Assuntos
Acuidade Visual , Humanos , Feminino , Masculino , Córnea/anormalidades , Córnea/patologia , Córnea/diagnóstico por imagem , Aberrações de Frente de Onda da Córnea/fisiopatologia , Aberrações de Frente de Onda da Córnea/diagnóstico , Lactente , Glaucoma/congênito , Glaucoma/fisiopatologia , Glaucoma/diagnóstico , Pressão Intraocular/fisiologia , Hidroftalmia/diagnóstico , Hidroftalmia/fisiopatologia , Hidroftalmia/cirurgia , Pré-EscolarRESUMO
Epithelial ingrowth is one of the most significant complications of Laser in Situ Keratomileusis (LASIK) refractive surgery. We present the case of a 72-year-old male with a history of myopic LASIK (1999), who underwent cataract surgery and a second thin LASIK sub-Bowman flap to correct refractive error. Then, three months after pars plana vitrectomy for an epiretinal membrane, the patient complained of progressive vision loss. A diffuse haze of the corneal stroma that did not exist before surgery was observed. As the main suspicion was epithelial ingrowth, the flap was lifted and meticulous de-epithelialization of the stromal bed was performed. Mitomycin C 0.02% was applied, the flap was sutured with 10-0 Nylon, and a bandage contact lens was placed. The epithelialization of the interface after vitrectomy in a patient with LASIK could occur even when it is a rare complication and without obvious flap traumatism.
Assuntos
Epitélio Corneano , Ceratomileuse Assistida por Excimer Laser In Situ , Vitrectomia , Humanos , Masculino , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Idoso , Vitrectomia/efeitos adversos , Epitélio Corneano/patologia , Complicações Pós-Operatórias/etiologia , Retalhos Cirúrgicos , Fatores de Tempo , Reoperação , Membrana Epirretiniana/cirurgia , Membrana Epirretiniana/etiologia , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgiaRESUMO
Age-related macular degeneration (AMD) is one of the main causes of visual acuity (VA) loss in people over 50 years of age worldwide, with neovascular AMD (nAMD) accounting for 80% of cases of severe vision loss due to this disease. Anti-vascular endothelial growth factor (anti-VEGF) drugs have been used for the treatment of this disease for more than a decade, changing drastically the visual prognosis of these patients. However, initial studies reporting data on outcomes were short term. Currently, there are different series published on the long-term results of AMD after treatment with anti-VEGF, and the aim of this review is to synthesize these results. The mean follow-up of the included studies was 8.2 years (range 5-12 years). The mean initial VA was 55.3 letters in the Early Treatment Diabetic Retinopathy Study (ETDRS) (range 45.6-65) and the mean final VA was 50.1 letters (range 33.0-64.3), with a mean loss of 5.2 letters. At the end of follow-up, 29.4% of the patients maintained a VA > 70 letters. The 67.9% of patients remained stable at the end of follow-up (< 15 letter loss), with a severe loss (≥ 15 letters) of 30.1%. Fibrosis and atrophy were the main causes of long-term VA loss, occurring at the end of follow-up in 52.5% and 60.5%, respectively.