Loma Linda University

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Julio Narvaez, MD
Adjunct Professor, Ophthalmology
School of Medicine
Publications    Scholarly Journals--Published
  • Fant B, Waring III GO, Fisher J, Tanchel N, Phillips S, Narvaez J.. "Laser in situ keratomileusis for spherical hyperopia and hyperopic astigmatism using the NIDEK EC-5000 excimer laser.." Journal of Refractive Surgery . (2008): -. ( 2/2008 )
  • Christensen A, Narvaez J, Zimmerman G. . "Comparison of corneal thickness measurement by ultrasound pachymetry, Konan non-contact optical Pachymetry and Orbscan pachymetry." Journal of Cornea . (2008): -. ( 1/2008 )
  • Bekendam PD, Narvaez J, Agarwal M.. "Case of corneal melting associated with the use of topical nepafenac.." Cornea. 26(8). (2007): 1002-3-. ( 9/2007 )
    PURPOSE: To report a case of corneal melting associated with the use of the topical nonsteroidal anti-inflammatory agent Nepafenac. METHODS: Case report and literature review. RESULTS: A 62-year-old woman with a complicated ocular history developed corneal melting associated with the use of Nepafenac. On discontinuation of Nepafenac, the melt rapidly resolved. CONCLUSIONS: Topical nonsteroidal anti-inflammatory agents have been associated with corneal ulceration and stromal melts. This is, to our knowledge, the first reported case involving the new agent, Nepafenac.
  • Narvaez J, Cherwik H, Stulting RD, Waldron R, Zimmerman G, Wessels IF, Waring GO. . "Comparison of biometry with high-precision immersion ultrasound and partial coherence interferometer, and accuracy of intraocular lens power prediction." Ophthalmic Surgery Lasers & Imaging . (2007): -. ( 1/2007 )
  • Narvaez J, Banning CS, Stulting RD. "Negative dysphotopsia associated with implantation of the Z9000 intraocular lens." Journal of Cataract and Refractive Surgery 31. (2005): 846-847-. ( 1/2005 )
  • Narvaez J, Kroll P, Tooma T. "Prospective, Randomized Trial of Diclofenac and Ketorolac after Refractive Surgery." Journal of Refractive Surgery 20. (2004): 76-78-. ( 1/2004 )
  • Chakrabarty A, Pang KR., Wu JJ, Narvaez J, Rauser M, Huang DB, Beutner KR., Tyring SK. "Emerging therapies for herpes viral infections (types 1 - 8). ." Expert Opin Emerg Drugs 9. (2004): 237-256-. ( 1/2004 )
  • Narvaez J, Kroll P, Guzek JP. "Effects of Diclofenac and Ketorolac on Patient Discomfort and Corneal Sensitivity." Journal of Refractive Surgery 18. (2002): 145-148-. ( 1/2002 )
  • Narvaez J, Wessels IF, Mattheis JK, Beierle F. "Intravitreal Antibiotics: Accuracy of Dilution by Pharmacists, Ophthalmologists, and Ophthalmic Assistants." Ophthalmic Surgery 23. (1992): -. ( 4/1992 )
  • NarvŠez J, Zimmerman G, Stulting RD, Chang DH.. "Accuracy of intraocular lens power prediction using the Hoffer Q, Holladay 1, Holladay 2, and SRK/T formulas.." J Cataract Refract Surg. 2006 Dec;32(12):2050-3. Related Articles, Links . (): -. (*)
    Department of Ophthalmology, Loma Linda University, Loma Linda, California, USA. narvaezjd@verizon.net PURPOSE: To compare the accuracy of intraocular lens (IOL) power calculations using 4 formulas: Hoffer Q, Holladay 1, Holladay 2, and SRK/T. SETTING: Tertiary care center. METHODS: This study was a retrospective comparative analysis. Immersion ultrasound biometry (axial length, anterior chamber depth, and lens thickness), manual keratometry, and postoperative manifest refraction were obtained in 643 eyes of consecutive patients who had routine uneventful cataract surgery with implantation of 1 of 2 IOLs using the same operative technique by the same surgeon. Biometric data were entered into each of the 4 IOL power calculation formulas, and the results were compared to the final manifest refraction. An optimized lens constant was used for each formula. Results were also stratified into groups of short, average, medium long, and very long axial length
  • NarvŠez J, Chakrabarty A, Chang K.. "Treatment of epithelial ingrowth after LASIK enhancement with a combined technique of mechanical debridement, flap suturing, and fibrin glue application.." Cornea. 2006 Oct;25(9):1115-7 . (): -. (*)
    Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA. narvaezjd@verizon.net PURPOSE: To report a case of clinically significant post-laser in situ keratomileusis (LASIK) epithelial ingrowth successfully treated with a combined technique of mechanical debridement, flap suturing, and fibrin glue application. METHODS: A retrospective case report. RESULTS: A 42-year-old female patient underwent LASIK and an enhancement procedure in 1998 and 2002, respectively. Two years after her enhancement, she developed severe, visually significant epithelial ingrowth. Treatment was undertaken using a combination of mechanical debridement, flap suturing, and fibrin glue application. No recurrence was found during a 15-month follow-up period. No adverse effects were seen with this approach. CONCLUSION: Severe progressive epithelial ingrowth may be treated successfully with a combination of mechanical debridement, flap suturing, and fibrin glue application.
  • Pereira Cda R, Narvaez J, King JA, Seery LS, Gimbel HV.. "Late-onset traumatic dislocation with central tissue loss of laser in situ keratomileusis flap.." Cornea. 2006 Oct;25(9):1107-10 . (): -. (*)
    Department of Ophthalmology, Loma Linda University, Loma Linda, CA 92354, USA. carlindo.pereira@med.va.gov PURPOSE: We report the occurrence and outcome of a severe late-onset traumatic dislocation of a laser in situ keratomileusis (LASIK) flap with loss of central flap tissue. METHODS: Case report. RESULTS: A 40-year-old woman underwent uncomplicated bilateral LASIK surgery, followed 5 years later by an enhancement procedure in both eyes. Ocular trauma with a power sander occurred 6 years after LASIK and 1 year after the enhancement procedure. The flap was found to have an almost complete tear from the nasal hinge and a central tissue defect. After irrigating, repositioning, and stabilizing the flap with 2 nylon sutures, a bandage contact lens was placed. The patient was treated with topical antibiotic and steroid drops. Stage 2 diffuse lamellar keratitis developed, which responded to topical treatment. Ten weeks after injury, the patient regained an uncorrected visual acuity of 20/20-1. CONCLUSION: Late-onset trauma to the LASIK flap can result in flap dehiscence and tissue loss. Prompt and appropriate management can lead to an excellent visual outcome even in severely traumatized dislocated LASIK flaps.
  • Michel AW, Kronberg BP, NarvŠez J, Zimmerman G.. "Comparison of 2 multiple-measurement infrared pupillometers to determine scotopic pupil diameter.." J Cataract Refract Surg. 2006 Nov;32(11):1926-31. . (): -. (*)
    House Staff Office, Loma Linda University, Loma Linda, California, USA. PURPOSE: To compare a monocular and a binocular multiple-measurement digital infrared pupillometers for measuring scotopic pupil diameter. SETTING: Department of Ophthalmology, Loma Linda University, Loma Linda, California, USA. METHODS: Scotopic pupil size was measured after 1 minute of dark adaptation in 42 eyes of 21 volunteers. Measurements were taken twice each with 2 multiple-measurement digital infrared pupillometers, the monocular pupillometer (Neuroptics, Inc.), and the binocular pupillometer (P2000D, Procyon, Ltd.) Intraclass correlation coefficients (ICC) and limits of agreement (LOA) were used to measure repeatability and agreement of measures with each instrument and between instruments. The Wilcoxon signed rank test was used to compare variability of measurements within each instrument. RESULTS: The mean scotopic pupil size was 4.79 mm +/- 0.95 (SD) with the Procyon and 4.86 +/- 0.93 mm with the Neuroptics. Repeatability and agreement tests for the Procyon measures showed the following: ICC, 0.954; 95% confidence interval (CI), 0.916-0.975; LOA, -0.60 to 0.56; range, 1.16. The Wilcoxon signed rank test of variability gave a Z score of -2.53 (P = .01, 2 tailed). The repeated measures testing with the Neuroptics pupillometer showed the following: ICC, 0.985; 95% CI, 0.972-0.992; LOA, -0.39 to 0.26; range, 0.64; Z score, -1.15 (P = .25, 2-tailed). Repeatability and agreement tests for measures between instruments showed the following: ICC, 0.954; 95% CI, 0.916-0.975; LOA, -0.60 to 0.50; range 1.11. CONCLUSIONS: There was a high repeatability and agreement in scotopic pupil diameter for repeated measures within each device and measurements between the devices. Differences in variability in scotopic pupil diameter evaluated by the Wilcoxon signed rank test were significant only with the Procyon pupillometer. PMID: 17081898 [PubMed - indexed for MEDLINE]
  Books and Chapters
  • Lichter H, Narvaez J, Waring GO. In: Alio JL, Perez-Santonja JJ, eds. . Refractive Surgery with Phakic IOLs: Fundamentals and Clinical Practice. Broad review of peer reviewed literature on phakic intraocular lenses. . Republic of Panama: Highlights of Ophthalmology International, , 2004. ( 1/2004 )
  • Narvaez J, Wong W. . Atlas of Clinical Gross Anatomy. . Barcelona: Elsevier Mosby, . (*)