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1.
Wien Klin Wochenschr ; 135(Suppl 6): 706-720, 2023 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-37821694

RESUMEN

The prevalence of overweight and obesity is steadily increasing in Austria as well as internationally. Obesity in particular is associated with multiple health risks, comorbidities, functional disability, and social stigma. Obesity is an independent, complex, chronic disease and should be treated as such by a multidisciplinary team of appropriately qualified personnel. In addition to recent international guidelines, this consensus paper outlines the overall principles of the management of overweight and obesity and provides guidance for the diagnosis and conservative treatment, focusing on lifestyle modifications and pharmacotherapy. Using the "5A" framework of behavioral health intervention, guidelines for a structured, pragmatic, and patient-centered medical care of adults with overweight or obesity are presented.


Asunto(s)
Tratamiento Conservador , Sobrepeso , Adulto , Humanos , Sobrepeso/epidemiología , Sobrepeso/terapia , Obesidad/diagnóstico , Obesidad/epidemiología , Obesidad/terapia , Estilo de Vida , Comorbilidad
2.
Wien Klin Wochenschr ; 135(Suppl 1): 32-44, 2023 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-37101023

RESUMEN

Hyperglycemia significantly contributes to complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety as well as cardiovascular effects is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hiperglucemia , Humanos , Hipoglucemiantes/uso terapéutico , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/complicaciones , Hiperglucemia/tratamiento farmacológico , Glucemia
3.
Wien Klin Wochenschr ; 135(Suppl 1): 78-83, 2023 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-37101027

RESUMEN

Lifestyle, in general and particularly regular physical activity, is known to be an important component in the prevention and therapy of type 2 diabetes.To gain substantial health benefits, a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week should be performed. Additionally, inactivity should be recognized as health hazard and prolonged episodes of sitting should be avoided.Especially exercise is not only efficient in improving glycaemia by lowering insulin resistance and enhance insulin secretion, but to reduce cardiovascular risk. The positive effect of training correlates directly with the amount of fitness gained and lasts only as long as the fitness level is sustained. Exercise training is effective in all age groups and for all genders. It is reversible and reproducible.Standardized, regional and supervised exercise classes are well known to be attractive for adults to reach a sufficient level of health enhancing physical activity. Additionally, based on the large evidence of exercise referral and prescription, the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care. Unfortunately, the implementation of booth-local exercise classes and advisers is missing so far.


Asunto(s)
Diabetes Mellitus Tipo 2 , Adulto , Femenino , Humanos , Masculino , Diabetes Mellitus Tipo 2/prevención & control , Ejercicio Físico/fisiología , Terapia por Ejercicio , Estilo de Vida , Austria , Aptitud Física/fisiología
4.
Wien Klin Wochenschr ; 131(Suppl 1): 141-150, 2019 May.
Artículo en Alemán | MEDLINE | ID: mdl-30980143

RESUMEN

These are the guidelines for diagnosis and treatment of diabetic neuropathy and diabetic foot. Diabetic neuropathy comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy.The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy, including the complex situation of the diabetic foot syndrome. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided. The needs to prevent and treat diabetic foot syndrome are summarized.


Asunto(s)
Pie Diabético , Neuropatías Diabéticas , Técnicas de Diagnóstico Neurológico/normas , Pie Diabético/diagnóstico , Pie Diabético/terapia , Neuropatías Diabéticas/diagnóstico , Neuropatías Diabéticas/terapia , Humanos , Examen Neurológico , Dolor , Manejo del Dolor , Guías de Práctica Clínica como Asunto , Síndrome
6.
Wien Klin Wochenschr ; 131(Suppl 1): 27-38, 2019 May.
Artículo en Alemán | MEDLINE | ID: mdl-30980148

RESUMEN

Hyperglycemia significantly contributes to complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety as well as cardiovascular effects is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.


Asunto(s)
Glucemia/efectos de los fármacos , Diabetes Mellitus Tipo 2 , Hipoglucemiantes/uso terapéutico , Guías de Práctica Clínica como Asunto , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Humanos , Hiperglucemia/tratamiento farmacológico , Estilo de Vida
7.
Wien Klin Wochenschr ; 131(Suppl 1): 61-66, 2019 May.
Artículo en Alemán | MEDLINE | ID: mdl-30980166

RESUMEN

Lifestyle in general and particularly health enhancing physical activity is known to be an important component in the prevention and therapy of type 2 diabetes mellitus.To gain substantial health benefits a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week are needed. Additionally, inactivity should be recognised as health hazard and prolonged episodes of sitting should be avoided.Exercise in particular is not only useful in improving glycaemia by lowering insulin resistance and positively affect insulin secretion, but to reduce cardiovascular risk. The positive effect of training correlates directly with the amount of fitness gained and lasts only as long as the fitness level is sustained. The effect of exercise is independent of age and gender. It is reversible and reproducible.Supervised exercise classes are well known to be attractive for adults to reach a sufficient level of health enhancing physical activity. The potential of regional, standardised exercise programmes could have been shown, although existing barriers to entry must be reduced. To tackle this public health challenge and based on the large evidence of exercise referral and prescription the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care.


Asunto(s)
Diabetes Mellitus Tipo 2 , Terapia por Ejercicio , Estilo de Vida , Terapia Nutricional , Adulto , Austria , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/prevención & control , Ejercicio Físico/fisiología , Humanos , Guías de Práctica Clínica como Asunto , Levantamiento de Peso/fisiología
8.
Cornea ; 36(7): 816-820, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28445192

RESUMEN

PURPOSE: To report the results of a 1-year follow-up analysis of the safety and efficacy of the Flexivue Microlens corneal inlay. METHODS: The Flexivue Microlens corneal inlay was implanted in the nondominant eye of patients with emmetropic presbyopia (a spherical equivalent of -0.5 to 1.00 diopter) after the creation of a 300-µm deep stromal pocket, using a femtosecond laser. The patients were followed up according to a clinical protocol involving refraction, anterior segment imaging analysis (Oculyzer), and optical quality analysis (OPD-Scan). RESULTS: Thirty-one patients were enrolled in this ongoing study. The mean age was 50.7 years (range 45-60 yrs), and 70% of the patients were female. The mean uncorrected near visual acuity improved to Jaeger 1 in 87.1% of the eyes treated with the inlays. All eyes improved 4 lines at all visits. The binocular uncorrected distance visual acuity was 20/20 in all patients. Ninety percent of the patients reported that their near vision was good or excellent. Some of the patients (16.1%) lost more than 3 lines of corrected distance visual acuity. At the latest follow-up, induction of a corneal spherical aberration to improve near visual acuity was statistically significant. No other intraoperative or postoperative complication was noted. CONCLUSIONS: The Flexivue Microlens provided patients with improved near vision, as a result of a negative spherical aberration. A significant loss of corrected distance visual acuity in the operated eyes was observed. Overall, this intracorneal inlay was an effective alternative to other procedures for the correction of presbyopia.


Asunto(s)
Sustancia Propia/cirugía , Presbiopía/cirugía , Prótesis e Implantes , Implantación de Prótesis , Materiales Biocompatibles , Sensibilidad de Contraste/fisiología , Sustancia Propia/fisiopatología , Topografía de la Córnea , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Presbiopía/fisiopatología , Estudios Prospectivos , Refracción Ocular/fisiología , Resultado del Tratamiento , Agudeza Visual/fisiología
9.
Heart ; 102(19): 1544-51, 2016 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-27226327

RESUMEN

OBJECTIVES/BACKGROUND: Based on previous experiences, the Food and Drug Administration and the European Medicines Agency recommend that clinical trials for novel antidiabetic drugs are powered to detect increased cardiovascular risk. In this context, data concerning licensed drugs such as metformin and sulfonylureas are conflicting. The influence of baseline cardiovascular risk on any treatment effect appears obvious but has not been formally proven. We therefore evaluated association of metformin and sulfonylureas with cardiovascular events in patients with different cardiovascular risk profiles indicated by N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) levels. METHODS: 2024 patients with diabetes mellitus were included in this observational study. The primary endpoint was defined as a combination of cardiovascular events and death. Association of metformin and sulfonylureas was assessed using Cox regression models. Possible differences of these associations in patients with different NT-proBNP levels were studied by stratifying and through interaction analysis. RESULTS: During a median follow-up of 60 months, the primary endpoint occurred in 522 (26%) of patients. The median age was 63 years. A Cox regression analysis was adjusted for site of treatment, concomitant medication, age, gender, body mass index, glycated haemoglobin, duration of diabetes, glomerular filtration rate, cholesterol, and history of smoking and cardiac disease. Metformin was associated with a decreased risk in the cohort with elevated NT-proBNP ≥300 pg/mL (HR 0.70, p=0.014) and a similar association was found for the interaction between metformin and NT-proBNP (p=0.001). There was neither an association for sulfonylureas nor a significant interaction between sulfonylureas and NT-proBNP. CONCLUSIONS: Metformin is associated with beneficial cardiovascular outcomes in patients with diabetes only when (sub)clinical cardiovascular risk defined by NT-proBNP levels is present.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Metformina/uso terapéutico , Compuestos de Sulfonilurea/uso terapéutico , Anciano , Austria , Biomarcadores/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/etiología , Distribución de Chi-Cuadrado , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Femenino , Humanos , Hipoglucemiantes/efectos adversos , Masculino , Metformina/efectos adversos , Persona de Mediana Edad , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores Protectores , Medición de Riesgo , Factores de Riesgo , Compuestos de Sulfonilurea/efectos adversos , Factores de Tiempo , Resultado del Tratamiento
10.
Wien Klin Wochenschr ; 128 Suppl 2: S80-4, 2016 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-27052225

RESUMEN

These are the guidelines for preventive care, diagnosis and treatment of the diabetic foot syndrome. Diabetic periphery neuropathy, peripheral vascular disease, bone deformity and altered biomechanics are foot-related risk conditions. The position statement is focused on screening methods and recommendations for clinical care for diabetics, who currently have no foot ulcers. A decision pathway is offered with respect to diagnosis and management of diabetic patients at an increased risk or manifest injuries.


Asunto(s)
Vías Clínicas/normas , Pie Diabético/diagnóstico , Pie Diabético/terapia , Tamizaje Masivo/normas , Guías de Práctica Clínica como Asunto , Austria , Toma de Decisiones Clínicas , Medicina Basada en la Evidencia , Humanos , Resultado del Tratamiento
11.
Wien Klin Wochenschr ; 128 Suppl 2: S73-9, 2016 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-27052228

RESUMEN

These are the guidelines for diagnosis and treatment of diabetic neuropathy. This diabetic late complication comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy. The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided.


Asunto(s)
Analgésicos/administración & dosificación , Neuropatías Diabéticas/diagnóstico , Neuropatías Diabéticas/terapia , Técnicas de Diagnóstico Neurológico/normas , Manejo del Dolor/normas , Guías de Práctica Clínica como Asunto , Austria , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Medicina Basada en la Evidencia , Humanos , Resultado del Tratamiento
12.
Wien Klin Wochenschr ; 128 Suppl 2: S141-5, 2016 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-27052239

RESUMEN

Lifestyle in general (nutrition, exercise, smoking habits), besides the genetic predisposition, is known to be a strong predictor for the development of diabetes. Exercise in particular is not only useful in improving glycaemia by lowering insulin resistance and positively affect insulin secretion, but to reduce cardiovascular risk.To gain substantial health benefits a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week are needed. The positive effect of training correlates directly with the amount of fitness gained and lasts only as long as the fitness level is sustained. The effect of exercise is independent of age and gender. It is reversible and reproducible.Based on the large evidence of exercise referral and prescription the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Terapia por Ejercicio/normas , Acondicionamiento Físico Humano/normas , Guías de Práctica Clínica como Asunto , Conducta de Reducción del Riesgo , Deportes/normas , Austria , Diabetes Mellitus Tipo 2/diagnóstico , Medicina Basada en la Evidencia , Ejercicio Físico , Humanos , Resultado del Tratamiento
13.
Wien Klin Wochenschr ; 128 Suppl 2: S45-53, 2016 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-27052250

RESUMEN

Hyperglycemia significantly contributes to micro- and macrovascular complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/prevención & control , Hiperglucemia/tratamiento farmacológico , Hiperglucemia/prevención & control , Hipoglucemiantes/administración & dosificación , Guías de Práctica Clínica como Asunto , Austria , Diabetes Mellitus Tipo 2/diagnóstico , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Medicina Basada en la Evidencia , Humanos , Resultado del Tratamiento
15.
J Ophthalmic Inflamm Infect ; 5(1): 35, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26590046

RESUMEN

BACKGROUND: Calcified band keratopathy is a chronic degenerative disease characterized by the deposition of gray to white opacity in superficial layers of the cornea that typically develops over months or years. It is associated with a variety of conditions, including chronic uveitis. PURPOSE: The objective of this study is to assess visual acuity and corneal changes in patients with band keratopathy secondary to uveitis who underwent phototherapeutic keratectomy (PTK). SETTING: The place where this study was performed was in the Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo. DESIGN: This is a retrospective study. METHODS: Patients with uveitic band keratopathy were submitted to PTK. The PTK was performed using Allegreto Wave EX500, with the ablation area of 6 mm. RESULTS: Twelve patients (13 eyes) diagnosed with band keratopathy secondary to chronic uveitis were analyzed. Of the 12 patients, 8 patients were female (66 %), aged 22 years (7-53 years). From the 12 patients (13 eyes) evaluated in this study, only one patient (one eye) did not have visual improvement, due to epithelial deposits 2 weeks after PTK, and all the others benefited with the procedure. In the children group, all eyes had visual improvement, and quantitatively speaking, the children had a more significant improvement than adults. CONCLUSIONS: PTK is a safe and effective procedure even for children. However, the improvement in visual acuity was restricted due to other ocular changes secondary to uveitis, such as cataract and retinal changes, or even the corneal irregularity.

16.
J Am Coll Cardiol ; 62(15): 1365-72, 2013 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-23810874

RESUMEN

OBJECTIVES: The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk diabetic patients selected by N-terminal pro-B-type natriuretic peptide (NT-proBNP). BACKGROUND: Few clinical trials have successfully demonstrated the prevention of cardiac events in patients with diabetes. One reason for this might be an inaccurate selection of patients. NT-proBNP has not been assessed in this context. METHODS: A total of 300 patients with type 2 diabetes, elevated NT-proBNP (>125 pg/ml) but free of cardiac disease were randomized. The "control" group was cared for at 4 diabetes care units; the "intensified" group was additionally treated at a cardiac outpatient clinic for the up-titration of renin-angiotensin system (RAS) antagonists and beta-blockers. The primary endpoint was hospitalization/death due to cardiac disease after 2 years. RESULTS: At baseline, the mean age of the patients was 67.5 ± 9 years, duration of diabetes was 15 ± 12 years, 37% were male, HbA1c was 7 ± 1.1%, blood pressure was 151 ± 22 mm Hg, heart rate was 72 ± 11 beats/min, median NT-proBNP was 265.5 pg/ml (interquartile range: 180.8 to 401.8 pg/ml). After 12 months there was a significant difference between the number of patients treated with a RAS antagonist/beta-blocker and the dosage reached between groups (p < 0.0001). Blood pressure was significantly reduced in both (p < 0.05); heart rate was only reduced in the intensified group (p = 0.004). A significant reduction of the primary endpoint (hazard ratio: 0.351; 95% confidence interval: 0.127 to 0.975, p = 0.044) was visible in the intensified group. The same was true for other endpoints: all-cause hospitalization, unplanned cardiovascular hospitalizations/death (p < 0.05 for all). CONCLUSIONS: Accelerated up-titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP. (Nt-proBNP Guided Primary Prevention of CV Events in Diabetic Patients [PONTIAC]; NCT00562952).


Asunto(s)
Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Diabetes Mellitus Tipo 2/epidemiología , Cardiopatías/prevención & control , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Anciano , Biomarcadores/sangre , Presión Sanguínea , Femenino , Cardiopatías/sangre , Cardiopatías/epidemiología , Frecuencia Cardíaca , Hospitalización/estadística & datos numéricos , Humanos , Estimación de Kaplan-Meier , Masculino , Prevención Primaria , Estudios Prospectivos
17.
Arq Bras Oftalmol ; 72(4): 519-25, 2009.
Artículo en Portugués | MEDLINE | ID: mdl-19820793

RESUMEN

PURPOSE: To compare the visual and clinical outcomes of Wavefront-guided laser in situ keratomileusis (Lasik) with Alcon CustomCornea and Zyoptix systems. METHODS: A prospective, randomized, masked and bilateral study was conducted. Fifty patients with preoperative spherical equivalent ranging from -1.00 to -6.50 D were enrolled for customized ablation in both eyes. All of them were submitted to Lasik CustomCornea treatment in one eye and Zyoptix in the other eye. Uncorrected visual acuity, best correct visual acuity (BCVA), manifest refraction, wavefront measurements, and contrast sensitivity testing were performed preoperatively and postoperatively at 1, 3 and 6 months. RESULTS: Preoperatively manifest refractive spherical equivalent was -3.29+/-1.56 D in the CustomCornea group and -3.22+/-1.50 D in the Zyoptix group. At 6 months, 86% of CustomCornea eyes and 70% of Zyoptix eyes had UCVA>or=20/20. One hundred percent of the CustomCornea group and 88% of the eyes in the Zyoptix were within 0.50 D of emmetropia. In both groups, the contrast sensitivity improved. Spherical aberration increased in both groups, with the CustomCornea group showing lower levels (p<0.001). CONCLUSION: There were no differences between the systems according to safety and effectiveness. The Zyoptix platform showed greater spherical aberration.


Asunto(s)
Queratomileusis por Láser In Situ/métodos , Miopía/cirugía , Agudeza Visual , Adulto , Humanos , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto Joven
18.
Arq. bras. oftalmol ; 72(4): 519-525, July-Aug. 2009. graf, tab
Artículo en Portugués | LILACS | ID: lil-528019

RESUMEN

OBJETIVO: Comparar os resultados obtidos após o Lasik personalizado utilizando duas plataformas diferentes. MÉTODOS: Estudo prospectivo, randomizado com 50 pacientes míopes submetidos a cirurgia refrativa em ambos os olhos. Foram selecionados para o estudo, pacientes com equivalente esférico semelhante entre os olhos. Todos foram submetidos a Lasik bilateral e simultâneo, sendo que um olho foi operado pela plataforma CustomCornea® e o outro pela Zyoptix®. Acuidade visual sem e com correção, refração dinâmica e estática, medida das aberrações oculares, teste de sensibilidade ao contraste foram realizados no período pré-operatório e pós-operatório de 1, 3 e 6 meses. RESULTADOS: No período pré-operatório a média do equivalente esférico era de -3,29 ± 1,56 D no grupo CustomCornea® e de -3,22 ± 1,50 D no Zyoptix® (p=0,267). No sexto mês de pós-operatório, a média do equivalente esférico no grupo CustomCornea® era de -0,077 ± 0,23 D e -0,282 ± 0,30 D no Zyoptix® (p<0,001*). Acuidade visual sem correção > 20/20 foi alcançada em 86 por cento dos olhos no grupo CustomCornea® e 70 por cento no grupo Zyoptix® (p=0,094). Nenhum paciente perdeu duas ou mais linhas da melhor acuidade visual corrigida. Cem por cento dos olhos CustomCornea® e 88 por cento dos Zyoptix® ficaram entre ± 0,50 D da emetropia (p=0,014*). Melhora da sensibilidade ao contraste em todas as frequências espaciais testadas foi observada em ambos os grupos. A aberração esférica apresentou aumento em ambos os grupos, porém este foi estatisticamente maior na plataforma Zyoptix® (p<0,001). CONCLUSÃO: Não foram observadas diferenças entre os grupos quanto à eficácia e segurança. O tratamento com a plataforma Zyoptix® consumiu menor quantidade de estroma. Melhor previsibilidade da correção cirúrgica foi obtida pelo grupo CustomCornea®, bem como menor indução de aberração esférica.


PURPOSE: To compare the visual and clinical outcomes of Wavefront-guided laser in situ keratomileusis (Lasik) with Alcon CustomCornea® and Zyoptix® systems. METHODS: A prospective, randomized, masked and bilateral study was conducted. Fifty patients with preoperative spherical equivalent ranging from -1.00 to -6.50 D were enrolled for customized ablation in both eyes. All of them were submitted to Lasik CustomCornea® treatment in one eye and Zyoptix® in the other eye. Uncorrected visual acuity, best correct visual acuity (BCVA), manifest refraction, wavefront measurements, and contrast sensitivity testing were performed preoperatively and postoperatively at 1, 3 and 6 months. RESULTS: Preoperatively manifest refractive spherical equivalent was -3.29 ± 1.56 D in the CustomCornea® group and -3.22 ± 1.50 D in the Zyoptix® group. At 6 months, 86 percent of CustomCornea® eyes and 70 percent of Zyoptix® eyes had UCVA > 20/20. One hundred percent of the CustomCornea® group and 88 percent of the eyes in the Zyoptix® were within 0.50 D of emmetropia. In both groups, the contrast sensitivity improved. Spherical aberration increased in both groups, with the CustomCornea® group showing lower levels (p<0,001). CONCLUSION: There were no differences between the systems according to safety and effectiveness. The Zyoptix® platform showed greater spherical aberration.


Asunto(s)
Adulto , Humanos , Adulto Joven , Queratomileusis por Láser In Situ/métodos , Miopía/cirugía , Agudeza Visual , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto Joven
19.
J Refract Surg ; 21(6): 722-6, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16329365

RESUMEN

PURPOSE: To retrospectively compare the irregularity of the corneal surfaces of 14 patients after LASIK in 1 eye and placement of intrastromal corneal ring segments (ICRS) in the other eye. METHODS: In a within-patient comparison, Orbscan corneal topography was used to retrospectively compare the corneal surface irregularity of LASIK-treated and ICRS-treated eyes at an outpatient tertiary-care ophthalmology clinic in Sao Paulo, Brazil. For the anterior corneal surface, irregularity measurements were compared for both the central and peripheral areas of the cornea. The differences between each group were analyzed for statistical significance. RESULTS: The corneal surfaces of eyes treated with ICRS were found to be more irregular than the corneal surfaces of eyes treated with LASIK, the mean irregularity being 1.91 for LASIK-treated eyes and 3.12 for ICRS-treated eyes in the anterior corneal surface and 0.51 for LASIK-treated eyes and 0.87 for ICRS-treated eyes in the posterior corneal surface. A statistically significant difference was noted only in the posterior surfaces. CONCLUSIONS: When measured with Orbscan topography, ICRS-treated eyes show more corneal surface irregularity than LASIK-treated eyes. The difference in outcome for the two types of treatment may be due to the mechanical effect of the ICRS on the shape of the cornea.


Asunto(s)
Astigmatismo/patología , Córnea/patología , Sustancia Propia/cirugía , Topografía de la Córnea , Queratomileusis por Láser In Situ/efectos adversos , Miopía/cirugía , Implantación de Prótesis , Astigmatismo/etiología , Estudios de Seguimiento , Humanos , Complicaciones Posoperatorias , Prótesis e Implantes , Refracción Ocular , Estudios Retrospectivos
20.
Arq. bras. oftalmol ; 68(6): 727-733, nov.-dez. 2005. tab, graf
Artículo en Portugués | LILACS | ID: lil-420178

RESUMEN

OBJETIVO: Realizar o primeiro censo brasileiro de cirurgia refrativa. MÉTODOS: Entre agosto de 2001 e fevereiro de 2002 foram enviados questionários para 7.890 oftalmologistas brasileiros, com questões sobre aspectos demográficos, tendências, padrões de práticas, instrumentos, cuidados pré-operatórios e mercado da cirurgia refrativa. RESULTADOS: Novecentos e vinte questionários (11,67 por cento) foram devidamente respondidos. O laser in situ ceratomileuse é a técnica preferida para correção de dioptrias entre +5,00 e -7,00 D. O excimer laser mais utilizado é o Nidek® EC 5000 e o microceratótomo mais freqüente é o Hansatome. Outros aspectos como: demográficos, procedimentos, técnicas, tendências, volume cirúrgico, cuidados pré-operatórios e mercado também foram analisados. CONCLUSÃO: A partir desta pesquisa, pode-se observar e monitorar aspectos demográficos, padrões de práticas, tendências, tecnologia e mercado da cirurgia refrativa no Brasil e compará-las com outras pesquisas semelhantes em outras partes do mundo.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Encuestas Epidemiológicas , Cirugía Laser de Córnea , Pautas de la Práctica en Medicina/estadística & datos numéricos , Errores de Refracción/cirugía , Brasil , Cirugía Laser de Córnea/economía , Cirugía Laser de Córnea/instrumentación , Queratomileusis por Láser In Situ/economía , Queratomileusis por Láser In Situ , Complicaciones Posoperatorias , Periodo Posoperatorio , Errores de Refracción/economía
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