Person: Fernández Pérez, Cristina
Universidad Complutense de Madrid
Faculty / Institute
Enfermería, Fisioterapia y Podología
Now showing 1 - 10 of 12
PublicationEffects of Implantable Collamer Lens V4c Placement on Iridocorneal Angle Measurements by Fourier-Domain Optical Coherence Tomography(Elsevier Masson, 2016-02) Fernández-Vigo, José Ignacio; Macarro Merino, Ana; Fernández-Vigo Escribano, Cristina; Fernández-Vigo, José Ángel; Martinez de la Casa, Jose Maria; Fernández Pérez, Cristina; García Feijoo, JuliánPurpose To assess by Fourier-domain optical coherence tomography (FDOCT) changes produced in iridocorneal angle measurements in patients undergoing Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG) placement. Design Prospective interventional case series. Methods In 50 eyes of 25 myopic subjects consecutively scheduled for ICL implant, FDOCT (RTVue; Optovue Inc) iridocorneal angle measurements were made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA) and angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared among the quadrants nasal, temporal, and inferior, and correlations with ocular variables including lens vault were examined. Results Preoperative TIA was 48.7 ± 8.7, 48.2 ± 8.7, and 48.7 ± 9.3 degrees for the nasal, temporal, and inferior quadrants, with no differences (P= 1.000). Following ICL implant, corresponding values fell to 31.2 ± 11.5, 30.0 ± 10.7, and 29.7 ± 8.1 degrees at 1 month postsurgery, indicating angle narrowing of 34%-42%, and to 30.6 ± 12.3, 30.1 ± 11.9, and 29.8 ± 12.3 degrees, respectively, at 3 months postsurgery. Angle measurements failed to vary between 1 month and 3 months postsurgery (P= .481). In 8 eyes, iridotrabecular contact attributable to surgery was observed. One month after surgery, vault measurements correlated with TIA (R = -.309;P= .048). Six variables were identified as predictors of TIA at 1 month postsurgery (R2= .907). Conclusions Although considerable angle narrowing was detected 1 month after ICL V4c implant, this narrowing remained stable at 3 months postsurgery. Factors predictive of TIA could serve to identify suitable candidates for ICL placement. PublicationMeasuring intraocular pressure after intrastromal corneal ring segment implantation with rebound tonometry and Goldmann applanation tonometry(Wolters Kluwer Health, 2015-05) Arribas Pardo, Paula; Méndez Hernández, Carmen D.; Cuiña Sardiña, Ricardo; Fernández Pérez, CristinaPurpose: The aim of this study was to compare intraocular pressure (IOP) measurements in patients with ectatic corneas after intrastromal corneal ring segment (ICRS) implantation using the Rebound tonometers (RBTs) Icare and Icare Pro, compared with Goldmann applanation tonometry (GAT) and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), and corneal astigmatism (CA) on IOP. Methods: This prospective cross-sectional study consecutively included 60 eyes of 60 patients with corneal ectasia having ICRS for at least 6 months from January 2011 to December 2013. All subjects underwent GAT, Icare, and Icare Pro IOP measurements in a random order, and CCT, CC, and CA evaluation using a Pentacam. The Bland–Altman method and multivariate regression analysis logistic method were used to assess intertonometer agreement and the influence of corneal variables on IOP measurements. Results: Icare significantly underestimated IOP compared with GAT [GAT - Icare 1.2 ± 3.0 mm Hg, P = 0.002 (95% confidence interval, 0.5–2.0)], whereas Icare Pro showed no statistical differences compared with GAT [GAT - Icare Pro 0.1 ± 3.1 mm Hg, P = 0.853 (95% confidence interval, -0.7 to 0.9)]. Both RBTs presented good concordance with GAT (intraclass coefficient correlation > 0.6). All tonometer measurements were influenced by CCT values and age (P < 0.05); the number of ICRS implanted did not influenced IOP measurement with any of the 3 tonometers. Conclusions: Both RBTs could be an alternative to GAT in patients with corneal ectasia and ICRS; however, Icare Pro shows greater accuracy. PublicationOcular Surface Disease in Patients under Topical Treatment for Glaucoma(Wichtig Publishing, 2018-01-10) Pérez Bartolomé, Francisco; Martínez de la Casa, Jose Maria; Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Polo Llorens, Vicente; García Feijoo, JuliánPurpose: To examine the relationship between ocular surface disease (OSD) and topical antiglaucoma therapy. Methods: A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication were recruited over 10 months. Controls were 51 eyes of 51 healthy age- and sex-matched volunteers. In each patient, we recorded the intraocular pressure-lowering eyedrops used, the number of medications used, and daily and cumulative preservative concentrations (PC). Main outcome measures were fluorescein corneal staining score (Oxford scale), lower tear meniscus height (LTMH) (spectral-domain optical coherence tomography), noninvasive tear film breakup time (NI-TBUT) (Oculus Keratograph 5M), and OSD symptom questionnaire index (OSDI). Results: Compared to controls, significantly higher OSDI (median [interquartile range] 10.24 [4.54-18.94] vs 2.5 [0-12.5]; p<0.001) and corneal staining (≥1: 64.93% vs 32.61%; p<0.001) scores were recorded in the medication group. The NI-TBUT and LTMH failed to vary between the groups (p>0.05). A higher daily PC was associated with a lower LTMH (R −0.142; p = 0.043). In the medication group, multivariate analysis identified correlations between benzalkonium chloride (BAK) (odds ratio [OR] 1.56) and BAK plus polyquaternium-containing drops (OR 5.09) or higher OSDI (OR 1.06) and abnormal corneal staining test results and between older age (mean ratio [MR] 1.05), longer treatment duration (MR 1.02), or corneal staining presence (MR 1.22) and a higher OSDI score. Conclusions: Ocular surface disease was more prevalent in the medication group. The main factors impacting OSD were drops with preservatives, longer treatment duration, and older age. PublicationIncreasing Influenza Vaccination in Primary Healthcare Workers Using Solidary Incentives: Analysis of Efficacy and Costs(MDPI, 2023) Bengoa Terrero, Christian; Bas Villalobos, Marian; Pastor Rodríguez-Moñino, Ana; Lasheras Carbajo, María Dolores; Pérez-Villacastín Domínguez, Julián; Fernández Pérez, Cristina; García Torrent, María Jesús; Sánchez del Hoyo, Rafael; García Lledó, AlbertoIntroduction: Influenza vaccination campaigns have difficulty in reaching the 75% uptake in healthcare workers (HCWs) that public health organizations target. This study runs a campaign across 42 primary care centers (PCCs) where for every HCW vaccinated against influenza, a polio vaccine is donated through UNICEF for children in developing nations. It also analyses the efficacy and cost of the campaign. Method: This observational prospective non-randomized cohort study was conducted across 262 PCCs and 15.812 HCWs. A total of 42 PCCs were delivered the full campaign, 114 were used as the control group, and 106 were excluded. The vaccine uptake in HCWs within each of those PCCs was registered. The cost analysis assumes that campaign costs remain stable year to year, and the only added cost would be the polio vaccines (0.59€). Results: We found statistically significant differences between both groups. A total of 1423 (59.02%) HCWs got vaccinated in the intervention group and 3768 (55.76%) in the control group OR 1.14, CI 95% (1.04–1.26). In this scenario, each additional HCW vaccinated in the intervention group costs 10.67€. Assuming all 262 PCCs had joined the campaign and reached 59.02% uptake, the cost of running this incentive would have been 5506€. The potential cost of increasing uptake in HCWs by 1% across all PCC (n = 8816) would be 1683€, and across all healthcare providers, 8862€ (n = 83.226). Conclusions: This study reveals that influenza vaccination uptake can be innovative by including solidary incentives and be successful in increasing uptake in HCWs. The cost of running a campaign such as this one is low. PublicationEvaluación del Trabajo Fin de Grado de Enfermería y medidas de mejora de la calidad(2017-10-31) Gallego Lastra, Ramón del; López Romero, María Antonia; Martín Trapero, Carlos; Pérez García, Santiago; Pellicer Garrido, Paloma; Blanco Rodríguez, José María; Diago Sánchez, Iván; Fernández Pérez, Cristina; Álejo Bru, NuryEstudio docimológico y transversal de los resultados académicos del Trabajo Fin de Grado de Enfermería, cursos 2012–2013 (216 trabajos) y 2013–2014 (250 trabajos), de los que se eligieron los más representativos: planes de cuidados y diagnósticos enfermeros, a través de la fiabilidad de la Rúbrica de Evaluación, comparando las notas de los tribunales y el equipo de investigación. En el caso de los TFG de Diagnósticos enfermeros se aprecia una mayor variabilidad en las notas intermedias que en las más extremas; en los Planes de cuidados la variabilidad es significativa (p<0,002) con una media de las diferencias en las calificaciones de 1,2 en 2012-2013 y de 1,5 para 2013-2014. La variabilidad encontrada aconseja ir hacia una evaluación cualitativa exigible a un trabajo científico profesional y promover un estudio formal de validación de la nueva rúbrica. PublicationAgreement and clinical comparison between a new swept-source optical coherence tomography-based optical biometer and an optical low-coherence reflectometry biometer(Nature Publishing Group, 2017-03-01) Arriola Villalobos, Pedro; Almendral Gómez, Jaime; Garzón Jiménez, Nuria; Ruiz Medrano, Jorge; Fernández Pérez, Cristina; Martínez de la Casa, Jose Maria; Díaz Valle, DavidPurpose To compare measurements taken using a swept-source optical coherence tomography-based optical biometer (IOLmaster 700) and an optical low-coherence reflectometry biometer (Lenstar 900), and to determine the clinical impacts of differences in their measurements on intraocular lens (IOL) power predictions. Methods Eighty eyes of 80 patients scheduled to undergo cataract surgery were examined with both biometers. The measurements made using each device were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW), and pupil diameter (PD). Holladay 2 and SRK/T formulas were used to calculate IOL power. Differences in measurement between the two biometers were determined using the paired t-test. Agreement was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results Mean patient age was 76.3±6.8 years (range 59-89). Using the Lenstar, AL and PD could not be measured in 12.5 and 5.25% of eyes, respectively, while IOLMaster 700 took all measurements in all eyes. The variables CCT, AQD, LT, and MK varied significantly between the two biometers. According to ICCs, correlation between measurements made with both devices was excellent except for WTW and PD. Using the SRK/T formula, IOL power prediction based on the data from the two devices were statistically different, but differences were not clinically significant. Conclusions No clinically relevant differences were detected between the biometers in terms of their measurements and IOL power predictions. Using the IOLMaster 700, it was easier to obtain biometric measurements in eyes with less transparent ocular media or longer AL. PublicationFourier domain optical coherence tomography to assess the iridocorneal angle and correlation study in a large Caucasian population(BioMed Central, 2016-04) Fernández Vigo, José Ignacio; García Feijoo, Julián; Martínez de la Casa, Jose Maria; García Bella, Javier; Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Fernández Vigo, José ÁngelBackground: Recently, novel anatomic parameters that can be measured by optical coherence tomography (OCT), have been identified as a more objective and accurate method of defining the iridocorneal angle. The aim of the present study is to measure the iridocorneal angle by Fourier domain (FD) OCT and to identify correlations between angle measurements and subject factors in a large healthy Caucasian population. Methods: A cross sectional study was performed in 989 left eyes of 989 healthy subjects. The iridocorneal angle measurements: trabecular-iris angle (TIA), angle opening distance (AOD500) and trabecular-iris space area (TISA500) 500 μm from the scleral spur, were made using the FD-OCT RTVue®. Iris thickness was also measured. Correlations were examined between angle measurements and demographic and ocular factors. The main determinants of angle width were identified by multivariate linear regression. Results: TIA could be measured in 94 % of the eyes, and AOD500 and TISA500 in 92 %. The means recorded were TIA 35.8 ± 12.2 degrees (range 1.5 to 76.1), AOD500 542.6 ± 285.4 μm (range 15 to 1755), and TISA500 0.195 ± 0.104 mm2 (range 0.02 to 0.62). The correlation between the temporal and nasal quadrant was R = 0.902 for TIA. The reproducibility of measurements was excellent (intraclass correlation coefficient >0.947). Mean angle width measurements were smaller in women (p = 0.02). Correlation was detected between angle means and anterior chamber volume (ACV; R = 0.848), anterior chamber depth (ACD; R = 0.818), spherical error (R = -0.619) and age (R = -0.487), while no correlation was observed with Intraocular pressure (R = -0.052). ACV emerged as the main determinant of TIA (R2 = 0.705; p < 0.001). Conclusions: In this Caucasian population, strong correlation was detected between FD-OCT anterior angle measurements and ACV, ACD, spherical refractive error and sex, emerging the ACV as the main determinant of TIA. PublicationImpact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment(MPDI, 2021-02-22) Marco Martínez, Javier; Bernal Sobrino, José Luis; Fernández Pérez, Cristina; Elola Somoza, Francisco Javier; Azaña Gómez, Javier; García Klepizg, José Luis; Andrès, Emmanuel; Zapatero Gaviria, Antonio; Barba Martín, Raquel; Marco Martínez, Fernando; Canora Lebrato, Jesus; Lorenzo Villalba, Noel; Méndez Bailón, ManuelBackground: Femoral neck fracture (FNF) is a common condition with a rising incidence, partly due to aging of the population. It is recommended that FNF should be treated at the earliest opportunity, during daytime hours, including weekends. However, early surgery shortens the available time for preoperative medical examination. Cardiac evaluation is critical for good surgical outcomes as most of these patients are older and frail with other comorbid conditions, such as heart failure. The aim of this study was to determine the impact of heart failure on in-hospital outcomes after surgical femoral neck fracture treatment. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2007–2015. We included patients older than 64 years treated for reduction and internal fixation of FNF. Demographic characteristics of patients, as well as administrative variables, related to patient’s diseases and procedures performed during the episode were evaluated. Results: A total of 234,159 episodes with FNF reduction and internal fixation were identified from Spanish National Health System hospitals during the study period; 986 (0.42%) episodes were excluded, resulting in a final study population of 233,173 episodes. Mean age was 83.7 (±7) years and 179,949 (77.2%) were women (p < 0.001). In the sample, 13,417 (5.8%) episodes had a main or secondary diagnosis of heart failure (HF) (p < 0.001). HF patients had a mean age of 86.1 (±6.3) years, significantly older than the rest (p < 0.001). All the major complications studied showed a higher incidence in patients with HF (p < 0.001). Unadjusted in-hospital mortality was 4.1%, which was significantly higher in patients with HF (18.2%) compared to those without HF (3.3%) (p < 0.001). The average length of stay (LOS) was 11.9 (±9.1) and was also significantly higher in the group with HF (16.5 ± 13.1 vs. 11.6 ± 8.7; p < 0.001). Conclusions: Patients with HF undergoing FNF surgery have longer length of stay and higher rates of both major complications and mortality than those without HF. Although their average length of stay has decreased in the last few years, their mortality rate has remained unchanged. PublicationLetter in response to article in journal of infection: “High SARS-CoV-2 antibody prevalence among healthcare workers exposed to COVID-19 patients”(Elsevier, 2020-09) Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Ariño Gutiérrez, Mayte; Fernández Vigo, José Ignacio; Benito Pascual, Blanca; Cabello Clotet, Noemí; Mayol Martínez, Julio; Gegúndez Fernández, José Antonio; Díaz Valle, David; Benítez del Castillo, José Manuel; García Feijoo, Julián PublicationGlaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study(HINDAWI PUBLISHING CORPORATION, 2016-11) Arriola Villalobos, Pedro; Martínez de la Casa, Jose Maria; Díaz Valle, David; Morales Fernández, Laura; Fernández Pérez, Cristina; García Feijoo, JuliánPurpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was months. Mean baseline IOP was mmHg with medication and mmHg after washout. Mean end-follow-up IOP was mmHg, representing an IOP decrease of 36.92%, mmHg (), from baseline washout IOP. The mean number of medications was significantly reduced from to (). 45% of patients were medication-free by the end of follow-up. Mean BCVA improved significantly from to (). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract.