Amniotic membrane transplantation in ocular surface diseases / Transplante de membrana amniótica em doenças da superfície ocular

Abstract Objective: To evaluate the clinical effectiveness of amniotic membrane transplantation for ocular surface reconstruction. Methods: Prospective study including 23 eyes of 21 patients who underwent amniotic membrane transplantation at Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR) and at Cirurgia e Diagnose em Oftalmologia do Paraná (CDOP) clinic, located in Curitiba, PR, Brazil, from may 2015 to july 2019. The amniotic membrane was collected from elective and term cesarean delivery, and conserved in preservation medium and glycerol 1:1, stored at -80° Celsius. The membrane was fixed on the ocular surface with 10-0 nylon, 8-0 vicryl, biological glue or a combination of these materials. Results: The ocular surface reconstruction was successful in 22 eyes (95.6%). Failure was observed only in 1 case (bullous keratopathy) in which the condition was maintained postoperatively. Patients' age ranged from 11-82 years, with a mean age of 37.4 years. There was a higher incidence in males (66.6%). A difference was perceived in the distribution of the affected eye (which was greater in the right eye - 65.2%). As for the previous ophthalmic surgery history, 12 of the 23 eyes had a positive history (52.2%). It was observed that all patients who had preoperative visual acuity assessed showed improvement or maintenance of corrected visual acuity. In the postoperative period, complications associated with the underlying disease were observed, although not particularly related to the amniotic membrane transplantation. There were not any cases of postoperative infection. Conclusions: There was an improvement in the general state of the ocular surface in almost all of the cases in which the transplant was performed. Therefore, the amniotic membrane can be considered a good alternative for reconstructing the ocular surface, as a single or supporting treatment.

Resumo Objetivo: Avaliar a eficácia clínica do transplante de membrana amniótica na reconstrução da superfície ocular. Métodos: Estudo prospectivo incluiu 23 olhos de 21 pacientes que realizaram transplante de membrana amniótica no Hospital de Clínicas da Universidade Federal do Paraná (UFPR) e na clínica de Cirurgia e Diagnose em Oftalmologia do Paraná (CDOP), localizados em Curitiba, PR, Brasil, no período de maio de 2015 a julho de 2019. A membrana amniótica foi captada a partir de parto cesárea eletivo e a termo, conservada em meio de preservação e glicerol 1:1 e armazenada a -80° Celsius. A membrana foi fixada na superfície ocular com fio nylon 10-0 ou vicryl 8-0 e/ou cola biológica. Resultados: A idade dos pacientes variou de 11-82 anos, com média de 37,4 anos. Houve maior incidência no sexo masculino (66,6%). Ocorreu diferença na distribuição do olho acometido (maior no olho direito - 65,2%). Quanto à história de cirurgia oftalmológica prévia, 12 dos 23 olhos tinham história positiva (52,2%). Observamos que nos pacientes em que foi possível a avaliação da acuidade visual pré-operatória, todos apresentaram melhora ou manutenção da acuidade visual. No pós-operatório foi observado complicações associadas à doença de base e não propriamente ao transplante de membrana amniótica. Não foram registrados casos de infecção pós-operatória. Conclusão: Houve melhora do estado geral da superfície ocular em quase totalidade dos casos em que o transplante foi realizado. Portanto, a membrana amniótica pode ser considerada uma boa alternativa para reconstrução da superfície ocular, como tratamento único ou coadjuvante.

Prostaglandin antagonist relieves blood-retinal barrier breakdown induced by anterior segment intraocular surgery in a rat model.

PURPOSE: To evaluate the efficacy of prostaglandin antagonists on blood-retinal barrier breakdown induced by anterior segment intraocular simulated surgery. METHODS: Rats were randomly assigned to a negative control group, model group, nonsteroidal anti-inflammatory drugs prophylactic treatment group, nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, and corticosteroid treatment group. Four hours and 48h after modeling, the concentrations of PGE1, PGE2, and PGF2 α in the aqueous humor and vitreous body of the rat model were visualized using ELISA. The integrity of the blood-retinal barrier was quantitatively measured using Evan's blue as a tracer. RESULTS: Four hours after modeling, the concentrations of PGE1, PGE2, and PGF2α in the aqueous humor and vitreous body in the negative control group and the nonsteroidal anti-inflammatory drugs prophylactic treatment group were significantly lower than those in the model group. The concentrations of PGE1, PGE2, and PGF2α in the aqueous humor and vitreous body in the corticosteroid prophylactic treatment group were higher than those in the negative control group and the nonsteroidal anti-inflammatory drugs prophylactic treatment group. Forty-eight hours after modeling, the concentrations of PGE1, PGE2, and PGF2α in the aqueous humor and vitreous body in the nonsteroidal anti-inflammatory drugs prophylactic treatment group, nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, and corticosteroid treatment group were lower than those in the model group, but higher than those in the negative group. Retinal Evan's blue leakage in the nonsteroidal anti-inflammatory drugs prophylactic treatment group was higher than that in the negative control group, and lower than those in the nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, corticosteroid treatment group, and model group. Retinal Evan's blue leakage in the nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, and corticosteroid treatment group were lower than those in the model group. CONCLUSIONS: This study confirms that prostaglandin antagonists can relieve blood-retinal barrier breakdown in a rat model and that nonsteroidal anti-inflammatory drugs prophylactic treatment can achieve better efficacy.

Prostaglandin antagonist relieves blood-retinal barrier breakdown induced by anterior segment intraocular surgery in a rat model / O antagonista das prostaglandinas alivia a ruptura da barreira sanguínea retiniana induzida pela cirurgia intraocular do segmento anterior em um modelo em ratos

ABSTRACT Purpose: To evaluate the efficacy of prostaglandin antagonists on blood-retinal barrier breakdown induced by anterior segment intraocular simulated surgery. Methods: Rats were randomly assigned to a negative control group, model group, nonsteroidal anti-inflammatory drugs prophylactic treatment group, nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, and corticosteroid treatment group. Four hours and 48h after modeling, the concentrations of PGE1, PGE2, and PGF2 α in the aqueous humor and vitreous body of the rat model were visualized using ELISA. The integrity of the blood-retinal barrier was quantitatively measured using Evan's blue as a tracer. Results: Four hours after modeling, the concentrations of PGE1, PGE2, and PGF2α in the aqueous humor and vitreous body in the negative control group and the nonsteroidal anti-inflammatory drugs prophylactic treatment group were significantly lower than those in the model group. The concentrations of PGE1, PGE2, and PGF2α in the aqueous humor and vitreous body in the corticosteroid prophylactic treatment group were higher than those in the negative control group and the nonsteroidal anti-inflammatory drugs prophylactic treatment group. Forty-eight hours after modeling, the concentrations of PGE1, PGE2, and PGF2α in the aqueous humor and vitreous body in the nonsteroidal anti-inflammatory drugs prophylactic treatment group, nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, and corticosteroid treatment group were lower than those in the model group, but higher than those in the negative group. Retinal Evan's blue leakage in the nonsteroidal anti-inflammatory drugs prophylactic treatment group was higher than that in the negative control group, and lower than those in the nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, corticosteroid treatment group, and model group. Retinal Evan's blue leakage in the nonsteroidal anti-inflammatory drugs treatment group, corticosteroid prophylactic treatment group, and corticosteroid treatment group were lower than those in the model group. Conclusions: This study confirms that prostaglandin antagonists can relieve blood-retinal barrier breakdown in a rat model and that nonsteroidal anti-inflammatory drugs prophylactic treatment can achieve better efficacy.

RESUMO Objetivos: Avaliar a eficácia do antagonista de prostaglandinas no rompimento da barreira hemato-retiniana induzida por cirurgia simulada intraocular do segmento anterior. Métodos: Os ratos foram divididos aleatoriamente em grupo controle negativo, grupo modelo, grupo de tratamento profilático com drogas anti-inflamatórias não esteroides, grupo de tratamento com anti-inflamatórias não esteroides, grupo de tratamento profilático com corticosteroides e grupo de tratamento com corticosteroides. Quatro e 48h após a modelagem, as concentrações de PGE1, PGE2 e PGF2 α no humor aquoso e no corpo vítreo em modelo em ratos foram detectadas através de Elisa. A integridade da barreira hemato-retiniana foi quantitativamente mensurada utilizando o azul de Evans como marcador. Resultados: Quatro horas após a modelagem, as concentrações de PGE1, PGE2 e PGF2α no humor aquoso e no corpo vítreo no grupo controle negativo e no grupo de tratamento profilático com anti-inflamatórias não esteroides foram significativamente menores do que as do grupo modelo. As concentrações de PGE1, PGE2 e PGF2α no humor aquoso e no corpo vítreo no grupo de tratamento profilático com corticosteroides foram maiores do que as observadas no grupo controle negativo e no grupo de tratamento profilático com anti-inflamatórias não esteroides. 48h após a modelagem, as concentrações de PGE1, PGE2 e PGF2α no humor aquoso e no corpo vítreo no grupo de tratamento profilático com anti-inflamatórias não esteroides, no grupo de tratamento com anti-inflamatórias não esteroides, no grupo de tratamento profilático com corticosteroides e no grupo de tratamento com corticosteroides foram menores do que as observadas no grupo modelo e maiores que as observadas no grupo negativo. O extravasamento retinal de azul de Evans no grupo de tratamento profilático com anti-inflamatórias não esteroides foi maior que no grupo controle negativo e menor que nos grupos de tratamento com anti-inflamatórias não esteroides, de tratamento profilático com corticosteroides, de tratamento com corticosteroides e no grupo modelo. O extravasamento retinal de azul de Evans observado nos grupos de tratamento com anti-inflamatórias não esteroides, de tratamento profilático com corticosteroides e de tratamento com corticosteroides foi inferior ao observado no grupo modelo. Conclusões: Este estudo valida que o antagonista das prostaglandinas pode aliviar a ruptura da barreira hemato-retiniana em um modelo em ratos e que o tratamento profilático com anti-inflamatórias não esteroides pode alcançar melhor eficácia.

ANTERIOR LENS CAPSULE IN THE MANAGEMENT OF CHRONIC FULL-THICKNESS MACULAR HOLE.

PURPOSE: To report the use of anterior lens capsule flap transplantation in two cases with chronic full-thickness macular hole (MH). METHODS: Case series. RESULTS: Two cases of chronic MH with a new treatment approach were reported. In the first case, a 66-year-old man presented with a chronic idiopathic MH in the left eye for 2 years. Presenting visual acuity was hand motion. The patient underwent phacoemulsification and vitrectomy with anterior lens capsule flap transplantation in the MH. At 5 months postoperatively, the visual acuity was 20/200 with MH closure. In the second case, a 68-year-old woman presented with decreased visual acuity for 2 years. Her visual acuity was hand motion in the right eye. The patient underwent phacoemulsification and vitrectomy with anterior lens capsule flap transplantation in the MH. Visual acuity improved to 20/400 with reduction in the MH diameter. Vision and MH diameter remained stable over 5 months postoperatively. CONCLUSION: Lens capsular flap transplantation is useful in closing chronic MH in the short term.

Síndrome tóxico del segmento anterior en el Hospital Oftalmológico Amistad Argelia-Cuba, en Djelfa / Toxic syndrome of the anterior segment in Amistad Argelia-Cuba Ophthalmological Hospital in Djelfa

Objetivos: describir un brote de síndrome tóxico del segmento anterior ocurrido en el Servicio de Catarata del Hospital Oftalmológico Amistad Argelia-Cuba, en Djelfa, en el año 2015. Métodos: se realizó un estudio descriptivo de corte transversal donde se incluyeron 14 casos notificados con diagnóstico de síndrome tóxico del segmento anterior, operados en el Servicio de Catarata del Hospital Oftalmológico Amistad Argelia-Cuba, en Djelfa, en el período comprendido del 13 al 17 de abril del año 2015. Resultados: la facoemulsificación fue la técnica más empleada. La membrana prelental fue el signo más frecuente encontrado, seguido de la hipertensión ocular y el edema corneal, respectivamente. Todos los casos tuvieron un período de resolución de hasta 7 días. El factor común en los 14 pacientes notificados fue la utilización, por primera vez en nuestro centro, del viscoelástico modelo Viscoelastics HMPM Eye Visc para cirugía intraocular del segmento anterior. Conclusión: la coincidencia de la introducción del viscoelástico dispersivo con la aparición del brote y la ausencia de nuevos casos una vez retirado este, confirma la sospecha de que esta es una de las posibles causas del brote de síndrome tóxico del segmento anterior(AU)

Objectives: to describe an outbreak of the anterior segment toxic syndrome occurred at the cataract service of Amistad Argelia-Cuba ophthalmological hospital in Djelfa in 2015. Methods: a cross-sectional descriptive study was carried out, which included 14 notified cases with diagnosis of segment anterior toxic syndrome, who had been operated on at the cataract service of Amistad Argelia-Cuba ophthalmological hospital in Djelfa, in the period of 13th to 17th April, 2015. Results: phacoemulsification was the most used technique. The prelental membrane was the most frequently found sign, followed by ocular hypertension and corneal edema, respectively. All these cases recovered in 7 days. The common factor found in the 14 confirmed patients were the use for the first time of Viscoelastics HMPM Eye Visc viscoelastic model in our center to perform intraocular surgery in the anterior segment. Conclusions: the coincidence of the introduction of this substance with the onset of outbreak and the lack of new case after its withdrawal has confirmed the suspicion that this is one of the possible causes of the outbreak of the anterior segment toxic syndrome(AU)

O papel da membrana de Descemet na patogenia do edema corneano após cirurgia de segmento anterior / The role of Descemet's membrane in the pathogeny of corneal edema following anterior segment surgery

Objetivo: Encontrar fatores importantes na patogenia do edema corneano pós-cirúrgico, em casos de pós-facectomia e pósceratoplastia, por meio do estudo dos achados histopatológicos, a fim de ver o que pode ser feito para evitar sucessivas ceratoplastias. Métodos: Estudo retrospectivo descritivo das alterações histopatológicas de casos de edema corneano pós-cirúrgicos. Os tecidos foram provenientes de ceratoplastia penetrante no período compreendido entre setembro de 2009 e agosto de 2013. Foi realizada revisão de prontuários em busca principalmente de informações sobre cirurgias prévias. Resultados: Foram incluídos 70 botões corneanos, sendo 34 de pacientes do sexo masculino e 36 do sexo feminino. A média das idades foi de 63,1±17,20 (média ± DP) anos. A maioria dos casos era de falência após transplante (71,43%). A rarefação celular foi a principal alteração encontrada no endotélio (58 casos), sendo também a alteração histopatológica mais frequente. Na membrana de Descemet, predominaram as alterações de integridade (53 casos), seja na forma de ruptura, de descolamento isolado ou de descolamento associado à ruptura. Foi frequente a associação de alterações endoteliais à ausência da integridade da membrana de Descemet. Conclusão: Descolamento da membrana de Descemet é um achado histopatológico frequente nos casos de edema corneano pós-cirúrgicos estudados, devendo ser considerado um fator importante na patogenia dos mesmos. Essa alteração deve ser procurada com atenção nos pós-operatórios, a fim de ser diagnosticada e tratada precocemente, vindo possivelmente a evitar muitas indicações de ceratoplastia. .

Objective: To find relevant factors in the pathogeny of postoperative corneal edema in post-cataract surgery and post-keratoplasty cases, through the study of histopathological findings in order to see what can be done to avoid successive keratoplasties. Methods: Retrospective descriptive study of histopathological findings in postoperative corneal edema cases. Tissues were obtained from penetrating keratoplasty in the period between september 2009 and august 2013. A medical record review was conducted primarily looking for information about previous surgeries. Results: Seventy corneal buttons were included, out of which 34 were from male patients and 36 were from female patients. The mean age was 63.1±17.20 (mean ± SD) years. Most of cases were corneal failure after keratoplasty (71.43%). The main change found in endothelium was cellular rarefaction (58 cases), and it was also the most common histopathological change. Changes in integrity predominated in Descemet's membrane (53 cases), whether in the form of rupture, isolated detachment or detachment associated with rupture. Endothelial changes associated with the absence in Descemet's membrane integrity were frequent. Conclusion: Descemet's membrane detachment is a frequent histopathological finding in postoperative corneal edema cases studied, thus it should be considered an important factor in the pathogeny of such cases. This change should be carefully researched in the postoperative period in order to be diagnosed and treated early, possibly avoiding many keratoplasty indications. .

Nuevo esteroide tópico en el tratamiento del edema macular / New topical steroid for the treatment of macular edema

El pilar principal de tratamiento de las inflamaciones oculares tanto postquirúrgicas como endógenas, se basa en el uso de esteroides. Aunque estos medicamentos son efectivos, su empleo no está exento de riesgos como la hipertensión ocular y la aceleración de la formación de la catarata, principalmente en el caso de los esteroides más fuertes como la prednisolona y la betametasona. Esta revisión estuvo encaminada a la profundización del conocimiento sobre la bioquímica y el desarrollo del difluprednate, nueva droga esteroidea sintética de alta potencia, cuyo uso está aprobado por la Food and Drug Administration FDA para el tratamiento del edema macular después de la cirugía del segmento anterior. Se analizaron algunos aspectos de este medicamento off-label como la farmacocinética, el metabolismo, la distribución ocular del medicamento y utilidad en las fases I, II y III de ensayos clínicos sobre su utilización en pacientes con inflamaciones posoperatorias, tanto del segmento anterior como posterior y con uveítis anterior

The main pillar of the treatment of both the postsurgical and endogenous eye inflammations is based on the use of steroids. Although these drugs are effective, their use has risks such as ocular hypertension and accelerated formation of cataracts, fundamentally in the case of stronger steroids such as prednisolone and betamethasone. This review was aimed at expanding the knowledge on biochemistry and the development of difluprednate, a new highly potent synthetic steroidal drug that has been approved by the Food and Drug Administration FDA to treat macular edema after the anterior segment surgery. Some aspects of this off-label drug were analyzed such as pharmacokinetics, metabolism, ocular distribution of drug and usefulness in phases I, II and II of clinical assays on the use of these drugs in patients with postoperative inflammations both in the anterior and the posterior segments and with anterior uveitis

Anestesia local en cirugía vitreorretinal y de polo anterior en pacientes menores de 20 años / Local anaesthesia for vitreoretinal and anterior segment surgery in patient under 20 year old

Introducción: Pese al aumento en el uso de anestesia regional en cirugía oftalmológica, esta técnica es aún poco usada en pacientes jóvenes. Objetivo: Analizar la utilidad y seguridad de la anestesia regional en pacientes menores de 20 años operados en la Fundación Oftalmológica Los Andes. Método: Revisión retrospectiva de 45 cirugías vitreorretinales y 27 cirugías de polo anterior, en menores de 20 años, realizadas con anestesia regional en nuestro servicio entre los años 2002 al 2004. Resultados: La edad fluctuó entre 12 y 20 años. No se reportaron complicaciones anestésicas intraoperatorias serias y en todos los casos se realizó el procedimiento sin inconvenientes, tanto para el cirujano como para el paciente. Los requerimientos de sedación fueron mayores en los pacientes sometidos a cirugía vitreorretinal (p<0,05). No hubo casos de conversión a anestesia general. Conclusión: La anestesia regional es una alternativa segura y bien tolerada, aún en cirugía vitreorretinal compleja.

Intraoperative peripheral anterior capsulotomy to prevent early postoperative capsular block syndrome.

We describe a new surgical technique, intraoperative peripheral anterior capsulotomy (IPAC), to prevent early postoperative capsular block syndrome (CBS). Eighty consecutive patients (80 eyes) had phacoemulsification and intraocular lens implantation with IPAC in the presence of a small (4.5 to 5.0 mm) anterior continuous curvilinear capsulorhexis (CCC). Patients were followed for a mean of 16 months (range 6 to 24 months), and none developed CBS or other complications. Our series suggests that IPAC may be an alternative to prevent CBS in high-risk eyes, including those with a small anterior CCC or ophthalmic viscosurgical device material trapped in the capsular bag. This surgical technique is safe, effective, inexpensive, and easy to perform.

Ultrasound biomicroscopy and Scheimpflug photography of angle-supported phakic intraocular lens for high myopia.

PURPOSE: To evaluate the equivalence of Scheimpflug photography (SP) and ultrasound biomicroscopy (UBM) in determining corneal epithelium-intraocular lens (IOL) and border IOL-iris distances. SETTING: Universität Erlangen-Nuremberg, Erlangen, Germany. METHODS: In 26 eyes of 17 patients who had a NuVita MA20 angle-supported anterior chamber intraocular lens (Chiron-Domilens), SP and UBM were used to evaluate the distance between the endothelium and the anterior IOL face in central and peripheral regions (12 o'clock and 6 o'clock positions) and between the border of the anterior IOL face and the iris. The Wilcoxon test was used for statistical analysis. RESULTS: The mean central endothelium-anterior IOL face distance was 2.01 mm and 2.00 mm by SP and UBM, respectively. The mean peripheral endothelium-anterior IOL border distance was 1.28 mm and 1.58 mm, respectively, and the mean peripheral anterior IOL face-iris distance, 0.89 mm and 0.75 mm, respectively. CONCLUSIONS: The difference between the 2 methods in the central endothelium-anterior IOL face distance was not significant (methods were equivalent), but the difference in the peripheral endothelium-anterior IOL face distance was. This may be the result of difficulty in obtaining the exact transition point between the IOL and the haptics by SP examination. The difference between the 2 methods in the IOL border-iris distance was also significant because of the irregularity of the iris surface; therefore, measurements were performed at different sites along this structure. The significant differences in the peripheral endothelium-IOL and IOL border-iris distances indicate that although both methods are useful, they are not equivalent.

Anterior Segment Trauma

Ocular is a leading cause of preventable blindness in developing countries. The trauma may involve the adnexae, anterior segment and/or posterior segment. This presentation will be confined to the anterior segment injury which may be caused by chemicals, blunt or sharp objects. The examination and treatment, both medical and surgical, of these injuries will be discussed. Emphasis will be placed on prevention especially in children, and industrial workers. Education of paramount immportance in reducing blindness due to trauma.(AU)

Diatermo coagulador bi-polar coaxial: modo de construçäo / Coagulating bipolar coaxial diathermy: constuction mode

Usando material facilmente disponível, os autores descrevem a construção de pontas de diatermia coaxial bipolar com diâmetros variáveis usados especialmente em cirurgias intra-oculares.

Eficacia y seguridad de la solución oftálmica de hidrocloruro de apraclonidina al 1 por ciento en pacientes sometidos a cirugía del segmento anterior con láser / Evaluate the efficacy of apraclonidine chlorhidrate 1 por ciento in patients who were undergone anterior segment laser surgery

Se realizó un estudio prospectivo, descriptivo y longitudinal, para evaluar el efecto de la solución oftálmica de clorhidrato de apraclonidina al 1 por ciento en pacientes sometidos a cirugía del segmento anterior con láser. Se incluyeron 61 sujetos candidatos a trabeculoplastia con láser de argón y capsulotomía o iridotomía con láser de nodinimun: YAG, en tres instituciones hospitalarias de atención oftalmológica en la ciudad de México. Las elevaciones postoperatorias de la presión intraocular fueron controladas de forma eficaz por la apraclonidina, sin reportarse eventos adversos y sistémicos. Este fármaco puede integrarse en las medidas de tratamiento preventivo de la hipertensión ocular en el postoperatorio en pacientes con y sin glaucoma.

Intraocular lens implantation in anterior megalophthalmus. Case report.

We report three cases of extracapsular cataract extraction with intraocular lens implantation in two patients with anterior megalophthalmus. This is the first report, to our knowledge, of intraocular lens implantation in this rare condition.

Subconjunctival anesthesia: an alternative to retrobulbar and peribulbar techniques.

We present a method of anesthesia for intraocular surgery of the anterior segment of the eye that avoids the risks of the potential complications associated with retrobulbar and peribulbar anesthesia. The method consists of topical anesthesia plus 0.5 cc of lidocaine (with hyaluronidase and epinephrine) injected beneath the superior conjunctiva. We have demonstrated the safety and effectiveness of this technique in 431 consecutive cases.

Reformación del segmento anterior en la queratopatía bulosa postfacoéresis: enfoque quirúrgico y sus resultados / Anterior segment reconstruction in corneal edema after cataract surgery: surgery and its results

La descompensación corneal postfacoéresis puede ir desde una simple pseudofaquia con descompensación endotelial hasta una afaquia con un trastorno global del segmento anterior con compromiso de cápsula, vítreo, iris, ángulo y córnea. Su reparación, por lo tanto, irá desde una simple queratoplastía penetrante hasta una restauración anatomofuncional lo más completa posible, incluso con la fijación de un LIO a la esclera. Este trabajo presenta 20 casos de reformación de segmento anterior postfacoéresis, en su mayoría con LIO fijado a esclera. Se analiza sus resultados, su manejo quirúrgico y su prevención. Su seguimiento de 6 a 30 meses y los resultados, tanto en su AV (mejor en el 75% de los casos) como en las complicaciones, permiten plantear a esta cirugía como una real alternativa terapéutica en este tipo de casos

Nuestras últimas experiencias en la microcirugía del segmento anterior / Our latest experiences in microsurgery of the anterior segment

Se presentan los resultados de las últimas experiencias de los autores con relación al empleo de la microcirugía del segmento anterior del ojo. Para ello utilizaron un microscopio quirúrgico de la casa Opton, combinado en ocasiones con la telelupa binocular de la casa Carl Zeiss. Se analizan las técnicas empleadas, las complicaciones trans y posoperatorias, el material de sutura, el tipo de iridectomía (cuando se realizó), y el estado ocular al mes de operado. Se tuvieron en cuenta en el estudio las afecciones generales que presentaba cada paciente