Sutureless lamellar keratoplasty: a modified approach for fibrin glue application.

PURPOSE: To report a case where fibrin glue was applied with a modified approach to secure the graft to the host bed in lamellar keratoplasty. METHODS: One patient with epithelial membrane dystrophy, Salzmann nodular degeneration, and amyloid deposits in the cornea underwent lamellar keratoplasty by using fibrin glue. The glue components were applied separately: the fibrin component on the stromal bed and thrombin component on the stromal side of the lamellar graft. Tissue adhesion, corneal condition, and visual acuity were evaluated postoperatively. RESULTS: Best-corrected visual acuity 4 months after surgery was 20/30. The graft remained clear and well positioned 9 months after surgery. CONCLUSIONS: We report a case of visual acuity improvement and efficient adhesion of the lamellar graft after lamellar keratoplasty by using fibrin adhesive. The components of the glue can be applied separately, allowing more time to position the graft on the stromal bed.

[Total testosterone level in postmenopausal women with dry eye]. / Nível de testosterona total em mulheres pós-menopausa com olho seco.

PURPOSE: The purpose of this study was to compare total testosterone blood level among three groups of postmenopausal women: control, mild to moderate dry eye and severe dry eye. METHODS: Twenty-nine postmenopausal women were selected. The exclusion criteria were: hormone replacement therapy in the last 8 weeks, mechanical palpebral abnormalities, pterygium, lacrimal obstructions, intraocular inflammation or contact lens use. A blood sample was collected for total testosterone level determination, and the patients were submitted to an ophthalmologic examination (emphasizing on dry eye detection) and answered the OSDI (Ocular Surface Disease Index) questionnaire. Five patients were excluded. Postmenopausal women were divided into three groups according to OSDI score and the ophthalmic examination. RESULTS: Five patients were classified in the no dry eye group (control), fifteen in the mild to moderate dry eye group and four in the severe dry eye group. There were no statistically significant differences regarding mean age (p=0.3915); instruction level (p=0.9333); number of comorbidities (p=0.2551); medication taken (p=0.2844) and total testosterone level among those groups (p=0.1275). CONCLUSION: Further research with a greater bigger sample is necessary to establish the relation of androgen levels in dry eye patients.

Nível de testosterona total em mulheres pós-menopausa com olho seco / Total testosterone level in postmenopausal women with dry eye

OBJETIVO: Comparar o nível sérico de testosterona total entre mulheres pós-menopausa divididas em 3 grupos: controle, olho seco leve a moderado e olho seco intenso. MÉTODOS: No ambulatório de climatério foram selecionadas 29 mulheres pós-menopausa que não faziam reposição hormonal há pelo menos 8 semanas. Critérios de exclusão: alterações palpebrais mecânicas, pterígio, obstrução de vias lacrimais, inflamação intra-ocular e uso de lente de contato. As mulheres selecionadas foram submetidas à dosagem de testosterona total, aplicação do questionário OSDI (Ocular Surface Disease Index) e exame oftalmológico para detecção de olho seco. As mulheres foram divididas em 3 grupos conforme o resultado do escore OSDI e do exame oftalmológico. RESULTADOS: Cinco pacientes foram classificadas como ausência de olho seco, 15 com olho seco leve a moderado e 4 com olho seco intenso. Não houve diferença estatisticamente significativa entre a média dos valores das idades (p=0,3915); nível de instrução (p=0,9333); doenças associadas (p=0,2551); tipo de medicação utilizada (p=0,2844) e nível sérico de testosterona total entre os grupos (p=0,1275). CONCLUSÃO: Não encontramos diferença estatisticamente significativa entre o nível de testosterona total entre mulheres pós-menopausa com olho seco. Novos estudos clínicos com maior amostra são necessários para melhor esclarecer a relação dos níveis séricos dos androgênios nos portadores de olho seco.

PURPOSE: The purpose of this study was to compare total testosterone blood level among three groups of postmenopausal women: control, mild to moderate dry eye and severe dry eye. METHODS: Twenty-nine postmenopausal women were selected. The exclusion criteria were: hormone replacement therapy in the last 8 weeks, mechanical palpebral abnormalities, pterygium, lacrimal obstructions, intraocular inflammation or contact lens use. A blood sample was collected for total testosterone level determination, and the patients were submitted to an ophthalmologic examination (emphasizing on dry eye detection) and answered the OSDI (Ocular Surface Disease Index) questionnaire. Five patients were excluded. Postmenopausal women were divided into three groups according to OSDI score and the ophthalmic examination. RESULTS: Five patients were classified in the no dry eye group (control), fifteen in the mild to moderate dry eye group and four in the severe dry eye group. There were no statistically significant differences regarding mean age (p=0.3915); instruction level (p=0.9333); number of comorbidities (p=0.2551); medication taken (p=0.2844) and total testosterone level among those groups (p=0.1275). CONCLUSION: Further research with a greater bigger sample is necessary to establish the relation of androgen levels in dry eye patients.