Publications by authors named "Jose Guell"

Article Synopsis
  • After 15 years of DMEK experience, the technique has shown high success rates but still struggles with certain eye conditions like aphakia and eyes that have had vitrectomy.
  • A new method involves injecting an air bubble under the Descemet membrane graft to help unroll it more efficiently during surgery.
  • This approach has been found to decrease surgical time while ensuring successful attachment of the graft, offering a promising option for complex DMEK cases.
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Article Synopsis
  • - Corneal haze results from abnormal healing processes following injuries or surgeries, causing vision impairment due to eye opacity and irregularities, often linked to myofibroblast formation triggered by inflammation.
  • - Major causes of corneal haze include surgical procedures like PRK and LASIK, as well as non-surgical factors such as trauma and infections, with research focusing on the TGFβ pathway and inflammation management methods.
  • - Losartan, usually used for treating high blood pressure, shows promise in ophthalmology for reducing corneal fibrosis after various injuries and surgeries, leading to this review of its effectiveness and potential future applications in treating corneal haze.
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Purpose: To determine predictive factors of higher levels of best-corrected visual acuity (BCVA) in the long-term after primary Descemet's membrane endothelial keratoplasty (DMEK).

Methods: Retrospective, single-surgeon case series of 129 successful primary DMEK eyes without graft failure and with a minimum postoperative follow-up of 12 months. Mixed effect model for repeated measurements (MMRM) analysis was performed to determine recipient, donor, surgical and postoperative factors associated with BCVA ≤ 0.

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Purpose: To determine risk factors for intraocular lens opacification (IOLop) after Descemet membrane endothelial keratoplasty (DMEK) and to analyze clinical outcomes after IOL exchange.

Methods: Cross-Sectional Study: Analysis of all cases of IOL exchange because of post-DMEK IOLop with a minimum of 6-month postoperative follow-up observed in clinic between November 2021 and April 2022. Main outcomes analyzed at the study visit were change in logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity after IOL exchange, endothelial cell loss (ECL), and graft survival.

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A 28-year-old nurse had an aberration-free femto-laser in situ keratomileusis (LASIK) performed for her myopia of -6.25 -0.50 × 096 and -6.

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Purpose: To update the literature on peripheral optics and vision following intraocular lens (IOLs) implantation.

Methods: We investigated how current IOLs influence peripheral visual function, peripheral optical quality, and visual perception and performance, in patients following cataract surgery. Peripheral vision is described as vision outside the central foveal region of the eye (beyond 4-5° of eccentricity).

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The efficacy and safety of Descemet's membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) have been recently compared in several systematic reviews (SRs). The aim of this study was to assess the evidence quality of such SRs, in order to obtain a scientifically rigorous comparison between the two techniques. We performed a systematic review of SRs and meta-analyses comparing the efficacy and safety between UT-DSAEK and DMEK up to 24th March 2023, using 3 electronic databases (PubMed, Cochrane Library, Google Scholar) plus manual reference search.

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Article Synopsis
  • This study evaluated the growth and functionality of human corneal endothelial cells (hCEC) sourced from elderly donors (>60 years) using a specific preservation method, aiming to determine their potential for clinical use despite not meeting standard criteria for corneal transplants.* -
  • Cells were cultured under controlled conditions, utilizing collagenase and trypsin to isolate them, and various assays (WST-1, morphometric analysis, immunocytochemistry, TEER) were conducted to assess their growth, morphology, and functionality over time.* -
  • Results showed equivalent growth profiles in hCEC from different preservation methods, maintained specific cell shapes and markers initially, but decreased in functionality after the first passage, indicating challenges in sustaining endothelial properties post-culture
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Purpose: To analyze the outcomes of Descemet's membrane endothelial keratoplasty (DMEK) for corneal endothelial failure secondary to phakic intraocular lens implantation (PIOL) at a reference center for corneal transplantation in Spain.

Design: Retrospective, single-surgeon case series.

Methods: Single-center analysis of patients who underwent DMEK for PIOL-related corneal decompensation between July 2011 and July 2020 with at least 6 months of follow-up postoperatively.

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The aim of this study was to analyze the outcomes of eyes with visually significant cystoid macular œdema (vs-CMO) after Descemet membrane endothelial keratoplasty (DMEK) in a referral center for keratoplasty in Spain. We conducted a retrospective, single-surgeon case series of eyes that developed post-DMEK vs-CMO performed between January 2011 and December 2020. Data collected included: indication for DMEK; biometric data; ocular comorbidities; past medical history; time to detection of vs-CMO after DMEK (T, weeks); best-corrected visual acuity (BCVA, logMAR) and central retinal thickness (CRT, µm) at diagnosis of vs-CMO, after resolution of CMO, and at last follow-up; and management strategy.

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Purpose: To evaluate long-term efficacy, safety, and spectacle independence after the treatment of hyperopic presbyopia with pseudophakic mini-monovision using standard monofocal intraocular lenses (IOLs) after bilateral cataract surgery.

Setting: Private practice in Barcelona, Spain.

Design: Retrospective, noncomparative case series.

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Purpose: To report a case of Descemet membrane endothelial keratoplasty (DMEK) for the management of post-laser in situ keratomileusis (LASIK) interface fluid syndrome (IFS) secondary to failed Descemet stripping automated endothelial keratoplasty (DSAEK) graft, and to provide a literature review on endothelial keratoplasty (EK) for this indication.

Observations: A 52-year-old patient presented with LASIK interface fluid accumulation and a non-functioning primary DSAEK graft. Past ophthalmic history was relevant for: (1) phakic intraocular lens (PIOL) implantation with later refinement by LASIK; (2) combined PIOL explantation and refractive lens exchange due to accelerated endothelial cell loss (ECL); (3) primary DSAEK due to corneal decompensation.

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All documented cases of acute corneal allograft rejection following SARS-CoV-2 vaccination were examined, to characterize possible risk factors and graft outcomes. Comprehensive search (4 electronic databases: PubMed, CENTRAL, ClinicalTrials.gov, Google Scholar, plus manual search in articles' reference lists) until March 1st 2022 to identify studies reporting acute corneal allograft rejection following SARS-CoV-2 vaccination; study protocol was developed in line with PRISMA statement.

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Ozonated oil has shown antimicrobial, anti-inflammatory and regenerative properties that make it useful in the prevention of infectious diseases and also as an adjuvant in wound-healing management. This review brings together most aspects of the use of liposomal ozonated oil for ocular infections and regeneration of the ocular surface. A search was performed in PubMed, Medline, Web of Science and Cochrane Library for studies published by June 2021.

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Purpose: To evaluate the long-term efficacy, safety, predictability, and stability of a foldable anterior chamber phakic intraocular lens (pIOL) (Artiflex) implantation in eyes with more than 10 years of follow-up.

Setting: Instituto de Microcirugía Ocular, Barcelona, Spain.

Design: Retrospective study.

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Purpose: To provide the first description of photorefractive keratectomy (PRK) for the correction of mild residual refractive error after Descemet membrane endothelial keratoplasty (DMEK).

Methods: Case report.

Results: A 45 year-old woman presenting with phakic intraocular lens (PIOL)-related corneal decompensation underwent staged DMEK surgery following PIOL explantation and cataract surgery.

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Purpose: To evaluate long-term efficacy, safety, predictability, and stability of a posterior chamber phakic intraocular lens (Visian implantable collamer lens [ICL]) in eyes with ≥10 years of follow-up.

Setting: Instituto de Microcirugía Ocular, Barcelona, Spain.

Design: Retrospective study.

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Intraoperative optical coherence tomography (OCT) was so far only available as a microscope-integrated or handheld device. Recently, this technology has been integrated into a femtosecond (FS) laser. This pilot study analyzed the potential of intraoperative imaging using OCT during FS-assisted procedures of the anterior eye segment.

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Whole eye visualization and morphometry are of high relevance in clinical practice. However, most standard ophthalmic OCT instruments are dedicated either to retinal or to anterior segment imaging. We demonstrate a swept source optical coherence tomography system (SS-OCT) that images both the whole anterior segment and the retina alternately using a single source and detector.

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Background: We review the literature on the efficacy and safety outcomes of secondary Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK).

Methods: Literature search of English-written publications up to September 27, 2020 in PubMed database, using the terms "endothelial keratoplasty" in combination with keywords "secondary" or "repeat." In addition, we manually searched the references of the primary articles.

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Objectives: To evaluate microbiological culture rate and positivity of corneoscleral rim and cornea storage media as well as possible risk factors for contamination with real-world data.

Methods: Data of consecutive cornea donors implanted in the reference centre from January 2013 to January 2018 were reviewed. Information about cornea characteristics (donor demographic data, endothelial cell density, type of cornea conservation, days of storage, and precut vs full-thickness tissue), and microbiological culture information (corneoscleral rim vs storage sample, positive result) were statistically analysed.

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