = 10/11) of statements reached consensus in Rounds 1, 2 and 3, respectively. There was agreement that the PMS may be used in patients with pigmentary, post-trauma or post-vitrectomy glaucoma and for patients with uveitic glaucoma without active inflammation. The PMS may be more suitable for patients with contact lenses than other subconjunctival filtering surgeries, without eliminating bleb-associated risks. Consensus was reached that combining PMS implantation and phacoemulsification may be as safe as standalone PMS surgery, but further efficacy data are required. Following a late rise in IOP ≥ 4 months post-surgery, topical aqueous suppressant drops or bleb revision may be suitable management options. Conclusions: This Delphi panel builds on the considerations explored in the 2021 Delphi panel and provides further detailed guidance for glaucoma surgeons on the use of the PMS, reflecting the availability of novel evidence and surgical experience. Videos are available for this article.
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    Comparision of intraocular pressure measured using the new icare 200™ rebound tonometer and the Perkins™ applanation tonometer in healthy subjects and in patients with primary congenital glaucoma
    (Archivos de la Sociedad Española de Oftalmología (English Edition), 2021) Pérez García, Pilar; Morales Fernández, Laura; Sáenz Francés, Federico; Méndez Hernández, Carmen Dora; García Feijoo, Julián; Santos Bueso, Enrique; Martínez De La Casa Fernández-Borrella, José María
    Objective: To compare intraocular pressure (IOP) measurements obtained using the Icare 200™ (IC200) rebound tonometer and the hand-held version of the Goldmann Applanation Tonometer (Perkins™ tonometer, GAT) in patients with primary congenital glaucoma (PCG) and in healthy subjects. Material and methods: A total of 42 eyes of healthy subjects (G1) and 40 patients with PCG (G2) were analysed. The following clinical data were collected: gender, age, Cup/Disc ratio, central corneal thickness (CCT). IOP was determined in the examination room using the IC200 and GAT tonometers, in the same order. Agreement between both tonometers was determined using the intraclass correlation coefficient (ICC) and Bland-Altman plot. A linear regression analysis was used to establish the IOP was affected by the studied variables. Results: Mean IOP between both tonometers (IC200 minus GAT) was: G1 = 15.91 (2.57) mmHg vs. 15.06 (2.12) mmHg (mean difference, MD = 0.84 (0.50) mmHg; P < .101) and G2=20.10 (6.37) vs.19.12 (5.62) (MD = 0.98 (1.36); P = 0.474). Excellent agreement was found between IC200 and GAT in both groups (ICC = G1: 0.875 (95% CI; 0.768−0.933; P < .001); G2: 0.924 (95% CI; 0.852−0.961; P < .001), and there was a statistically significant correlation between the IOP difference measured with IC200 and GAT and CCT in G1 (B=0.021; 95% CI; 0.005–0.037; P = .008), but was not statistically significant in G2. Conclusions: There was excellent agreement between the IC200 and GAT tonometers, both in healthy subjects and PCG, with a trend to overestimate IOP when measured with IC200. There was no influence by CCT on IOP measurements in patients with PGC.
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    Scheie's line as a first sign of pigment dispersion syndrome
    (Archivos de la Sociedad Española de Oftalmología (English Edition), 2019) Santos Bueso, Enrique; García Sáenz, Sofía; Morales Fernández, Laura; Martínez De La Casa Fernández-Borrella, José María; Sáenz Francés, Federico
    A 50 year old woman was diagnosed with pigment dispersion syndrome (PDS) in the right eye and pigmentary glaucoma in the left eye in a routine medical examination. A line of pigment was observed in the vitreo-lenticular interface (Scheie's line) of the left eye and with an intraocular pressure of 26 mmHg. The Scheie's line (SL) develops by the accumulation of detached iris pigment in PDS and accumulated in the ligament of Wieger that forms the vitreo-lenticular union. The SL is considered a pathognomonic sign of PDS.
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    Effects of corneal biomechanical properties on rebound tonometry (Icare200) and applanation tonometry (Perkins) readings in patients with primary congenital glaucoma
    (Journal of Glaucoma, 2021) Morales Fernández, Laura; Sáenz Francés, Federico; Pérez García, Pilar; García Feijoo, Julián; García Sáenz, Sofía; Gómez De Liaño Sánchez, María Rosario; Martínez De La Casa Fernández-Borrella, José María
    Objective: To assess the influence of corneal biomechanics on intraocular pressure (IOP) measurements made with the Icare200 (IC200) rebound tonometer and the Perkins hand-held applanation tonometer in patients with primary congenital glaucoma (PCG). Materials and methods: 40 PCG patients and 40 healthy controls, age and gender-matched, were recruited. IOP was measured with the Ocular Response Analyzer (IOPc, IOPg), Icare200 and Perkins. The variables age, IOP, corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), best corrected visual acuity, spherical equivalent, medications and glaucoma surgeries were recorded for each subject. Uni and multivariate analysis were used to detect effects of variables on IOP measurements. Results: Mean CCT was 545.65±71.88 μm in PCG vs. 558.78±27.58 μm in controls (p=0.284). CH and CRF were significantly lower in PCG group than in control group: mean CH 8.11±1.69 mmHg vs. 11.15±1.63 mmHg (p<0.001), and mean CRF 9.27 ± 2.35 mmHg vs. 10.71 ± 1.75 mmHg (p=0.002). Mean differences between IOP IC200-Perkins were 0.79 ± 0.53 mmHg in PCG vs. 0.80 ± 0.23 mmHg in controls (p<0.001) and mean differences IC200-IOPc were -0.89 ± 5.15 mmHg in PCG (p<0.001) vs. 1.60 ± 3.03 mmHg in controls (all p<0.009). Through multivariate analysis, CRF showed positive association and CH negative association with IOP measured with Perkins or IC200 in both subject groups. No association was detected for CCT, age or gender. Conclusion: CH and CRF were identified as the main factors interfering with IOP measurements made with both tonometers in patients with PCG and healthy controls.
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    Easyton ® transpalpebral versus Perkins applanation tonometry in different clinical populations
    (2023) Montolío Marzo, Elena; Morales Fernández, Laura; Sáenz Francés, Federico; García Sáenz, Sofía; García Feijoo, Julián; Piñero, David Pablo; Martínez De La Casa Fernández-Borrella, José María
    Objective: To compare intraocular pressure (IOP) measurements obtained using the new transpalpebral Easyton® tonometer and Perkins applanation tonometer (PAT) in three different clinical populations. Methods: The participants of this prospective study were 84 subjects divided into the groups: 22 healthy children (G1), 42 healthy adults (G2), and 20 adult patients with primary open angle glaucoma (G3). The data recorded in 84 eyes of these subjects were age, sex, eye, central corneal thickness (CCT) and axial length (AL). In all eyes, IOP was determined in the same examination room by the same experienced examiner using Easyton® and PAT in random order. Results: Mean differences in IOP readings between Easyton® and PAT were 0.45 ± 1.97 (p = 0.295), -0.15 ± 2.13 (p = 0.654), -1.65 ± 3.22 (p = 0.033), and − 0.018 ± 2.500 mmHg (p = 0.500) in the groups G1, G2, G3 and whole sample (G4), respectively. Correlations between Easyton® and PAT IOP values were 0.668 (p = 0.001) for G1, 0.463 (p = 0.002) for G2, 0.680 (p < 0.001) for G3 and 0.605 (p < 0.001) for G4. Moderate to good agreement between the two tonometers was found in all groups according to intraclass correlation coefficients, which were 0.794 (p < 0.001) for G1, 0.632 (p < 0.001) for G2, 0.809 (p < 0.001) for G3, and 0.740 (p < 0.001) for G4. The lower and upper limits of agreement between the devices were − 5.1 and 4.7 mmHg, respectively. No correlation was noted between CCT or AL and the Easyton® IOP measurements. Conclusion: IOP measurements obtained with Easyton® and PAT show an acceptable level of agreement both in healthy individuals and in patients with glaucoma.
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    Intraocular pressure and biomechanical corneal properties measure by ocular response analyser in patients with primary congenital glaucoma
    (Acta Ophthalmologica, 2016) Perucho González, Lucía; Martínez De La Casa Fernández-Borrella, José María; Morales Fernández, Laura; Bañeros Rojas, Paula; Sáenz Francés, Federico; García Feijoo, Julián
    Purpose: To measure the differences in corneal hysteresis (CH) and corneal resistance factor (CRF) in primary congenital glaucoma (PCG) and in control subjects using ocular response analyser (ORA) and also to compare intraocular pressure (IOP) measurements given by ORA against IOP given by Perkins tonometer, a handheld version of Goldman applanation tonometer (GAT), to determine correlation. Methods: One hundred and eighteen eyes of 78 patients with PCG (group I) and 103 eyes of 53 controls (group II) were evaluated using ORA. In all participants, IOP was measured using the Perkins tonometer. The ORA device uses applanation pressure peaks to generate the corneal-compensated IOP (IOPcc), which is reportedly independent of corneal thickness, and the measurement of Goldman-correlated IOP (IOPg), which is influenced by corneal thickness. Results The measures in group I were as follows: IOPcc 20.92 ± 5.33; IOPg 18.87 ± 6.67; CH 8.51 ± 2.25; CRF 9.85 ± 3.03; and IOP measured by Goldman 18.32 ± 5.13. The measures in group II were as follows: IOPcc 14.33 ± 2.91; IOPg 14.77 ± 3.00; CH 11.37 ± 1.61; CRF 11.02 ± 1.74; and IOP measured by Goldman 13.74 ± 2.42. The differences of all parameters compared between both groups were statistically significant (p < 0.001 for CH and for all IOP measures and p = 0.001 for CRF). The values of IOPcc, IOPg and IOP measured with Goldman were higher in group I than the values in group II. However, CH and CRF values were lower in group I. Conclusion: A decrease in CH and CRF has been observed in patients with PCG compared to controls. Future research should assess how these parameters are modified in PCG and whether they could provide more information about progression.
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    Safety and Effectiveness of the PRESERFLO® MicroShunt in Primary Open-Angle Glaucoma: Results from a 2-Year Multicenter Study
    (Ophthalmology Glaucoma, 2021) Beckers, Henny J.M.; Aptel, Florent; Webers, Carroll A.B.; Angeles, Raymund; Bluwol, Elisa; Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián; Lachkar, Yves; Méndez Hernández, Carmen Dora; Riss, Isabelle; Shao, Hui; Pinchuk, Leonard; Sadruddin, Omar; Shaarawy, Tarek M.
    To assess the safety and effectiveness of the PRESERFLO® MicroShunt (formerly InnFocus MicroShunt) in patients with primary open-angle glaucoma (POAG).The MicroShunt, a controlled ab externo glaucoma filtration surgery device, was investigated in a 2-year, multicenter, single-arm study.Eligible patients were aged 18-85 years with POAG inadequately controlled on maximal tolerated medical therapy with intraocular pressure (IOP) ≥18 and ≤35 mmHg or when glaucoma progression warranted surgery.The MicroShunt was implanted as a stand-alone procedure with adjunctive use of topical mitomycin C (MMC; 0.2-0.4 mg/ml) for 2-3 minutes.The primary effectiveness outcome was IOP reduction and success (not requiring reoperation or pressure failures [IOP > 21 mmHg and < 20% reduction in IOP]) at year 1. Additional end points at year 2 included IOP reduction, success, glaucoma medications, adverse events (AEs), and reoperations. Results are reported in the overall population and subgroups of patients receiving 0.2 or 0.4 mg/ml MMC.In 81 patients, mean (± standard deviation [SD]) IOP decreased from 21.7 ± 3.4 mmHg at baseline to 14.5 ± 4.6 mmHg at year 1 and 14.1 ± 3.2 mmHg at year 2 (P < 0.0001). Overall success (with and without supplemental glaucoma medication use) at year 1 was 74.1%. Mean (± SD) number of medications decreased from 2.1 ± 1.3 at baseline to 0.5 ± 0.9 at year 2 (P < 0.0001), and 73.8% of patients were medication free. Most common nonserious AEs were increased IOP requiring medication or selective laser trabeculoplasty (25.9%) and mild-to-moderate keratitis (11.1%). There were 6 (7.4%) reoperations and 5 (6.2%) needlings by year 2. In an analysis (post hoc) according to MMC concentration, overall success was 78.1% (0.2 mg/ml) and 74.4% (0.4 mg/ml; P = 0.710). In the 0.2 and 0.4 mg/ml MMC groups, 51.9% and 90.3% of patients were medication free, respectively (P = 0.001). There was a trend toward lower IOP and higher medication reduction in the 0.4 mg/ml MMC subgroup.In this study, mean IOP and glaucoma medication reductions were significant and sustained over 2 years postsurgery. No long-term, sight-threatening AEs were reported. Further studies may confirm potential risk/benefits of higher MMC concentration