Characterization of cryopreserved primary human corneal endothelial cells cultured in human serum-supplemented media.

PURPOSE: To compare cryopreserved human corneal endothelial cells (HCECs) grown in human serum-supplemented media (HS-SM) with cryopreserved HCECs grown in fetal bovine serum-supplemented media (FBS-SM). METHODS: Three pairs of human corneas from donors aged 8, 28, and 31 years were obtained from the eye bank. From each pair, one cornea was used to start a HCEC culture using HS-SM; the other cornea was grown in FBS-SM. On reaching confluence, the six cell populations were frozen using 10% dimethyl sulfoxidecontaining medium. Thawed cells grown in HS-SM were compared with those grown in FBS-SM with respect to morphology, growth curves, immunohistochemistry, real time-reverse transcriptase polymerase chain reaction (RT-PCR) for endothelial cell markers, and detachment time. RESULTS: No difference in morphology was observed for cells grown in the two media before or after cryopreservation. By growth curves, cell counts after thawing were similar in both media, with a slight trend toward higher cell counts in FBS-SM. Cells grown in both the media demonstrated a similar expression of endothelial cell markers when assessed by immunohistochemistry, although HCEC marker gene expression was higher in cells grown in HS-SM than in those grown in FBS-SM as assessed by RT-PCR. With FBS-SM, there was a tendency of longer detachment time and lower cell passages. CONCLUSIONS: HS-SM was similar to FBS-SM for cryopreservation of cultured HCECs as assessed by analysis of cell morphology, proliferation, and protein expression, although marker gene expression was higher in cells grown in HS-SM than in those grown in FBS-SM. Detachment time was longer with FBS-SM and in lower passages.

Characterization of cryopreserved primary human corneal endothelial cells cultured in human serum-supplemented media / Caracterização de células endoteliais corneanas humanas primárias criopreservadas cultivadas em meio suplementado com soro humano

ABSTRACT Purpose: To compare cryopreserved human corneal endothelial cells (HCECs) grown in human serum-supplemented media (HS-SM) with cryopreserved HCECs grown in fetal bovine serum-supplemented media (FBS-SM). Methods: Three pairs of human corneas from donors aged 8, 28, and 31 years were obtained from the eye bank. From each pair, one cornea was used to start a HCEC culture using HS-SM; the other cornea was grown in FBS-SM. On reaching confluence, the six cell populations were frozen using 10% dimethyl sulfoxidecontaining medium. Thawed cells grown in HS-SM were compared with those grown in FBS-SM with respect to morphology, growth curves, immunohistochemistry, real time-reverse transcriptase polymerase chain reaction (RT-PCR) for endothelial cell markers, and detachment time. Results: No difference in morphology was observed for cells grown in the two media before or after cryopreservation. By growth curves, cell counts after thawing were similar in both media, with a slight trend toward higher cell counts in FBS-SM. Cells grown in both the media demonstrated a similar expression of endothelial cell markers when assessed by immunohistochemistry, although HCEC marker gene expression was higher in cells grown in HS-SM than in those grown in FBS-SM as assessed by RT-PCR. With FBS-SM, there was a tendency of longer detachment time and lower cell passages. Conclusions: HS-SM was similar to FBS-SM for cryopreservation of cultured HCECs as assessed by analysis of cell morphology, proliferation, and protein expression, although marker gene expression was higher in cells grown in HS-SM than in those grown in FBS-SM. Detachment time was longer with FBS-SM and in lower passages.

RESUMO Objetivo: Comparar células endoteliais de córnea humana (HCECs) criopreservadas e cultivadas em meio suplementado com soro humano (HS-SM) com HCEC criopreservadas e cultivadas em meio suplementado com soro bovino fetal (FBS-SM). Métodos: Três pares de córneas humanas de doadores com 8, 28 e 31 anos de idade foram obtidos do banco de olhos e, de cada par, uma córnea foi utilizado para iniciar uma cultura com HS-SM e outra com FBS-SM. Ao atingir a confluência, as populações de células foram congeladas utilizando-se dimetil-sulfóxido 10% no respectivo meio de cultura. Após descongeladas, as células cultivadas em HS-SM foram comparados com as cultivadas em FBS-SM por meio de morfologia, curva de crescimento, imuno-histoquímica, reação em cadeia de Reação em cadeia da polimerase da transcrição reversa em tempo real (RT-PCR) para marcadores de células endoteliais e tempo de descolamento. Resultado: Não foram observadas diferenças morfológicas antes ou após a criopreservação. Curva de crescimento mostrou contagens celulares semelhantes em ambos os meios, com discreta tendência para um maior número em FBS-SM. As células cultivadas em ambos os meios mostraram expressão semelhante de marcadores celulares endoteliais quando avaliadas por imuno-histoquímica, embora a expressão genética de marcadores para HCEC tenha sido maior em HS-SM quando avaliado por RT-PCR. Houve uma tendência de maior tempo de descolamento com FBS-SM e passagens iniciais. Conclusões: HS-SM foi semelhante ao FBS-SM na criopreservação de HCEC cultivadas in vitro quando avaliadas por morfologia celular, proliferação celular e expressão proteica, embora a expressão genética de marcadores endoteliais tenha sido maior em células cultivadas em HS-SM quando comparadas a células cultivadas em FBS-SM. O tempo de descolamento foi maior quando utilizado FBS-SM e em passagens iniciais.

Use of human serum for human corneal endothelial cell culture.

BACKGROUND/AIMS: To study human corneal endothelial cells (HCECs) cultured in vitro with human serum (HS) supplemented media (HS-SM) compared with HCEC cultured in fetal bovine serum (FBS) supplemented media (FBS-SM). METHODS: One cornea from a donor aged 21 years and a pair of corneas from a 16 year-old donor were obtained from the eye bank and used to create two different cell populations. At the first passage, the cell populations were equally divided and seeded in two different wells containing FBS-SM or HS-SM. In subsequent passages, HS-SM was compared with FBS-SM by morphology, growth curves, immunohistochemistry and real-time reverse-transcriptase PCR for endothelial cell markers. RESULTS: No difference in morphology could be seen in P2, P5 or in any other passages for cells grown in the two media. By growth curves, cell counts were similar in FBS-SM and HS-SM from days 1 to 5, with a trend towards higher cell counts in HS-SM at day 7. Cells grown in FBS-SM and HS-SM media showed similar expression of endothelial cell markers when assessed by immunohistochemistry and real-time reverse-transcriptase PCR. CONCLUSIONS: HS-SM was similar to FBS-SM for HCEC culture when assessed by cell morphology, proliferation and protein/gene expression.

Efficacy of a lutein-based dye (Phacodyne™) for visualizing anterior capsulorhexis during cataract surgery by phacoemulsification.

PURPOSE: To evaluate the efficacy and safety of a novel lutein-based dye for the anterior capsulorhexis during phacoemulsification in cataract surgery in humans. METHODS: Twenty-five eyes from 25 patients were operated by 25 different surgeons who performed continuous circular capsulorhexis (CCC) guided by a lutein-based dye (Phacodyne™) during cataract surgery by phacoemulsification. A questionnaire assessed the surgeon's opinion regarding the efficacy of the dye. Follow-up examinations were performed at 1, 7, and 30 days post-surgery. Eyes were evaluated by full ophthalmic examination, corneal topography/pachymetry, and corneal endothelial cell count. RESULTS: As revealed by the answers to the questionnaire, the dye facilitated the CCC procedure in all eyes. Baseline nuclear cataract classification (according to the Lens Opacities Classification System III; LOCS III) was 3.24 (± 1.12). Preoperative BCVA (logMAR) was 0.89 ± 0.59 and improved to 0.23 ± 0.22 on day 30 after surgery. The intraocular pressure (IOP) remained stable and the inflammatory reaction subsided in all cases within the first 7 days after surgery. The pre-operative values of corneal pachymetry and IOP were similar to those found on follow-up day 30. Loss in endothelial cell number was similar to earlier reports. CONCLUSION: Phacodyne™ was efficient when used for anterior capsulorhexis during cataract surgery by phacoemulsification and

Efficacy of a lutein-based dye (PhacodyneTM) for visualizing anterior capsulorhexis during cataract surgery by phacoemulsification / Eficácia de corante à base de luteína (PhacodyneTM) para observação da capsulorrexis anterior em cirurgia de facoemulsificação

Purpose: To evaluate the efficacy and safety of a novel lutein-based dye for the anterior capsulorhexis during phacoemulsification in cataract surgery in humans. Methods: Twenty-five eyes from 25 patients were operated by 25 different surgeons who performed continuous circular capsulorhexis (CCC) guided by a lutein-based dye (PhacodyneTM) during cataract surgery by phacoemulsification. A questionnaire assessed the surgeon's opinion regarding the efficacy of the dye. Follow-up examinations were performed at 1, 7, and 30 days post-surgery. Eyes were evaluated by full ophthalmic examination, corneal topography/pachymetry, and corneal endothelial cell count. Results: As revealed by the answers to the questionnaire, the dye facilitated the CCC procedure in all eyes. Baseline nuclear cataract classification (according to the Lens Opacities Classification System III; LOCS III) was 3.24 (± 1.12). Preoperative BCVA (logMAR) was 0.89 ± 0.59 and improved to 0.23 ± 0.22 on day 30 after surgery. The intraocular pressure (IOP) remained stable and the inflammatory reaction subsided in all cases within the first 7 days after surgery. The pre-operative values of corneal pachymetry and IOP were similar to those found on follow-up day 30. Loss in endothelial cell number was similar to earlier reports. Conclusion: PhacodyneTM was efficient when used for anterior capsulorhexis during cataract surgery by phacoemulsification and showed no signs of toxicity or side effects during the 30-day follow-up period. .

Objetivos: Avaliar a eficácia e eficiência de um novo corante à base de luteína para coloração da cápsula anterior durante cirurgia de facoemulsificação em humanos. Métodos: Vinte e cinco olhos de 25 pacientes foram operados por 25 cirurgiões diferentes que realizaram capsulorrexis circular contínua e facoemulsificação após coloração da cápsula anterior com corante à base de luteína. Um questionário avaliou a opinião dos cirurgiões sobre a eficácia do corante. Exames pós-operatórios foram realizados nos dias 1, 7 e 30 por meio de exame oftalmológico completo, topografia/ paquimetria e contagem de células endoteliais. Resultados: De acordo com o questionário aplicado, o corante facilitou a cirurgia em todos os olhos. A classificação da catarata de acordo com o LOCS III foi de 3,24 ± 1,12. A acuidade visual pré-operatória com melhor correção foi de 0,89 ± 0,59 (logMAR), passando a 0,23 ± 0,22 no pós-operatório. A pressão intraocular (PIO) permaneceu estável e houve reação de câmara leve que desapareceu em todos os casos durante os primeiros 7 dias de pós-operatório. Não houve significância estatística comparando a paquimetria e PIO pré e pós-operatórios. Conclusão: O novo corante se mostrou eficiente e sem sinais de toxicidade ou efeitos adversos, após 30 dias, quando usado para auxiliar a cirurgia de facoemulsificação. .

Avaliação do desempenho visual da lente intraocular difrativa multifocal - Zeiss AT Lisa 809 MTM / Visual outcomes of the diffractive multifocal intraocular lens - Zeiss AT Lisa 809MTM

Objetivo: Avaliar a função visual dos pacientes com implante bilateral da LIO multifocal difrativa AT-Lisa 809 MTM por meio dos exames de acuidade visual com e sem correção óptica, curva de sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF39). Métodos: Estudo clínico, prospectivo e de intervenção, que avaliou os resultados de 20 olhos de 10 pacientes, submetidos à facoemulsificação e implante de LIO, entre fevereiro e junho de 2012. Resultados: A ametropia residual média pós-operatória foi de 0,05 ± 0,42 (-0,75 a +1,25 D) dioptrias esféricas e -0,30 ± 0,42 (0 a -1,25 D) dioptrias cilíndricas. Na curva de desenfoque mono e binocular, a melhor acuidade visual média obtida com 0.00 D de desenfoque (AV de longe). O segundo pico foi obtido com desenfoque de -3,00 D, o que equivale à visão de perto a 33 cm. Entre esses picos, observamos uma perda de desempenho visual, com desenfoque de -2,00 D, que equivale a visão intermediária a 50 cm. A sensibilidade ao contraste foi similar aos relatados na literatura com este tipo de LIO, tanto com quanto sem ofuscamento, e é mostrada em gráficos. O questionário de função visual (VFQ-39) teve valor médio de 91,91 +- 6,82. Conclusão: A LIO multifocal difrativa AT-Lisa 809MTM (Carl Zeiss Meditec Company - Alemanha) apresentou resultados condizentes com a literatura quando avaliada pelos exames de acuidade visual com e sem correção óptica, sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF 39). .

Purpose: To evaluate the visual function of patients with bilateral implantation of multifocal diffractive IOL AT Lisa 809MTM by visual acuity with and without correction, contrast sensitivity curve, defocus curve and visual function questionnaire (39 VQF). Methods: Interventional clinical prospective study, which evaluated the results of 20 eyes of 10 patients who underwent phacoemulsification and IOL implantation between february and june 2012. Results: The average of residual postoperative ametropia was 0.05 ± 0.42 (-0.75 to +1.25 D) spherical diopters and -0.30 ± 0.42 (0 to -1.25 D) cylindrical diopters. In the mono and binocular defocus curve, the best visual acuity was obtained with 0.00 D of defocus (far VA). The second peak was obtained with -3.00 D (near vision at 33 cm) and among these peaks, it was observed a loss of visual performance with -2.00 D, which corresponds to intermediate vision at 50 cm. Contrast sensitivity was similar to those reported in the literature with this type of IOL, both with and without glare, and is shown in the figures. The visual function questionnaire (VFQ-39) had a mean value of 91.91 + - 6.82. Conclusion: The diffractive multifocal IOL-AT LISA 809M presented results consistent with the literature as measured by tests of visual acuity with and without optical correction, contrast sensitivity curve, defocus curve and visual function questionnaire (39 VQF). .

Intracapsular dexamethasone implant in patients undergoing phacoemulsification and intraocular lens implantation.

PURPOSE: To relate the outcomes of 7 eyes of 7 patients in which a dexamethasone 0.7 mg implant (Ozurdex(®)) was placed inside the capsule bag after phacoemulsification and intraocular lens (IOL) implantation and compare with the fellow eyes, that were operated by the same technique and received dexamethasone eyedrops in the post-operatory. METHODS: Report review of 7 eyes of 7 patients who received dexamethasone 0.7 mg implant after phacoemulsification and IOL, comparing them to the fellow eyes. All the patients underwent bilateral cataract surgery, with one month interval, by the same technique and by experienced surgeons, without complications. Post operatory medication consisted of moxifloxacin eye drops for all the 14 eyes and topic dexamethasone for the 7 eyes that did not received the implant. RESULTS: Nuclear cataract classification (according to LOCS III) was 3.28 ± 0.69 in the implant eye group and 3.14 ± 0.83 in the fellow eye group. Postoperative best spectacle correct visual acuity (BSCVA) was 0.85 ± 0.12 and 0.87 ± 0.13, respectively in the implant and fellow eye groups. The intraocular pressure remained stable and similar to the pre-operative measurements. Anterior chamber reaction and cornea edema were similar in both groups in the follow-up. Two of the four no sutured pellet migrated to the anterior chamber during the first post-operative week and had to be repositioned. Another no sutured pellet dislocated and remained partially inside the capsule bag. The 3 patients with IOL haptic-sutured pellet had no complications. CONCLUSIONS: In the present study, dexamethasone 0.7 mg implant were effective in controlling the inflammation after phacoemulsification and IOL implantation, with no significant side effects.

Intracapsular dexamethasone implant in patients undergoing phacoemulsification and intraocular lens implantation / Implante intracapsular de dexametasona em pacientes submetidos a facoemulsificação e implante de lente intraocular

PURPOSE: To relate the outcomes of 7 eyes of 7 patients in which a dexamethasone 0.7 mg implant (Ozurdex®) was placed inside the capsule bag after phacoemulsification and intraocular lens (IOL) implantation and compare with the fellow eyes, that were operated by the same technique and received dexamethasone eyedrops in the post-operatory. METHODS: Report review of 7 eyes of 7 patients who received dexamethasone 0.7 mg implant after phacoemulsification and IOL, comparing them to the fellow eyes. All the patients underwent bilateral cataract surgery, with one month interval, by the same technique and by experienced surgeons, without complications. Post operatory medication consisted of moxifloxacin eye drops for all the 14 eyes and topic dexamethasone for the 7 eyes that did not received the implant. RESULTS: Nuclear cataract classification (according to LOCS III) was 3.28 ± 0.69 in the implant eye group and 3.14 ± 0.83 in the fellow eye group. Postoperative best spectacle correct visual acuity (BSCVA) was 0.85 ± 0.12 and 0.87 ± 0.13, respectively in the implant and fellow eye groups. The intraocular pressure remained stable and similar to the pre-operative measurements. Anterior chamber reaction and cornea edema were similar in both groups in the follow-up. Two of the four no sutured pellet migrated to the anterior chamber during the first post-operative week and had to be repositioned. Another no sutured pellet dislocated and remained partially inside the capsule bag. The 3 patients with IOL haptic-sutured pellet had no complications. CONCLUSIONS: In the present study, dexamethasone 0.7mg implant were effective in controlling the inflammation after phacoemulsification and IOL implantation, with no significant side effects.

OBJETIVOS: Relatar os resultados de 7 olhos de 7 pacientes em que foi realizado o implante de dexametasona 0,7 mg (Ozurdex®) no saco capsular após facoemulsificação e implante de lente intraocular (LIO) e comparar com os olhos contralaterais, que foram operados pela mesma técnica e receberam colírio de dexametasona no pós-operatório. MÉTODOS: Relato de casos de 7 olhos de 7 pacientes que receberam o implante de dexametasona 0,7 mg após facoemulsificação e implante de LIO, comparando-os com os olhos contralaterais. Todos os pacientes foram submetidos a cirurgia de catarata bilateral, com intervalo de um mês entre as cirurgias, pela mesma técnica, por cirurgiões experientes e sem complicações. No pós-operatório foi utilizado colírio de moxifloxacino em todos os 14 olhos e dexametasona tópica nos olhos que não receberam o implante. RESULTADOS: A classificação da catarata de acordo com o LOCS III foi de 3,28 ± 0,69 no grupo que recebeu o implante e 3,14 ± 0,83 no grupo de olhos contralateral. A acuidade visual com melhor correção foi de 0,85 ± 0,12 e 0,87 ± 0,13 respectivamente nos grupos com e sem implante. A pressão intraocular permaneceu estável e similar aos valores pré-operatórios. A reação de câmara anterior e o edema de córnea foram similares nos dois grupos. Dois dos 4 implantes sem sutura migraram para a câmara anterior durante a primeira semana de pós-operatório e necessitaram de reposicionamento. Outro implante sem sutura teve deslocamento e permaneceu parcialmente dentro do saco capsular. Os 3 pacientes com implante suturado não tiveram complicações. CONCLUSÃO: No presente estudo, o implante de dexametasona 0,7 mg foi efetivo no controle da inflamação intraocular após cirurgia de facoemulsificação e implante de LIO, sem efeitos colaterais significativos.

Mansonella ozzardi corneal lesions in the Amazon: a cross-sectional study.

OBJECTIVES: To characterise and confirm the presence of Mansonella ozzardi microfilariae in the cornea by biomicroscopy and corneal confocal microscopy. DESIGN: Cross-sectional study. SETTINGS: Clinical practice study in patients from rural communities in Coari city on the Solimões river, Amazonas state, Brazil. PARTICIPANTS: The eyes of 212 consecutive volunteer patients were examined using a flash light and their blood checked for the presence of microfilariae by an expert microscopist. Patients with suspicious corneal lesions (characterised as nummular keratitis) were submitted to biomicroscopy, fundoscopy and corneal confocal microscopy evaluation (CCME). In two patients, a biopsy of the limbal conjunctiva adjacent to the nummular keratitis was carried out and blood collected from the surgical wound for microfilariae investigation by thick blood film examination. PRIMARY AND SECONDARY OUTCOME MEASURES: Positive correlation between corneal biomicroscopic and confocal lesions and M ozzardi microfilaremia. RESULTS: Of the 212 patients, 56 (26.4%) were positive for microfilaremia. 22 patients with nummular keratitis identified under flash light examination underwent biomicroscopy and CCME. Corneal lesions were positively correlated to microfilaremia (p=0.0001). At biomicroscopy, lesions were classified as quiescent or active. At CCME, lesions were categorised as circular or filiform. The associations between corneal lesions, CCME findings and microfilaremia are shown. CONCLUSIONS: We describe M ozzardi microfilariae in the cornea and the associated eye pathology. Further studies using ocular tissue PCR and other imaging techniques would be helpful.

Sebaceous carcinoma of the eyelid - different diagnostic times, different outcomes: case reports / Carcinoma de glândulas sebáceas palpebral - diferentes momentos de diagnósticos, diferentes resultados cirúrgicos: relatos de casos

Sebaceous carcinoma of the eyelid is a very rare slow-growing tumor and is considered an aggressive eyelid neoplasm. It can reach mortality rate of about 6 percent. Diagnosis is often delayed because of its ability to masquerade as other periocular lesions, both clinically and histologically. We present three cases of sebaceous carcinoma, with different surgical outcomes, showing the importance of early diagnosis.

Carcinoma sebáceo é um tumor raro de crescimento lento considerado uma das mais agressivas neoplasias palpebrais. Pode alcançar taxa de mortalidade de aproximadamente 6 por cento. O diagnóstico tardio é comum devido a sua habilidade de se confundir com outras lesões perioculares tanto clinicamente quanto histologicamente. Relatamos três casos de carcinoma sebáceo da pálpebra com diferentes resultados cirúrgicos, enfatizando a importância do diagnóstico precoce.

Retratamento de LASIK com fotoablação personalizada versus fotoablação convencional utilizando o LADAR: Alcon / LASIK retreatment with customized versus conventional photo-ablation using LADAR: Alcon

OBJETIVO:Avaliar os resultados do retratamento convencional (LADAR, Alcon) e do retratamento personalizado(LADARWave, Alcon) em olhos submetidos a LASIK primário convencional. MÉTODOS: Estudo retrospectivo de revisão de prontuários consecutivos, de 38 olhos em 38 pacientes, submetidos a retratamento de LASIK para correção de miopia e astigmatismo. Os olhos operados foram divididos em dois grupos iguais. No primeiro grupo foi realizado o retratamento personalizado e, no outro, o retratamento convencional. As seguintes variáveis foram comparadas: acuidade visual de alto contraste e refração manifesta. A qualidade visual foi estimada e comparada através de inquérito subjetivo proposto aos pacientes. RESULTADOS: Não houve diferença estatística entre os grupos comparando-se as variáveis estudadas. O equivalente esférico pós-retratamento foi de 0,36 no grupo convencional e de 0,47 no personalizado (p=0,079). A acuidade visual de Snellen foi de 0,91 e 0,87, respectivamente, com p=0,07. O total de aberrações pré-operatório foi maior do que o pós-operatório no grupo personalizado (p<0,001). Já no grupo convencional não houve esta diferença para nenhuma aberração avaliada. As queixas de glare (p=0,117), fotofobia (p=0,987) e flutuação da visão (p=0,545) foram estatisticamente semelhantes entre os grupos. CONCLUSÃO: Comparando-se as cirurgias personalizada e convencional para o retratamento de LASIK primário com o LADAR, Alcon, não houve diferença estatística em relação à quantidade e qualidade visual. Apesar disso, houve maior porcentagem de pacientes com queixas em relação à qualidade visual no grupo submetido à cirurgia convencional. A cirurgia personalizada parece ter maior capacidade em reduzir o total de aberrações do que a cirurgia convencional.

OBJECTIVE: To evaluate the results of conventional (Ladar, Alcon) and customized (LADARWave, Alcon) retreatment ineyes undergoing conventional primary LASIK. METHODS: Retrospective revision of consecutive clinical report forms of 38 eyes of 38 patients who underwent LASIK retreatment for myopia and astigmatism. The operated eyes were divided into two equal groups. In the first was performed customized retreatment and, in the other, conventional retreatment. The following variables were compared: high contrast visual acuity and manifest refraction. The visual quality was estimated and compared using subjective survey offered to patients. RESULTS: There was no statistical difference between the groups when comparing the variables studied. The spherical equivalent after retreatment was 0.36 in the conventional group and 0.47 in the custom (p = 0.079). Snelen visual acuity was 0.91 and 0.87, respectively (p = 0.07). The preoperative total aberrations was higher than the postoperative period in custom group (p <0.001). In the conventional group there was no difference for any aberration evaluated. Complaints of glare (p = 0.117), photophobia (p = 0.987) and vision fluctuation (p = 0.545) were statistically similar between the two groups. CONCLUSION: Comparing the custom and conventional surgery for primary LASIK retreatment with LADAR, Alcon, there wasno statistical difference in the quantity and quality of vision. Nevertheless, there was a higher percentage of patients with complaints in relation to the visual quality in the group undergoing conventional surgery. Custom surgery seems to have greater capacity to reduce the total aberrations than conventional.

Sebaceous carcinoma of the eyelid - different diagnostic times, different outcomes: case reports.

Sebaceous carcinoma of the eyelid is a very rare slow-growing tumor and is considered an aggressive eyelid neoplasm. It can reach mortality rate of about 6%. Diagnosis is often delayed because of its ability to masquerade as other periocular lesions, both clinically and histologically. We present three cases of sebaceous carcinoma, with different surgical outcomes, showing the importance of early diagnosis.