RESUMEN
INTRODUCTION: Fluctuating elevated intraocular pressure (IOP) is one of the complications of an implantable collamer lens (ICL), and its alteration is a predictive factor for the development of glaucoma. MATERIAL AND METHODS: A prospective, cross-sectional analytic study was conducted on patients suitable for ICL implantation. Complete clinical and biometric work-ups were performed, as well as night-time IOP curve, in supine position, with 4 determinations, in order to assess fluctuation, considering abnormal with a value higher than 5 mmHg. Patients underwent surgery with conventional technique and three months after the work-ups were repeated, including a night-time IOP curve to assess any changes in IOP fluctuations. RESULTS: A total of 31 eyes of 16 patients were studied. Mean IOP fluctuation in the preoperative assessment was 3.35 ± 2 mmHg, whereas the postoperative mean was 3.0 ± 2.2 mmHg, with the difference not being statistically significant. Visual acuity and capacity, as well as spheric equivalent did show a statistically significant improvement. There were 6 cases of complications, which were related to a higher vault and a greater ICL size. There was no relationship between these findings and the angle grade, pigment, and the level of training of the surgeon. CONCLUSIONS: The effect of an ICL on IOP fluctuations, has been studied for the first time, which was found to be not statistically significant. As in previous publications, the procedure was safe and reproducible, adding the fact that the level of training of the surgeon is not a determining factor in these findings.
Asunto(s)
Presión Intraocular/fisiología , Hipertensión Ocular/fisiopatología , Lentes Intraoculares Fáquicas/efectos adversos , Complicaciones Posoperatorias/fisiopatología , Adulto , Estudios Transversales , Femenino , Estudios de Seguimiento , Glaucoma/etiología , Humanos , Implantación de Lentes Intraoculares/métodos , Masculino , México , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Prospectivos , Reproducibilidad de los Resultados , Factores de Tiempo , Agudeza Visual , Adulto JovenRESUMEN
To compare intraocular pressure (IOP) measurements obtained with Goldmann applanation (GAT) and dynamic contour tonometry (DCT) in a Mexican population. 40 glaucoma patients were included in this cross-sectional observational cohort study. IOP measurements were performed in the following order: DCT, ultrasonic pachymetry and GAT, with a 5-minute difference between each measurement, between 8 am and 2 pm. Only DCT measurements of good quality (Q ≤ 3) were accepted. GAT measurements were made three times with the same Goldmann tonometer, previously checked for calibration errors, and the mean was used for statistical purposes. The IOP (mean [standard deviation], 95 % confidence interval [CI]) measured with the Goldmann tonometer (13.2 [2.4], 12.4-14.0 mmHg) was significantly lower than that obtained with the DCT (18.4 [3.3], 17.0-19.2 mmHg), p < 0.0001. Pearson's correlation coefficients between CCT and IOP measured with GAT and DCT were (r = 0.24, 95 % CI = 0.07-0.52, p = 0.133) and (r = 0.13, 95 % CI = -0.19 to 0.43, p = 0.412), respectively. The concordance correlation coefficient between GAT and DCT was r c = 0.3, 95 % CI = 0.17-0.41). DCT seems to overestimate the IOP as compared to GAT. Additionally, although there was a good correlation between the IOP measurements assessed with either GAT or DCT, the agreement was poor.
Asunto(s)
Glaucoma de Ángulo Abierto/fisiopatología , Presión Intraocular/fisiología , Tonometría Ocular/métodos , Anciano , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , México , Persona de Mediana EdadRESUMEN
Las proteínas de superficie del merozoíto (MSP) son de importancia en la invasión parasitaria al glóbulo rojo. La proteína MSP-5, encontrada en merozoítos libres, tiene un papel en la inmunización de ratones al P. falciparum y P. yoelii, pese a lo cual algunos estudios cuestionan su rol en la invasión. La proteína MSP-6 forma junto con MSP-1 y MSP-7 un complejo en la superficie del merozoíto, liberado del parásito cerca del momento de la invasión al glóbulo rojo. Con el fin de predecir el fenómeno de unión de péptidos de las proteínas de superficie MSP-5 y MSP-6, se aplicó una teoría de unión al HLA clase II, a la totalidad de secuencias de 20 aminoácidos de tales moléculas. Se calcularon los valores de probabilidad, combinatoria y entropía de 168 secuencias nonámeras sobrelapadas de la proteína MSP-5 y 228 de MSP-6. Por último se aplicó la teoría de unión a todos los péptidos nonámeros de tres proteínas construidas computacionalmente, cada una con una longitud de 500 aminoácidos. Para la proteína MSP-5 se predijo un total de 31 secuencias asociadas al macroestado de unión y 137 al de no unión, mientras que se predijo la existencia de 35 secuencias asociadas al macroestado de unión para MSP-6 y 193 al de no unión. Se encontraron respectivamente 100, 111 y 91 secuencias predichas de unión para las tres proteínas teóricas construidas. La predicción teórica de unión de péptidos es útil para facilitar el desarrollo de vacunas, al evidenciar el orden físico-matemático subyacente al fenómeno.(AU)