Carracedo Rodríguez, Juan Gonzalo

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First Name
Juan Gonzalo
Last Name
Carracedo Rodríguez
Universidad Complutense de Madrid
Faculty / Institute
Óptica y Optometría
Optometría y Visión
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Now showing 1 - 8 of 8
  • Publication
    Comparison Between Viscous Teardrops and Saline Solution to Fill Orthokeratology Contact Lenses Before Overnight Wear
    (Contact Lens Association of Ophthalmologists, Inc, 2018-09) Carracedo Rodríguez, Juan Gonzalo; Villa Collar, César; Martín Gil, Alba; Serramito Blanco, María; Santamaría, Leticia
    Objective: To compare, in terms of efficacy, the differences between the use of saline solution and a viscous artificial tear to fill the lens during the first month of orthokeratology wear. Methods: A pilot, double-masked, crossed, randomized, and prospective study was conducted. In this study, 20 subjects (14 males and 6 females) with a mean age of 16.29±6.22 years (range, 10–26) were fitted with orthokeratology contact lenses. For the study, nonpreserved 0.9% NaCl commercial saline solution (Avizor, Madrid, Spain) and nonpreserved artificial teardrops with 0.3% of hyaluronic acid (Ocudry 0.3%; Avizor, Madrid, Spain) were used. Corneal staining, tear break up time (TBUT), topography, refraction, visual acuity, and subjective comfort and vision with the visual analog scale (score from 0 to 10, being 10 better comfort and vision) were evaluated at 1 day, 1 week, and 1 month of contact lens wear. Results: The corneal staining was statistically greater in the saline group than in the Ocudry group for the first day and during 1 week of wear (P<0.05). Comfort was found to be statistically better, with Ocudry 0.3% than saline solution, being 7.17±1.94 and 6.37±1.63, for the first day, and 8.78±0.43 and 8.15±0.62 for the day 28, respectively (P<0.05). However, no differences were found for subjective vision scores, TBUT, spherical equivalent, best-corrected visual acuity and uncorrected visual acuity, and mean keratometry between groups for any visit (P>0.05). Conclusion: Viscous artificial tears improve the subjective comfort of patients and reduce the corneal staining, compared with saline solution during the orthokeratology lenses fitting process. However, no differences between solutions for the treatment efficacy, in vision and corneal topography, were found.
  • Publication
    Corneal surface wettability and tear film stability before and after scleral lens wear
    (Elsevier, 2019-04-06) Serramito Blanco, María; Privado Aroco, Ana; Batres Valderas, Laura; Carracedo Rodríguez, Juan Gonzalo
    Purpose: The aim of this study was to evaluate the anterior surface of scleral contact lens and ocular surface wettability before and after one-month of scleral lens wear in patients with keratoconus. Methods: Forty-nine patients with keratoconus (36.26 ± 9.03 years) were recruited. The sample was divided into two groups: patients with intrastromal corneal ring (KCICRS group) and patients without ICRS (KC group). TFSQ, Schirmer I test, Ocular Surface Disease Index (OSDI questionnaire), tear break-up time (TBUT) and corneal staining were evaluated in two different visits: Baseline (before lens wear) and one-month visit (10 min after lens removal). Visual Analog Scale (VAS questionnaire) was filled in just after inserting the lenses and just before removing them. TFSQ mean and inferior were evaluated over the contact lens surface at the moment of inserting the lens (baseline visit) and after 8 h of lens wear (one-month visit). Results: Anterior corneal surface TFSQ values increased in all groups after scleral lens wear (p < 0.05). However, there were no statistical differences found at the moment of inserting or after 8 h of lens wear on previous contact lens surface TFSQ (p > 0.05). No changes were found in tear volume for total and in KC and KCICRS groups (p > 0.05). For all groups, there was a statistical decrease of TBUT (p < 0.05). In addition, OSDI score, corneal staining and VAS score improved after scleral lens wear from baseline in total and in both KC and KCICRS groups (p < 0.05). Conclusion: The scleral contact lens surface keeps its wettability after one-month of wear. However, the wettability of the ocular surface is worse after contact lens wearing.
  • Publication
    Short-term Effect of Scleral Lens on the Dry Eye Biomarkers in Keratoconus
    (Lippincott Williams & Wilkins, 2016-02) Carracedo Rodríguez, Juan Gonzalo; Serramito Blanco, María; Martín Gil, Alba; Wang, Zicheng; Carballo Álvarez, Jesús; Pintor, Jesús
    Purpose: To evaluate the most important signs of dry eye, such as osmolarity, inflammation, and diadenosine tetraphosphate (Ap4A) concentration before and after wearing scleral lenses for 8 h in keratoconus patients. Methods: A pilot, experimental, short-term study involved 26 keratoconus patients (average age, 36.95 ± 8.95 years). They voluntarily enrolled in the study at the Optometry Clinic of the Faculty of Optics and Optometry in the University Complutense of Madrid. They were divided into two groups: patients with intrastromal corneal ring, the ICRS group, and patients without ICRS, the keratoconus (KC) group. Ocular Surface Disease Index questionnaire, the Schirmer test without anesthesia, tear break-up time, matrix metalloproteinase 9 (MMP-9) concentration, osmolarity, and Ap4A concentration were evaluated before and after wearing a scleral lens for 8 h. Results: The patients wore the scleral lenses from 6 to 9 h, with a mean of 7.59 ± 0.73 h. The mean scleral lens sag for all patients was 4310 ± 166.31 μm, ranging from 4200 μm to 4800 μm. No significant changes in the Schirmer test and tear break-up time were found for either group. Ocular Surface Disease Index scores were statistically lower after wearing scleral lenses for both groups (p < 0.05). A significantly lower osmolarity and a significant rise of MMP-9 concentration after wearing scleral lenses were found in both groups (p < 0.05). Diadenosine tetraphosphate concentration was lower after wearing the scleral lens in the KC group (p < 0.05) but no significant difference was found for the ICRS group (p > 0.05). Conclusions: Short-term scleral lens wearing improves the symptomatology and some signs of dry eye, such as osmolarity and Ap4A concentration. The increase of MMP-9 concentration could be caused by tear film stagnation and use of preserved saline.
  • Publication
    Posterior cornea and thickness changes after scleral lens wear in keratoconus patients
    (Elsevier, 2018-05) Serramito Blanco, María; Carpena Torres, Carlos; Carballo Álvarez, Jesús; Piñero, David Pablo; Lipson, Michael; Carracedo Rodríguez, Juan Gonzalo
    Purpose: To evaluate the changes in the corneal thickness, anterior chamber depth and posterior corneal curvature and aberrations after scleral lens wear in keratoconus patients with and without intrastromal corneal ring segments (ICRS). Methods:Twenty-six keratoconus subjects (36.95 ± 8.95 years) were evaluated after 8 h of scleral lens wear. The subjects were divided into two groups: those with ICRS (ICRS group) and without ICRS (KC group). The study variables evaluated before and immediately after scleral lens wear included corneal thickness evaluated in different quadrants, posterior corneal curvature at 2, 4, 6 and 8 mm of corneal diameter, posterior corneal aberrations for 4, 6 and 8 mm of pupil size and anterior chamber depth. Results: There was a statistically significant corneal thinning (p < 0.05) in the inferior region of the KC group and in the superior region of the ICRS group. No change (p > 0.05) in the anterior chamber depth was found. The KC group showed a steepening (p < 0.05) in the temporal quadrant and a flattening that mainly affected to the superior-nasal quadrant. The ICRS group showed a steepening (p < 0.05) that mainly affected to the superior-nasal quadrant. Regarding posterior corneal aberrations, only changes (p < 0.05) in Z4 for 8 mm and Z8 for 4 mm were found in the KC group. Conclusions: Short-term scleral lens wear showed a thinning of the cornea and changes in the posterior corneal curvature affects different regions in keratoconus patients with and without ICRS.
  • Publication
    Comparison Between Aberrometry-Based Binocular Refraction and Subjective Refraction
    (Association for Research in Vision and Ophthalmology (ARVO), 2018-08) Carracedo Rodríguez, Juan Gonzalo; Carpena Torres, Carlos; Serramito Blanco, María; Batres Valderas, Laura
    Purpose: We evaluate the efficacy of a new system of binocular refraction, mainly based on ocular aberrometry (EYER) and compare it with the traditional subjective refraction as gold standard. Methods: A prospective, double blind, and transversal study was performed on 99 subjects (35 men, 64 women; mean age 37.22 ± 18.04 years; range, 7–70 years). Refractive surgery or irregular cornea were considered exclusion criteria. Subjective refraction was performed by three different optometrists and EYER by other optometrists on three different days randomly. The binocular best corrected visual acuity (BBCVA), subjective vision evaluated with visual analogue scale (VAS), refraction spent time, and mean spherical equivalent (MSE), and vertical and oblique cylindrical components (J0 and J45) were analyzed. Results: A positive strong correlation between EYER and subjective refraction was found for MSE (Pearson, 0.984; P < 0.001) and J0 and J45 (Pearson, 0.837; P < 0.001 and Pearson, 0.852; P < 0.001, respectively) in the total group. There were no statistically significant differences for BBCVA (P < 0.05). The VAS scores were 84.29 ± 12.29 with the EYER and 86.89 ± 12.38 with subjective refraction (P = 0.031). The spent time to perform the refraction was statistically lower (P < 0.05) with the EYER compared to conventional subjective refraction for all groups. Conclusions: The EYER system showed similar results in terms of spherical and cylindrical components, visual acuity being the spent time in the refraction lower than conventional subjective refraction. Translational Relevance: This new objective refraction system provides less chair spent time with similar results than subjective refraction
  • Publication
    Ocular Surface Temperature During Scleral Lens Wearing in Patients With Keratoconus
    (Contact Lens Association of Ophthalmologists, Inc., 2016-05) Carracedo Rodríguez, Juan Gonzalo; Wang, Zicheng; Serramito Blanco, María; Martín Gil, Alba; Carballo Álvarez, Jesús; Pintor, Jesús
    Objective: To evaluate the ocular surface temperature using an infrared thermography camera before and after wearing scleral lens in patients with keratoconus and correlate these results with the tear production and stability. Methods: A pilot, experimental, short-term study has been performed. Twenty-six patients with keratoconus (36.95+/-8.95 years) participated voluntarily in the study. The sample was divided into two groups: patients with intrastromal corneal ring (KC-ICRS group) and patients without ICRS (KC group). Schirmer test, tear breakup time (TBUT), and ocular surface temperature in the conjunctiva, limbus, and cornea were evaluated before and after wearing a scleral lens. Results: The patients wore the scleral lenses from 6 to 9 hours with average of 7.59+/-0.73 hours. No significant changes in Schirmer test and TBUT were found for both groups. No temperature differences were found between the KC-ICRS and the KC groups for all zones evaluated. There was a slight, but statistically significant, increase in the inferior cornea, temporal limbus, and nasal conjunctival temperature for KC-ICRS group and temporal limbus temperature decreasing for the KC group after wearing scleral lens (P<0.05). The conjunctiva and limbus temperature was statistically higher than the central cornea for both groups before and after scleral lenses wearing (P<0.05), but no difference in the peripheral cornea was found. No statistically significant differences in the central corneal temperature were found between the groups after scleral lens wearing (P>0.05). Conclusion: Scleral contact lens seems not to modify the ocular surface temperature despite the presence of the tear film stagnation under the lens.
  • Publication
    Post-lens tear turbidity and visual quality after scleral lens wear
    (Wiley, 2017-11) Carracedo Rodríguez, Juan Gonzalo; Serramito Blanco, María; Martín Gil, Alba; Wang, Zicheng; Rodríguez Pomar, Candela; Pintor, Jesús
    Background: The aim was to evaluate the turbidity and thickness of the post-lens tear layer and its effect on visual quality in patients with keratoconus after the beginning of lens wear and before lens removal at the end of eight hours. Methods: Twenty-six patients with keratoconus (aged 36.95 ± 8.95 years) participated voluntarily in the study. The sample was divided into two groups: patients with intrastromal corneal ring (ICRS group) and patients without ICRS (KC group). Distance visual acuity (VA), contrast sensitivity, pachymetry, post-lens tear layer height and post-lens tear layer turbidity (percentage area occupied and number of particles per mm2) were evaluated with optical coherence tomography before and after wearing a scleral lens. Results: A significant increase of turbidity was found in all groups assessed (p < 0.05). The number of particles per square millimetre was eight times higher after scleral lens wear than at the beginning of wearing the lens for all groups. VA decreases in all groups after scleral lens wear (p < 0.001). All patients showed a statistical diminishing of contrast sensitivity after scleral lens wear (p < 0.05). A significant correlation was found for both turbidity parameters with distance VA but no correlation between turbidity and post-lens tear layer thickness at the beginning was found (p > 0.05). A strong correlation in all groups between the post-lens tear layer at the beginning and differences of tear layer thickness between two measures was also found (p < 0.05). Conclusion: The VA decrease during the scleral lens wearing, filled with preserved saline solution, was due to the increasing post-lens tear layer turbidity.
  • Publication
    Anterior Corneal Curvature and Aberration Changes After Scleral Lens Wear in Keratoconus Patients With and Without Ring Segments
    (Wolters Kluwer, 2019-03) Serramito Blanco, Maria; Carpena Torres, Carlos; Carballo, Jesús; Piñero, David; Lipson, Michael; Carracedo, Gonzalo; Serramito Blanco, María; Carpena Torres, Carlos; Carballo Álvarez, Jesús; Carracedo Rodríguez, Juan Gonzalo
    Objective: To evaluate changes in the anterior corneal curvature and aberrometry after scleral contact lens wear in keratoconus (KC) subjects with and without intracorneal ring segments (ICRS). Methods: Twenty-six subjects diagnosed with keratoconus were selected to participate in the study. Subjects were divided into 2 groups, those with ICRS (KC-ICRS group) and those without ICRS (KC group). Subjects were instructed to wear 16.5-mm scleral lenses for 8 hours. Topographic and aberrometric parameters were evaluated before lens wear and immediately after lens removal. Anterior corneal curvature was evaluated at corneal diameters of 2, 4, 6, and 8 mm, and corneal aberrations were measured at 4-, 6-, and 8-mm pupil diameters. Results: The mean age of subjects was 36.95±8.95 years. In KC group, there was a statistically significant flattening of the central corneal curvature, from 6.98 to 7.09 mm (P<0.05). No changes were found in the central corneal curvature in the KC-ICRS group. The KC group showed anterior corneal curvature flattening, mainly in the nasal quadrant. The KC-ICRS group showed flattening primarily in the inferior hemisphere. In the KC group, spherical aberration for 6-mm pupil increased significantly. In the KC-ICRS group, changes in aberrations were significant for high-order root mean square at 4- and 6-mm pupil diameters (P<0.05), for oblique astigmatism for 4 mm and 6 mm, and for vertical coma for 4-mm pupil (P<0.05). Conclusion: Short-term scleral lens wear showed flattening of the anterior corneal surface in all subjects. In the KC group, the flattening was more pronounced in the nasal quadrant while changes were more pronounced inferiorly in KC-ICRS group.