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Medicinas Complementárias
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1.
Transl Vis Sci Technol ; 12(9): 20, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37750746

RESUMEN

Purpose: To evaluate the efficacy of topical losartan after blast injury-simulating irregular phototherapeutic keratectomy (PTK) in rabbits. Methods: Twelve NZW rabbits underwent 100 pulse 6.5 mm diameter PTK over a metal screen to generate severe surface irregularity and inhibit epithelial basement membrane regeneration. Corneas were treated with 0.8 mg/mL losartan in balanced salt solution (BSS) or BSS 50 µL six times per day for six weeks after PTK. All corneas had slit lamp photography, with and without 1% fluorescein at two, four, and six weeks after PTK, and were analyzed using immunohistochemistry for the myofibroblast marker α-smooth muscle actin (α-SMA), keratocyte marker keratocan, mesenchymal cell marker vimentin, transforming growth factor (TGF)-ß1, and collagen type IV. Results: Topical 0.8 mg/mL losartan six times a day significantly decreased anterior stromal α-SMA intensity units compared to BSS at six weeks after anterior stromal irregularity-inducing screened PTK (P = 0.009). Central corneal opacity, however, was not significantly different between the two groups. Keratocan, vimentin, TGF-ß1, or collagen type IV levels in the anterior stroma were not significantly different between the two groups. Conclusions: Topical losartan effectively decreased myofibroblast generation after surface blast simulation irregular PTK. However, these results suggest initial masking-smoothing PTK, along with adjuvant topical losartan therapy, may be needed to decrease corneal stromal opacity after traumatic injuries that produce severe surface irregularity. Translational Relevance: Topical losartan decreased scar-producing stromal myofibroblasts after irregular PTK over a metal screen but early smoothing of irregularity would also likely be needed to significantly decrease corneal opacity.


Asunto(s)
Opacidad de la Córnea , Losartán , Conejos , Animales , Losartán/farmacología , Miofibroblastos , Vimentina , Colágeno Tipo IV , Opacidad de la Córnea/tratamiento farmacológico
2.
Arq Bras Oftalmol ; 78(3): 173-4, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26222107

RESUMEN

PURPOSE: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. METHODS: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30) and a control (n=30) group. RESULTS: There were no records of intraoperative or postoperative intracameral bleeding complications in both the groups. At 1-month postoperative follow-up, 90.0% of patients presented spectacle-corrected visual acuity of at least 20/40. CONCLUSION: Cataract surgery by phacoemulsification with topical anesthesia can be successfully conducted without discontinuing warfarin.


Asunto(s)
Anticoagulantes/administración & dosificación , Extracción de Catarata/métodos , Warfarina/administración & dosificación , Administración Oral , Anestesia Local , Anestésicos Locales/administración & dosificación , Extracción de Catarata/efectos adversos , Hemorragia del Ojo/inducido químicamente , Estudios de Seguimiento , Humanos , Relación Normalizada Internacional/métodos , Periodo Intraoperatorio , Implantación de Lentes Intraoculares , Hemorragia Posoperatoria/inducido químicamente , Estudios Prospectivos , Agudeza Visual
3.
Arq. bras. oftalmol ; 78(3): 173-174, May-Jun/2015.
Artículo en Inglés | LILACS | ID: lil-753013

RESUMEN

ABSTRACT Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30) and a control (n=30) group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications in both the groups. At 1-month postoperative follow-up, 90.0% of patients presented spectacle-corrected visual acuity of at least 20/40. Conclusion: Cataract surgery by phacoemulsification with topical anesthesia can be successfully conducted without discontinuing warfarin. .


RESUMO Objetivo: Avaliar a segurança da cirurgia de catarata com anestesia tópica em pacientes em uso de varfarina. Métodos: Estudo comparativo não aleatorizado, prospectivo de 30 olhos de 30 indivíduos sob terapia anticoagulante por via oral com Varfarina que se submeteram à cirurgia de catarata com anestesia tópica. O grupo controle foi composto por 30 olhos de 30 pacientes, com indicação de cirurgia de catarata, que não faziam uso de terapia anticoagulante. Resultados: Não houve registro de complicações hemorrágicas intracamerais transoperatórias ou pós-operatórias em ambos os grupos. Na visita pós-operatória de 30 dias, 90,0% dos pacientes apresentavam acuidade visual corrigida por óculos de pelo menos 20/40. Conclusão: A cirurgia de catarata por facoemulsificação com anestesia tópica pode ser realizada com sucesso sem interrupção da terapia com varfarina. .


Asunto(s)
Humanos , Anticoagulantes/administración & dosificación , Extracción de Catarata/métodos , Warfarina/administración & dosificación , Administración Oral , Anestesia Local , Anestésicos Locales/administración & dosificación , Extracción de Catarata/efectos adversos , Hemorragia del Ojo/inducido químicamente , Estudios de Seguimiento , Periodo Intraoperatorio , Relación Normalizada Internacional/métodos , Implantación de Lentes Intraoculares , Estudios Prospectivos , Hemorragia Posoperatoria/inducido químicamente , Agudeza Visual
4.
Clinics (Sao Paulo) ; 67(9): 1059-62, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23018304

RESUMEN

OBJECTIVE: This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification. METHODS: This prospective, randomized clinical trial comprised 78 eyes (39 patients) that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate or 2.0% hydroxypropylmethylcellulose on the first eye. The other eye was treated later and received the other viscoelastic agent. Preoperative and postoperative examinations (5, 24 and 48 hours; 7 and 14 days; 3 and 6 months) included measurements of the total volume of the ophthalmic viscosurgical device, ultrasound and washout times to completely remove the ophthalmic viscosurgical device, intraocular pressure, central corneal thickness and best-corrected visual acuity. The corneal endothelial cell count was measured at baseline and at six months postoperatively. ClinicalTrials.gov: NCT01387620. RESULTS: There were no statistically significant differences between groups in terms of cataract density or ultrasound time. However, it took longer to remove 2.0% hydroxypropylmethylcellulose than 1.6% hyaluronic acid/ 4.0% chondroitin sulfate, and the amount of viscoelastic material used was greater in the 2.0% hydroxypropylmethylcellulose group. In addition, the best-corrected visual acuity was significantly better in the hyaluronic acid/ chondroitin sulfate group, but this preferable outcome was only observed at 24 hours after the operation. There were no statistically significant differences between the two ophthalmic viscosurgical devices regarding the central corneal thickness or intraocular pressure measurements at any point in time. The corneal endothelial cell count was significantly higher in the hyaluronic acid/chondroitin sulfate group. CONCLUSION: The ophthalmic viscosurgical device consisting of 1.6% hyaluronic acid/4.0% chondroitin sulfate was more efficient during phacoemulsification and was easier to remove after IOL implantation than 2.0% hydroxypropylmethylcellulose. In addition, the corneal endothelial cell count was significantly higher following the use of hyaluronic acid/chondroitin sulfate than with hydroxypropylmethylcellulose, which promoted an improved level of corneal endothelium protection.


Asunto(s)
Metilcelulosa/análogos & derivados , Soluciones Oftálmicas/administración & dosificación , Facoemulsificación/métodos , Anciano , Sulfatos de Condroitina/administración & dosificación , Métodos Epidemiológicos , Femenino , Humanos , Ácido Hialurónico/administración & dosificación , Derivados de la Hipromelosa , Presión Intraocular , Masculino , Metilcelulosa/administración & dosificación , Persona de Mediana Edad , Periodo Perioperatorio , Facoemulsificación/instrumentación , Factores de Tiempo , Resultado del Tratamiento , Viscosuplementos/administración & dosificación , Agudeza Visual
5.
Clinics ; 67(9): 1059-1062, Sept. 2012. tab
Artículo en Inglés | LILACS | ID: lil-649386

RESUMEN

OBJECTIVE: This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification. METHODS: This prospective, randomized clinical trial comprised 78 eyes (39 patients) that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate or 2.0% hydroxypropylmethylcellulose on the first eye. The other eye was treated later and received the other viscoelastic agent. Preoperative and postoperative examinations (5, 24 and 48 hours; 7 and 14 days; 3 and 6 months) included measurements of the total volume of the ophthalmic viscosurgical device, ultrasound and washout times to completely remove the ophthalmic viscosurgical device, intraocular pressure, central corneal thickness and best-corrected visual acuity. The corneal endothelial cell count was measured at baseline and at six months postoperatively. ClinicalTrials.gov: NCT01387620. RESULTS: There were no statistically significant differences between groups in terms of cataract density or ultrasound time. However, it took longer to remove 2.0% hydroxypropylmethylcellulose than 1.6% hyaluronic acid/ 4.0% chondroitin sulfate, and the amount of viscoelastic material used was greater in the 2.0% hydroxypropylmethylcellulose group. In addition, the best-corrected visual acuity was significantly better in the hyaluronic acid/ chondroitin sulfate group, but this preferable outcome was only observed at 24 hours after the operation. There were no statistically significant differences between the two ophthalmic viscosurgical devices regarding the central corneal thickness or intraocular pressure measurements at any point in time. The corneal endothelial cell count was significantly higher in the hyaluronic acid/chondroitin sulfate group. CONCLUSION: The ophthalmic viscosurgical device consisting of 1.6% hyaluronic acid/4.0% chondroitin sulfate was more efficient during phacoemulsification and was easier to remove after IOL implantation than 2.0% hydroxypropylmethylcellulose. In addition, the corneal endothelial cell count was significantly higher following the use of hyaluronic acid/chondroitin sulfate than with hydroxypropylmethylcellulose, which promoted an improved level of corneal endothelium protection.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metilcelulosa/análogos & derivados , Soluciones Oftálmicas/administración & dosificación , Facoemulsificación/métodos , Sulfatos de Condroitina/administración & dosificación , Métodos Epidemiológicos , Ácido Hialurónico/administración & dosificación , Presión Intraocular , Metilcelulosa/administración & dosificación , Periodo Perioperatorio , Facoemulsificación/instrumentación , Factores de Tiempo , Resultado del Tratamiento , Agudeza Visual , Viscosuplementos/administración & dosificación
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