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- ItemAcesso aberto (Open Access)Análise das alterações na curvatura corneana com implante intra-estromal: estudo experimental em coelhos(Conselho Brasileiro de Oftalmologia, 2007-03-01) Godoy, Cinara Sakuma De Oliveira; Wahab, Samia Ali; Moreira, Hamilton [UNIFESP]; Moreira, Luciane Bugman; Godoy, Glaucio De [UNIFESP]; Universidade Federal do Paraná; UFPR; Universidade Federal de São Paulo (UNIFESP); Faculdade Evangélica do Paraná; Hospital de Olhos do ParanáPURPOSE: To evaluate the effect of intrastromal corneal ring implantation on corneal curvature in rabbits. METHODS: Thirty eyes of 15 rabbits were divided into two groups: group 1 with 7 animals and group 2 with 8 animals. The left eye underwent surgery and the right eye was used as control. Ultrasound pachymetry and corneal topography were performed prior to surgery. Anterior segment biomicroscopy and corneal topography were performed after surgery. In group 1, implantation of two ring segments was performed. In group 2, ring segments were implanted separately. Topographical findings, before and after surgery, were compared through quantitative and qualitative alterations and divided into four quadrants. RESULTS: Quantitative analysis showed no significant difference between the groups in the preoperative period. Experiment group 1 showed nasal (p=0.02) and temporal (p=0.04) corneal steepening, compared to control group 1. Experiment group 2 showed nasal and temporal corneal steepening and superior and inferior corneal flattening (p=0.02 for all quadrants) compared to the control group 2. Qualitative analysis showed uniform astigmatism in both control groups. In experiment group 1, against-the-rule regular symmetrical astigmatism was observed after surgery. In experiment group 2, against-the-rule regular asymmetrical astigmatism was found after implantation of the first ring segment, and against the rule regular symmetrical astigmatism was observed after implantation of the second segment. CONCLUSION: In this study, significant corneal flattening occurred in quadrants where ring segments extremities were located and corneal steepening was observed in quadrants where its body was located. Implantation of one ring segment induces asymmetrical astigmatism.
- ItemAcesso aberto (Open Access)Anel corneano intra-estromal para baixa miopia: estudo comparativo com a técnica de LASIK(Conselho Brasileiro de Oftalmologia, 2004-02-01) Forseto, Adriana dos Santos [UNIFESP]; Schor, Paulo [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Nosé, Walton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Eye Clinic Day Hospital; Universidade Metropolitana de SantosPURPOSE: To evaluate the efficacy and safety of intrastromal corneal ring segments (ICRS) for the correction of low myopia, and to compare the obtained results with a control group submitted to laser in situ keratomileusis (LASIK). METHODS: Prospective, nonrandomized and bilateral study. Fourteen patients with preoperative spherical equivalent ranging from -1.00 to -4.50 D received ICRS in one eye and LASIK in the other. Postoperative evaluations were performed at day one and seven and months 1, 3, 6, 12 and 24. RESULTS: At the last follow-up, 64.29% of ICRS eyes (9/14) and 85.71% of LASIK eyes (12/14) were within ± 0.50 D of the predicted refractive outcome (p=0.385). Uncorrected visual acuity of 20/20 or better was observed in four of 14 ICRS eyes (28.57%), and in 12 of 14 LASIK eyes (85.71%) (p=0.002²). No variances of more than 1.00 D in the manifest spherical equivalent refraction between two consecutive examinations or significant loss of best spectacle-corrected visual acuity were observed in both groups. Surgically induced astigmatism was greater in ICRS eyes than in LASIK eyes. At 24 months, the ICRS eyes scored lower in contrast sensitivity testing, especially at higher spatial frequencies (p=0.032² at 18 cpd). The patients reported more subjective complaints in the early postoperative period for the ICRS eyes. CONCLUSIONS: ICRS were considered effective for the correction of low myopia, but their safety was limited by the observed surgically induced astigmatism, and their results were inferior compared to the control group.
- ItemAcesso aberto (Open Access)Infectious keratitis in patients undergoing Boston Type 1 keratoprosthesis (Boston KPro) procedure: case series(Conselho Brasileiro de Oftalmologia, 2011-04-01) Nascimento, Heloisa Moraes do [UNIFESP]; Oliveira, Lauro Augusto de [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Description of two cases of infectious keratitis in patients after Boston Type 1 keratoprosthesis (Boston KPro) implantation. The first case refers to a patient that had the device indicated due to limbal deficiency secondary to severe dry eye who presented a fungal infection by Aerobasidium pullulans that was successfully treated with amphotericin B eye drops. The second case reports a patient with Boston KPro implantation due to previous corneal transplant rejection showing bacterial keratitis in the fourth postoperative month. The etiologic agent was identified asStreptococcus sp and topical treatment with vancomycin was effective. The importance of postoperative surveillance in Boston KPro eyes is discussed.
- ItemAcesso aberto (Open Access)Resultados da conjuntivodacriocistorrinostomia com implante de prótese lacrimal de polietileno de baixa densidade(Conselho Brasileiro de Oftalmologia, 2002-01-01) Bison, Simone [UNIFESP]; Soccol, Ovídio; Scarpi, Marinho Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Departamento de OftalmologiaPurpose: To analyze the postoperative complications of conjunctivodacryocystorhinostomy with low-density polyethylene tube and the possible correlations between the various etiologies and complications and surgical success rate. Methods: The study was carried out on 35 lacrimal apparatus of 34 patients who were submitted to conjunctivodacryocystorhinostomy with low-density polyethylene tube during a six-year period, from August 1991 to November 1997. With the aim of studying the possible correlations between the findings (etiology x complications and etiology x success rate) exact Fisher's test was carried out. Results: The most important etiologies were chronic dacryocystitis and failure of dacryocystorhinostomy (53.9%) followed by traumatisms (16.3%). The complication rate was 74.3%. The surgical success rate in one intervention was 25.7%. After two or more surgeries, 17 tubes became pervious and well-located (48.6%). Unsuccessful procedures occurred in 25.7% of the lacrimal apparatus. There was no significant correlation between etiology and complication occurrence neither between etiology and surgical success. Conclusions: There is no difference between complications and success in this study and those reported in the international literature. These findings were not correlated with the obstruction etiology. The advantages of low-density polyethylene tube are its great availability, the easy manufacture in the intraoperative period according to the lenght and width needs of and, finally, it can be exchanged for borosilicate glass when the edema regress.