Visual performance after toric IOL implantation in patients with corneal astigmatism.

PURPOSE: To analyze visual acuity without correction and rotational stability outcomes following toric IOL implantation. METHODS: Prospective study of 20 eyes of 13 patients that underwent phacoemulsification surgery indicated for cataract associated with regular keratomeric astigmatism, symmetrical, ranging from 1 to 4 diopters. Best corrected visual acuity, refraction, keratometry and computed topography were performed preoperatively. The calculation of cylindrical lens power and its placement were determined by the manufacturer. All lenses were implanted in the capsular bag by the same surgeon. The patients were examined by a second independent observer, at 1st, 10th, 20th, 30th, and 60th postoperative day. RESULTS: Visual acuity without correction ranged between 20/15 and 20/40. One eye achieved 20/15 (5%), 4 eyes 20/20 (20%), 6 eyes 20/25 (30%), 7 eyes 20/30 (35%) and 2 eyes 20/40 (10%). Best corrected visual acuity ranged between 20/15 and 20/40; two eyes with 20/15 (10%), 9 eyes 20/20 (45%), 7 eyes 20/25 (35%), 1 eye 20/30 (5%) and 1 eye 20/40 (5%). It is important to remember that the average spherical refraction was -0.05 SD (ranging from -0.50 to +0.75 SD). The mean cylindrical refraction was -0.63 CD ranging from -0.50 to -1.25 CD. The IOL rotation in this study had an average of 3.2 masculine to 30 masculine, ranging from 0 masculine of rotation to a maximum of 13 masculine; 7 lenses (35%) suffered no rotation, 9 lenses (45%) suffered rotation between 1 masculine to 5 masculine, 3 lenses (15%) had rotation between 6 masculine to 10 masculine, and ultimately 1 lens (5%) had rotation between 11 masculine to 15 masculine. There was no significant rotation after the 30th postoperative day. DISCUSSION: The average of rotation of the IOL was 3.2 masculine, where 95% of IOLs presented rotation less than or equal to 10 masculine what means a very good rotational stability. In daily practice, a good visual acuity is directly related to IOL rotational stability and refractive predictability.

[Evaluation of the quality of donor corneas in relation to the age of donor and cause of death]. / Avaliação da qualidade das córneas doadoras em relação à idade do doador e causa do óbito.

PURPOSE: To analyze the quality of the corneas evaluated by slit lamp examination in the Eye Bank of the Hospital de Clínicas UFPR and its relation to donor age and cause of death. METHODS: Analysis of 492 corneas, evaluated in BTO HC-UFPR between August 2006 to August 2008. Each cornea was classified regarding the quality as: very good, good, regular and bad; and according to clarity, epithelial defect, stromal edema, Descemet's folds, stromal opacity, corneal scarring, endothelial density and guttata. RESULTS: The mean donor age was 42.74 years (sd=17.77 years). Among the causes of death, trauma was the most common with 46.18%, followed by cardiovascular causes with 41.86%. In relation to the cornea, 57.11% were classified as 'good', followed by 20.73% as 'regular', 16.87% as 'very good' and 5.28% as 'bad'. With the application of statistical tests based on ordinal regression model, trauma deaths corneas tend to be better, as well as those of younger patients. CONCLUSIONS: Statistically, the corneas from younger donors tend to have better graduations in the assessment, as well as the corneas from donors dead by trauma that tend to have better quality when compared to corneas from donors dead by cardiovascular and other systemic diseases.

Avaliação da qualidade das córneas doadoras em relação à idade do doador e causa do óbito / Evaluation of the quality of donor corneas in relation to the age of donor and cause of death

OBJETIVO: Analisar a qualidade das córneas avaliadas em lâmpada de fenda no Banco de Tecidos Oculares do Hospital de Clínicas da Universidade Federal do Paraná (BTO HC-UFPR) relacionando com a idade e causa de óbito. MÉTODOS: Foram analisadas retrospectivamente fichas de avaliações padronizadas de 492 córneas, avaliadas no BTO HC-UFPR, do período de agosto de 2006 a agosto de 2008. Cada córnea avaliada foi classificada em relação a sua qualidade em: Muito bom, bom, regular e ruim; mediante os seguintes fatores: claridade da córnea, edema epitelial, defeito epitelial, edema estromal, dobras de Descemet, opacidade estromal, cicatrizes corneanas, densidade endotelial e guttata. RESULTADOS: A idade média dos doadores foi de 42,74 anos (dp=17,77). Dentre as causas de óbito, a mais comum foi trauma com 46,18 por cento, seguindo por causas cardiovasculares com 41,86 por cento. Na avaliação da córnea, foram classificadas: 57,11 por cento como "bom", seguido por 20,73 por cento "regular", 16,87 por cento "muito bom" e 5,28 por cento "ruim". Com aplicação de testes estatísticos baseados em modelo de regressão ordinal verificou-se que as córneas provenientes de mortes por traumas tendem a ser melhores, bem como aquelas de pacientes mais jovens. CONCLUSÕES: Estatisticamente, córneas de doadores mais jovens tendem a ter melhores graduações na avaliação, bem como córneas provenientes de doadores com morte por trauma tendem a ser de melhor qualidade quando comparadas com as provenientes de mortes por doenças cardiovasculares e outras doenças sistêmicas.

PURPOSE: To analyze the quality of the corneas evaluated by slit lamp examination in the Eye Bank of the Hospital de Clínicas UFPR and its relation to donor age and cause of death. METHODS: Analysis of 492 corneas, evaluated in BTO HC-UFPR between August 2006 to August 2008. Each cornea was classified regarding the quality as: very good, good, regular and bad; and according to clarity, epithelial defect, stromal edema, Descemet's folds, stromal opacity, corneal scarring, endothelial density and guttata. RESULTS: The mean donor age was 42.74 years (sd=17.77 years). Among the causes of death, trauma was the most common with 46.18 percent, followed by cardiovascular causes with 41.86 percent. In relation to the cornea, 57.11 percent were classified as "good", followed by 20.73 percent as "regular", 16.87 percent as "very good" and 5.28 percent as "bad". With the application of statistical tests based on ordinal regression model, trauma deaths corneas tend to be better, as well as those of younger patients. CONCLUSIONS: Statistically, the corneas from younger donors tend to have better graduations in the assessment, as well as the corneas from donors dead by trauma that tend to have better quality when compared to corneas from donors dead by cardiovascular and other systemic diseases.

Performance visual após implante de LIO tórica em pacientes com astigmatismo corneano / Visual performance after toric IOL implantation in patients with corneal astigmatism

OBJETIVO: Avaliar acuidade visual final sem correção e com correção e estabilidade rotacional da LIO. MÉTODOS: Estudo prospectivo de 20 olhos de 13 pacientes submetidos à facoemulsificação, por catarata associado a astigmatismo ceratométrico regular, simétrico, variando de 1 a 4 dioptrias. No pré-operatório foram avaliadas a melhor acuidade visual corrigida, a refração, a ceratometria e topografia computadorizada. O cálculo do poder cilíndrico da lente e seu posicionamento foram determinados pelo fabricante. Todas as lentes foram implantadas por um mesmo cirurgião, dentro do saco capsular. Os pacientes foram analisados por um segundo observador, no 1É, 10É, 20É, 30É e 60É dia pós-operatório. RESULTADOS: A acuidade visual dos pacientes deste estudo sem correção variou entre 20/15 e 20/40, sendo 1 olho com 20/15 (5 por cento), 4 olhos 20/20 (20 por cento), 6 olhos 20/25 (30 por cento), 7 olhos 20/30 (35 por cento) e 2 olhos 20/40 (10 por cento). A acuidade visual com a melhor correção variou entre 20/15 e 20/40, sendo 2 olhos com 20/15 (10 por cento), 9 olhos 20/20 (45 por cento), 7 olhos 20/25 (35 por cento), 1 olho 20/30 (5 por cento) e 1 olho 20/40 (5 por cento). Lembrando ainda que a refração esférica média foi de -0,05 DE variando entre -0,50 até +0,75. Refração cilíndrica teve média de -0,63 DC, variando entre -0,50 e -1,25 DC. A rotação da LIO teve uma média de 3,2º até o 30É dia pós-operatório, variando de 0º de rotação e rotação máxima de 13º, sendo que 7 lentes (35 por cento) não sofreram rotação, 9 lentes (45 por cento) sofreram rotação entre 1º e 5º, 3 lentes (15 por cento) tiveram rotação entre 6º e 10º e por fim 1 lente (5 por cento) teve rotação entre 11º e 15º. Não houve rotação significativa após o 30É dia pós-operatório. DISCUSSÃO: A média da rotação da LIO foi de 3,2º, onde 95 por cento das LIO tiveram rotação menor ou igual a 10º, o que se traduz em uma estabilidade rotacional muito boa. Na prática percebemos que a boa...

PURPOSE: To analyze visual acuity without correction and rotational stability outcomes following toric IOL implantation. METHODS: Prospective study of 20 eyes of 13 patients that underwent phacoemulsification surgery indicated for cataract associated with regular keratomeric astigmatism, symmetrical, ranging from 1 to 4 diopters. Best corrected visual acuity, refraction, keratometry and computed topography were performed preoperatively. The calculation of cylindrical lens power and its placement were determined by the manufacturer. All lenses were implanted in the capsular bag by the same surgeon. The patients were examined by a second independent observer, at 1st, 10th, 20th, 30th, and 60th postoperative day. RESULTS: Visual acuity without correction ranged between 20/15 and 20/40. One eye achieved 20/15 (5 percent), 4 eyes 20/20 (20 percent), 6 eyes 20/25 (30 percent), 7 eyes 20/30 (35 percent) and 2 eyes 20/40 (10 percent). Best corrected visual acuity ranged between 20/15 and 20/40; two eyes with 20/15 (10 percent), 9 eyes 20/20 (45 percent), 7 eyes 20/25 (35 percent), 1 eye 20/30 (5 percent) and 1 eye 20/40 (5 percent). It is important to remember that the average spherical refraction was -0.05 SD (ranging from -0.50 to +0.75 SD). The mean cylindrical refraction was -0.63 CD ranging from -0.50 to -1.25 CD. The IOL rotation in this study had an average of 3.2º to 30º, ranging from 0º of rotation to a maximum of 13º; 7 lenses (35 percent) suffered no rotation, 9 lenses (45 percent) suffered rotation between 1º to 5º, 3 lenses (15 percent) had rotation between 6º to 10º, and ultimately 1 lens (5 percent) had rotation between 11º to 15º. There was no significant rotation after the 30th postoperative day. DISCUSSION: The average of rotation of the IOL was 3.2º, where 95 percent of IOLs presented rotation less than or equal to 10º what means a very good rotational stability. In daily practice, a good visual acuity is directly related to...

Uso de corticóide sistêmico e intravítreo na inflamação secundária a cisticercose intra-ocular: relato de caso / The use of systemic and intravitreous steroid in inflammation secondary to intraocular cysticercosis: case report

A cisticercose é uma parasitose causada por ovos de Taenia solium, que pode acometer diversos tecidos como coração, músculo esquelético, cérebro e olhos. Neste estudo será descrito o caso de um paciente de 62 anos do sexo masculino encaminhado com queixa de baixa acuidade visual progressiva no olho direito há dois meses. O exame biomicroscópico e ultra-sonográfico permitiu o diagnóstico ocular de cisticercose intravítrea. Foi realizada cirurgia de vitrectomia via pars plana para remoção do parasita e no intra-operatório ocorreu ruptura do cisto com extravasamento intravítreo. Durante o procedimento foram injetadas 400 microgramas de dexametasona intravítreo e prescrito 60 mg/dia de prednisona via oral por 14 dias. O paciente evoluiu com recuperação visual e acuidade visual final de 20/25, retina aplicada e vítreo claro. Em conclusão, farmacoterapia com corticóide intravítreo associada à terapia com corticóide sistêmico pode ser considerada como alternativa a ser associada para o controle inflamatório após cirurgia vitreorretiniana de cisticercose ocular.

Cysticercosis is a parasitosis caused by Taenia solium eggs that could affect several tissues, such as heart, skeletal muscles, brain and eyes. This study describes the case of a 62-year-old male who complained of progressively loss of vision in his right eye for two months. Slit-lamp and ultrasound exams suggested a diagnosis of intravitreous cysticercosis. The patient underwent pars plana vitrectomy to remove the intravitreous parasite. Intraoperatively the cyst ruptured and leaked into the vitreous cavity. Therefore, 400 µg of intravitreous dexamethasone was injected intraoperatively, and 60 mg/day of prednisone PO was prescribed for 14 days. The post-operative best corrected visual acuity was 20/25, the retina was attached and vitreous remained clear. In conclusion, drug therapy with intravitreous corticosteroids associated with systemic steroids showed to be an alternative approach to control inflammation following vitreoretinal surgery.

[The use of systemic and intravitreous steroid in inflammation secondary to intraocular cysticercosis: case report]. / Uso de corticóide sistêmico e intravítreo na inflamação secundária a cisticercose intra-ocular: relato de caso.

Cysticercosis is a parasitosis caused by Taenia solium eggs that could affect several tissues, such as heart, skeletal muscles, brain and eyes. This study describes the case of a 62-year-old male who complained of progressively loss of vision in his right eye for two months. Slit-lamp and ultrasound exams suggested a diagnosis of intravitreous cysticercosis. The patient underwent pars plana vitrectomy to remove the intravitreous parasite. Intraoperatively the cyst ruptured and leaked into the vitreous cavity. Therefore, 400 microg of intravitreous dexamethasone was injected intraoperatively, and 60 mg/day of prednisone PO was prescribed for 14 days. The post-operative best corrected visual acuity was 20/25, the retina was attached and vitreous remained clear. In conclusion, drug therapy with intravitreous corticosteroids associated with systemic steroids showed to be an alternative approach to control inflammation following vitreoretinal surgery.