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Las lentes de contacto blandas son una buena alternativa al uso de gafas para la corrección de defectos refractivos. Sin embargo, un mal uso puede asociarse a complicaciones. La manipulación incorrecta, la mala higiene o el sobreuso de dichas lentes pueden producir mala tolerancia, inflamación ocular e incluso secuelas visuales. En esta revisión se describen las complicaciones más frecuentes, y también las más graves, de tipo infeccioso y no infeccioso asociadas al uso de lentes de contacto blandas, así como las recomendaciones para su correcto uso

Soft contact lenses are a good alternative to the use of glasses for the correction of refractive defects. However, improper use can be associated with complications. Incorrect handling, poor hygiene, or over-use of the lenses can lead to poor tolerance, eye inflammation, and even visions sequelae. In this review, the most common and also the most serious are described, including the infectious and non-infectious complications associated with the use of soft contact lenses, including recommendations for their correct use

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Soft contact lenses are a good alternative to the use of glasses for the correction of refractive defects. However, improper use can be associated with complications. Incorrect handling, poor hygiene, or over-use of the lenses can lead to poor tolerance, eye inflammation, and even visions sequelae. In this review, the most common and also the most serious are described, including the infectious and non-infectious complications associated with the use of soft contact lenses, including recommendations for their correct use.

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PURPOSE: To observe trends in surgical techniques for corneal transplantation and main indications in our hospital over the past five years. METHODS: Retrospective descriptive study, including all keratoplasties performed at the Hospital Clinic of Barcelona, Spain, between January 2014 and December 2018. RESULTS: In total, 332 keratoplasties were performed. In total, 127 (38.25%) were penetrating keratoplasties (PK), and 205 (61.75%) were lamellar keratoplasties (LK). In 2014, a total of 48 keratoplasties were carried-out, whereas in 2018, the total was 93, which represents a 93.75% increase in corneal transplantation surgeries. Eye bank-delivered precut tissue for DMEK was introduced in 2016, and 3 cases (6.25%), were carried out that year. In 2018, DMEK became the leading technique with 56 cases (60.22%). Fuchs' dystrophy was the leading indication for corneal transplant (37.63%) in 2018. CONCLUSION: Introduction of DMEK in a single center can be implemented in a relatively short period of time, becoming the most popular surgical procedure in corneal transplantation. A possible factor encouraging this change is the availability of eye bank-delivered precut tissue, and standardization of donor preparation and host surgical steps, optimizing surgical time in the operating room. This trend should lead to better visual outcomes, faster recovery times, and eventually to a higher surgical volume per year.

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La discitis infantil es poco frecuente, su diagnóstico resulta difícil por la clínica y los datos de laboratorio poco específicos y los cambios radiográficos aparecen a las 2-3 semanas. No hay consenso sobre la antibioterapia adecuada, aunque sí en su inicio empírico precoz. Presentamos a una niña de 3 años derivada a Rehabilitación infantil por lumbalgia de 5 meses de evolución. Tras la exploración y telerradiografía es diagnosticada de discitis D11-12. Se trató con cefotaxima por vía intravenosa 2 g cada 6 h durante 3 semanas y después con amoxicilina-ácido clavulánico oral 1 g cada 8 h durante 1 semana. Fue revisada cada 6 meses, observando el desarrollo de escoliosis toracolumbar izquierda, tratada con corsé de Málaga desde los 7 a 12 años. Actualmente, con 14 años, presenta estabilidad de la curvatura. No hemos encontrado bibliografía que relacione la espondilodiscitis con desarrollo de escoliosis. El seguimiento a largo plazo de los pacientes permite detectar alteraciones radiológicas y tratarlas de manera eficaz (AU)

Discitis in children is rare. Diagnosis is difficult because clinical and laboratory results are inconclusive and radiographic changes begin at 2 to 3 weeks. There is no consensus on the appropriate antibiotic treatment, although there is general agreement on the need for early empirical initiation. We present the case of a 3-year-old girl referred for child rehabilitation due to a 5-month history of low back pain. After examination and teleradiography, the patient was diagnosed with D11-12 discitis. She was treated with intravenous cefotaxime 2 g every 6 hours for 3 weeks and then with oral amoxicillin-clavulanic acid 1 g every 8 hours for 1 week. The girl was followed-up every 6 months. She developed left thoracolumbar scoliosis, which was treated with a Malaga corset from the age of 7 to 12 years. Currently, the girl is aged 14 years and shows stable curvature. We have found no reports of spondylodiscitis with the subsequent development of scoliosis. Long-term monitoring of patients allows detection of radiographic abnormalities and their effective treatment (AU)

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CASO CLÍNICO: Varón de 76 años con agudeza visual (AV) de 0,05, que presentaba retinopatía hipertensiva, con hemorragias y manchas algodonosas en haz papilomacular y edema macular. La angiografía fluoresceínica mostró una dilatación sacular hiperfluorescente arterial correspondiente con un macroaneurisma papilar y la tomografía de coherencia óptica (OCT), edema macular. A los 2 meses, la AV mejoró a 0,7, con cierre espontáneo del macroaneurisma y resolución del edema macular. DISCUSIÓN: Los macroaneurismas papilares son infrecuentes y presentan dificultades en su diagnóstico. No existe ningún tratamiento seguro y eficaz y, en concordancia con los pocos casos publicados, la involución espontánea permite la recuperación visual

CASE REPORT: A 75-year old man with reduced vision in his left eye (0.05) presented with hypertensive retinopathy, retinal haemorrhages and cotton wool spots in the papillomacular bundle, as well as macular oedema. Fluorescein angiography showed a saccular hyperfluorescent lesion corresponding to arterial macroaneurysm on the optic disc, with the optical coherence tomography demonstrating macular oedema. At 2 months follow-up, vision had improved to 0.7 with spontaneous closure of the macroaneurysm and resolution of the macular oedema. DISCUSSION: Arterial macroaneurysms on the optic disc are unusual and are difficult to diagnose clinically. There is no safe and effective treatment, and our case, as the few single cases reported, showed that they can spontaneously close and enable visual function to recover

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CASE REPORT: A 75-year old man with reduced vision in his left eye (0.05) presented with hypertensive retinopathy, retinal haemorrhages and cotton wool spots in the papillomacular bundle, as well as macular oedema. Fluorescein angiography showed a saccular hyperfluorescent lesion corresponding to arterial macroaneurysm on the optic disc, with the optical coherence tomography demonstrating macular oedema. At 2 months follow-up, vision had improved to 0.7 with spontaneous closure of the macroaneurysm and resolution of the macular oedema. DISCUSSION: Arterial macroaneurysms on the optic disc are unusual and are difficult to diagnose clinically. There is no safe and effective treatment, and our case, as the few single cases reported, showed that they can spontaneously close and enable visual function to recover.

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Caso clínico: Una mujer de 56 años con mixoma atrial presentó una agudeza visual de no percepción luminosa tras la obstrucción aguda de la arteria oftálmica (OAO) asociada a accidente vascular cerebral. Tardíamente desarrolló cambios pigmentarios retinianos por infartos coroideos, una característica que diferencia la OAO de la obstrucción de arteria central de la retina. Discusión: La obstrucción simultánea de las circulaciones retiniana y coroidea se observa en la OAO. Debe sospecharse la presencia de un mixoma atrial en aquellos pacientes con una OAO asociada a accidente vascular cerebral. Deben realizarse estudios sistémicos para encontrar la etiología de la OAO (AU)

Case report: A 56 year old woman with atrial myxoma presented with a visual acuity of no light perception after acute ophthalmic artery obstruction (OAO) associated with stroke. She developed late retinal pigmentary changes due choroidal infarction, typical of the OAO. Discussion: Simultaneous obstruction of the retinal and choroidal circulation was observed in the OAO. Atrial myxoma should be suspected in patients who suffer from OAO associated with stroke. Systemic studies should be performed to find the origin of OAO (AU)

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CASE REPORT: A 56 year old woman with atrial myxoma presented with a visual acuity of no light perception after acute ophthalmic artery obstruction (OAO) associated with stroke. She developed late retinal pigmentary changes due choroidal infarction, typical of the OAO. DISCUSSION: Simultaneous obstruction of the retinal and choroidal circulation was observed in the OAO. Atrial myxoma should be suspected in patients who suffer from OAO associated with stroke. Systemic studies should be performed to find the origin of OAO.

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