Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 130
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Clinics (Sao Paulo) ; 74: e1294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664421

RESUMO

OBJECTIVES: To compare the amount of ultrasound energy and irrigation volume in conventional phacoemulsification cataract surgery versus femtosecond laser-assisted phacoemulsification at different nuclear-cortical cataract grades. METHOD: This was a prospective, consecutive, investigator-masked nonrandomized parallel cohort study. Patients were divided into 4 groups (Phaco1, Phaco2, Femto1 and Femto2) according to the surgical technique (conventional phacoemulsification [Group Phaco] or femtosecond laser-assisted cataract surgery [Group Femto]) and the Lens Opacity Classification System III (LOCS) grade (LOCS<11 [group 1] or LOCS≥11 [group 2]). The measured outcomes were effective phacoemulsification time (EPT), indicating the ultrasound energy, and balanced salt solution (BSS) use, indicating the irrigation volume, to indirectly estimate the damage to the corneal endothelium caused by the cataract surgery. RESULTS: A total of 160 eyes from 109 patients were included: 87 eyes in Group Phaco, 73 eyes in Group Femto, 76 eyes in group 1 and 84 eyes in group 2. The EPT mean in Femto1 was 53% less (2.73±1.88, 0.1 to 8.65) than that in Phaco1 (5.80±2.86) (p=0.00) and in Femto2 (8.38±9.32) was 33% less than that in Phaco2 (12.55±8.38) (p=0.00). No significant differences in mean LOCS grades between the Phaco1 (8.21±1.44) and Femto1 (7.90±1.90) groups (p=0.73) or between the Phaco2 (13.15±2.55) and Femto2 (12.72±2.18) groups (p=0.95) were found. There were no significant differences in the mean BSS use between the Phaco1 (55.73±12.45) and Femto1 (59.37±10.93) groups (p=0.48) or between the Phaco2 (64.34±21.00) and Femto2 (65.71±17.60) groups (p=0.47). CONCLUSIONS: Compared to conventional phacoemulsification at different nuclear-cortical cataract grades, femtosecond laser-assisted cataract surgery provides an EPT reduction but does not influence the BSS use.

2.
Clinics (Sao Paulo) ; 74: e966, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31365618

RESUMO

OBJECTIVES: To compare long-term postoperative complications of pediatric cataract surgery with primary intraocular lens (IOL) implantation associated with posterior capsulotomy (PC) and anterior vitrectomy (AV) between patients treated with a corneal or pars plicata/pars plana approach. METHODS: Children who underwent cataract surgery with in-the-bag primary IOL implantation were divided into two groups according to PC and AV surgical approach: a corneal approach (group 1) and a pars plicata/pars plana approach (group 2). Only patients with a follow-up duration of more than two years were included. Long-term surgical outcomes were retrospectively reported. RESULTS: The mean follow-up period was 10.00±3.13 years. No cases of glaucoma or retinal detachment were reported. The mean age at surgery was 34.57±22.66 months. Forty-six children were included (27 eyes in group 1 and 29 eyes in group 2). The most frequent postoperative complication was corectopia, followed by visual axis opacification. Both complications occurred more frequently in group 1 (p<0.001). After cataract surgery, the rate of additional surgeries in group 1 was 51.9%, while in group 2, the rate was 27.6% (p=0.1132). CONCLUSION: The pars plicata/pars plana approach with PC and vitrectomy with primary in-the-bag IOL implantation for pediatric cataracts is a safe procedure.

3.
Arq. bras. oftalmol ; 82(4): 329-331, July-Aug. 2019. graf
Artigo em Inglês | LILACS-Express | ID: biblio-1019407

RESUMO

ABSTRACT Intraoperative and postoperative cataract surgery in eyes with anterior megalophthalmos are challenging procedures. Herein we describe the case of a 53-year-old male with anterior megalophthalmos who developed unilateral Urrets-Zavalia Syndrome following cataract surgery.


RESUMO O intraoperatório e o pós-operatório de cirurgia de catarata em olhos com megaloftalmo anterior é desafiador. Descrevemos o caso de um homem de 53 anos com megaloftalmo anterior que desenvolveu a Síndrome de Urrets-Zavalia unilateral após cirurgia de catarata.

4.
Rev. bras. oftalmol ; 78(3): 157-158, May-June 2019.
Artigo em Português | LILACS-Express | ID: biblio-1013667
5.
Arq Bras Oftalmol ; 82(4): 329-331, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31116316

RESUMO

Intraoperative and postoperative cataract surgery in eyes with anterior megalophthalmos are challenging procedures. Herein we describe the case of a 53-year-old male with anterior megalophthalmos who developed unilateral Urrets-Zavalia Syndrome following cataract surgery.

6.
Clinics ; 74: e966, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1011924

RESUMO

OBJECTIVES: To compare long-term postoperative complications of pediatric cataract surgery with primary intraocular lens (IOL) implantation associated with posterior capsulotomy (PC) and anterior vitrectomy (AV) between patients treated with a corneal or pars plicata/pars plana approach. METHODS: Children who underwent cataract surgery with in-the-bag primary IOL implantation were divided into two groups according to PC and AV surgical approach: a corneal approach (group 1) and a pars plicata/pars plana approach (group 2). Only patients with a follow-up duration of more than two years were included. Long-term surgical outcomes were retrospectively reported. RESULTS: The mean follow-up period was 10.00±3.13 years. No cases of glaucoma or retinal detachment were reported. The mean age at surgery was 34.57±22.66 months. Forty-six children were included (27 eyes in group 1 and 29 eyes in group 2). The most frequent postoperative complication was corectopia, followed by visual axis opacification. Both complications occurred more frequently in group 1 (p<0.001). After cataract surgery, the rate of additional surgeries in group 1 was 51.9%, while in group 2, the rate was 27.6% (p=0.1132). CONCLUSION: The pars plicata/pars plana approach with PC and vitrectomy with primary in-the-bag IOL implantation for pediatric cataracts is a safe procedure.

7.
Arq. bras. oftalmol ; 81(6): 529-538, Nov.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-973859

RESUMO

ABSTRACT A retrospective and analytical study was conducted by using data from the National Transplantation System on 184,575 corneal transplantations performed between January 2001 and December 2016 in order to analyze thetrends in corneal transplantation from 2001 to 2016 in Brazil. The Cochran-Armitage test, analysis of variance, and Duncan's multiple comparisons were used to verify the existence of trends, compare the mean values between regions, and verify the mean differences, respectively. A significance level of 5% was used for all tests. The analysis showed that there was a 2.4-fold increase in the number of corneal transplantations (from 6,193 [35.2 per million people (pmp)] to 14,641 [71 pmp]; p<0.001), a 50.7% increase in the efficacy of meeting the population's demand for corneal transplantation (from 35.3% to 53.2%; p<0.001), an 11-fold increase in the number of corneal transplantation centers (from 32 to 356), and a 2.5-fold increase in the number of corneal transplantation teams (from 276 to 688) in Brazil during the period studied. The waiting list for corneal transplantation decreased by 45.4% (from 23,549 [123 pmp] to 12,865 [62.4 pmp]; p<0.001), and the corneal transplantation teams performed about 19 corneal transplantations per year. The best indices were observed in the southern, midwestern, and southeastern regions, and the worst indices were in the northern and northeastern regions. Brazil has been improving its capacity to perform corneal transplantation in the past 16 years, although this improvement varies across regions. However, the population's demand for corneal transplantation is yet to be satisfactorily met, primarily due to the low number of corneal donations.


RESUMO Estudo retrospectivo e analítico, baseado em dados do Sistema Nacional de Transplantes de 184.575 transplantes de córnea realizados no período de janeiro de 2001 a dezembro de 2016, com o objetivo de analisar as tendências do transplante de córnea no Brasil de 2001 a 2016. Os testes de Cochran-Armitage, análise de variância e comparações múltiplas de duncan foram realizados para verificar a existência de tendência, comparação de médias entre regiões e verificação da diferença média, respectivamente. Um nível de significância de 5% foi utilizado em todos os testes. No Brasil, houve um aumento: de 2,4 vezes no número de transplantes de córnea (de 6.193 [35,2 pmp] para 14.641 [71 pmp] - p<0,001); de 50,7% na eficácia de atender a demanda populacional de transplantes de córnea (de 35,3% para 53,2% - p<0,001); de 11 vezes no número de centros de transplantes de córnea (de 32 para 356); e de 2,5 vezes no número de equipes transplantadoras de córnea (de 276 para 688). A lista de espera para o transplantes de córnea diminuiu em 45,4% (de 23.549 [123 pmp] para 12.865 [62,4 pmp] - p<0,001). A produtividade das equipes de córnea ao longo dos anos foi de 19 transplantes de córnea ao ano. Os melhores índices foram apresentados nas regiões Sul, Cen tro-Oeste e Sudeste e os piores no Norte e Nordeste. O Brasil, embora de forma heterogênea entre as regiões, vem melhorando a capacidade de realizar o transplante de córnea nos últimos 16 anos, porém a demanda populacional por transplante de córnea ainda não é adequadamente atendida, principalmente devido ao baixo número de doações de córnea.

8.
Arq Bras Oftalmol ; 81(6): 529-538, 2018 Nov./Dec..
Artigo em Inglês | MEDLINE | ID: mdl-30304091

RESUMO

A retrospective and analytical study was conducted by using data from the National Transplantation System on 184,575 corneal transplantations performed between January 2001 and December 2016 in order to analyze thetrends in corneal transplantation from 2001 to 2016 in Brazil. The Cochran-Armitage test, analysis of variance, and Duncan's multiple comparisons were used to verify the existence of trends, compare the mean values between regions, and verify the mean differences, respectively. A significance level of 5% was used for all tests. The analysis showed that there was a 2.4-fold increase in the number of corneal transplantations (from 6,193 [35.2 per million people (pmp)] to 14,641 [71 pmp]; p<0.001), a 50.7% increase in the efficacy of meeting the population's demand for corneal transplantation (from 35.3% to 53.2%; p<0.001), an 11-fold increase in the number of corneal transplantation centers (from 32 to 356), and a 2.5-fold increase in the number of corneal transplantation teams (from 276 to 688) in Brazil during the period studied. The waiting list for corneal transplantation decreased by 45.4% (from 23,549 [123 pmp] to 12,865 [62.4 pmp]; p<0.001), and the corneal transplantation teams performed about 19 corneal transplantations per year. The best indices were observed in the southern, midwestern, and southeastern regions, and the worst indices were in the northern and northeastern regions. Brazil has been improving its capacity to perform corneal transplantation in the past 16 years, although this improvement varies across regions. However, the population's demand for corneal transplantation is yet to be satisfactorily met, primarily due to the low number of corneal donations.

9.
Eye Contact Lens ; 44 Suppl 2: S376-S381, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30256231

RESUMO

PURPOSE: To analyze 15-year of corneal transplant in Brazil. METHODS: Cross-sectional, retrospective, observational, and analytical study, between available data from the Brazilian Transplant Registry (January 2002-December 2016), collected by the Brazilian Association of Organ Transplantation was performed. The variables analyzed per year were number of corneal transplants, corneal transplants per million people (pmp), corneal transplant teams, and individuals on the waiting list for corneal transplants. Quantitative variables were expressed by their respective values. To verify the relationship of time with the variables, the Spearman correlation test was applied, adopting P<0.05 for rejection of the null hypothesis. RESULTS: Evaluation of the data from 2002 to 2016 revealed an increase in number of (1) corneal transplants (4,976-14,534-approximately 292% in 15 years; P<0.0001); (2) corneal transplants pmp (29.4-71.1 pmp; P<0.0001); (3) productivity of corneal transplants teams (40.1-79 transplants by each team per year; P=0.067); (4) effectiveness in meeting the Brazilian population demand for corneal transplants per year (18.2%-57.0%; P<0.0001); (5) potential donors (P<0.0001), effective donors (P<0.0001), and nondonors (P<0.0001). There was a reduction in the number of patients on the waiting list (19,189-10,923; P=0.056). CONCLUSION: Despite the progress in the last decade, the number of corneal transplants in Brazil cannot meet the growing population demand. Thus, this study suggests the implementation of more effective public policies of corneal transplants in Brazil, to minimize disparities in national territory, adequately meet the population demand, and reduce the time in waiting lists for corneal transplants.

10.
Eye (Lond) ; 2018 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-30154574

RESUMO

PURPOSE: To report the long-term outcome of early secondary intraocular lens (IOL) implantation following congenital cataract extraction in a large number of eyes. METHODS: Data of aphakic children under 30 months of age who underwent secondary IOL implantation and had at least one year of follow-up after the surgery was reviewed. In all of the patients, a foldable three-piece acrylic IOL was implanted in the ciliary sulcus by the same surgeon using the same technique. The database studied included refractive and visual acuity (VA) outcomes and complications. RESULTS: Fifty patients (75 eyes) were included. The average age at the time of cataract extraction was 94.20 ± 44.94 days and 20.7 ± 6.0 months in the secondary IOL implantation. After 82.32 ± 48.91 months, the VA was 0.58 ± 0.35 LogMAR and the spherical equivalent was -2.20 ± 4.19 D. There was a negative correlation between a longer follow-up period and myopia at the SE measured (P = .001). The most frequent complications included glaucoma and corectopia. Performing the secondary IOL implantation ≤ 20 months of age was not a risk factor for glaucoma development (P = 0.095). CONCLUSION: Secondary IOL implantation under 30 months of age is an option for children with unsatisfactory management of the optic treatment. A predictable IOL power calculation and satisfactory visual outcomes compared to results of later secondary IOL implantation are possible.

11.
Arq. bras. oftalmol ; 81(4): 348-353, July-Aug. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-950474

RESUMO

ABSTRACT Patients undergoing cataract surgery are generally elderly, and many take drugs with systemic effects. The surgeon must be aware of the risks of continuing or discontinuing such medications perioperatively. Antiplatelet drugs and anticoagulants, prescribed to reduce the incidence of thromboembolic events, are often used in this population. This paper aims to review the perioperative use of antiplatelet and anticoagulant drugs in the setting of cataract surgery. Topical or intracameral anesthesia is preferred over anesthesia injected with needles. Aspirin can be safely continued in patients undergoing cataract surgery. Warfarin has been extensively studied, and the risk of hemorrhage associated with cataract surgery is low if the international normalized ratio is in the therapeutic range. Only a few studies of direct oral anticoagulants are available, and therefore no definite recommendations regarding those agents can be made at this time. Anesthesia in cataract surgery carries a low risk, even for patients taking anticoagulant or antiplatelet drugs. The discontinuation of this class of drugs before cataract surgery may increase the risk of thromboembolism.


RESUMO Os pacientes submetidos à cirurgia de catarata são geralmente idosos e muitos deles usam drogas com efeitos sistêmicos. No entanto, o cirurgião deve estar ciente dos riscos em manter ou descontinuar medicamentos sistêmicos no pré-operatório da cirurgia de catarata, como os anticoagulantes e os antiplaquetários. Este artigo tem como objetivo revisar a classe de drogas antiplaquetárias e anticoagulantes e orientar o cirurgião de catarata. A classe de fármacos anticoagulantes e antiplaquetária reduz a incidência de eventos potencialmente tromboembólicos. A anestesia tópica ou intracameral nesses pacientes deve ser preferida em relação à anestesia com agulhas. Aspirina pode ser mantida com segurança nos pacientes submetidos à cirurgia de catarata. A varfarina foi amplamente estudada e os riscos na cirurgia de catarata são baixos, no entanto, o INR deve ser controlado. Mais estudos são necessários com anticoagulantes orais diretos. Anestesia na cirurgia de catarata tem baixo risco de complicações, mesmo em uso de anticoagulantes ou antiplaquetários sistêmicos. A descontinuação desta classe de medicamentos no pré-operatório da cirurgia de catarata pode aumentar os riscos sistêmicos tromboembólicos.

12.
Arq Bras Oftalmol ; 81(4): 348-353, 2018 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29995131

RESUMO

Patients undergoing cataract surgery are generally elderly, and many take drugs with systemic effects. The surgeon must be aware of the risks of continuing or discontinuing such medications perioperatively. Antiplatelet drugs and anticoagulants, prescribed to reduce the incidence of thromboembolic events, are often used in this population. This paper aims to review the perioperative use of antiplatelet and anticoagulant drugs in the setting of cataract surgery. Topical or intracameral anesthesia is preferred over anesthesia injected with needles. Aspirin can be safely continued in patients undergoing cataract surgery. Warfarin has been extensively studied, and the risk of hemorrhage associated with cataract surgery is low if the international normalized ratio is in the therapeutic range. Only a few studies of direct oral anticoagulants are available, and therefore no definite recommendations regarding those agents can be made at this time. Anesthesia in cataract surgery carries a low risk, even for patients taking anticoagulant or antiplatelet drugs. The discontinuation of this class of drugs before cataract surgery may increase the risk of thromboembolism.


Assuntos
Anticoagulantes/administração & dosagem , Extração de Catarata/métodos , Inibidores da Agregação de Plaquetas/administração & dosagem , Anticoagulantes/efeitos adversos , Extração de Catarata/efeitos adversos , Humanos , Período Intraoperatório , Inibidores da Agregação de Plaquetas/efeitos adversos , Fatores de Risco , Tromboembolia Venosa/prevenção & controle
15.
Rev. bras. oftalmol ; 77(3): 142-145, May-June 2018.
Artigo em Português | LILACS-Express | ID: biblio-959089

RESUMO

Resumo As doenças da córnea são responsáveis por cerca de 4 a 5% da cegueira reversível no mundo. O transplante de córnea é o tecido mais transplantado em todo o mundo e o único tratamento amplamente aceito para promover a transparência corneana e restaurar a visão. O monitoramento incorporou-se ao campo da Saúde Pública, com o objetivo de acompanhar sistematicamente a atuação das equipes e os dados de produção, por meio da criação de normas, inspeções de avaliação periódicas e acompanhamento dos indicadores de qualidade. As análises críticas dos resultados objetivam apontar falhas e riscos envolvidos no processo, e empreender ações capazes de modificar os achados negativos, a fim de aprimorar a qualidade dos serviços prestados à população. No Brasil, existem diferentes fontes de dados sobre transplantes de córnea e bancos de tecidos oculares. Nesta revisão, foi avaliada a precisão dos dados e a confiabilidade das informações divulgadas pelo Sistema Nacional de Transplantes, pela Associação Brasileira de Transplante de Órgãos e pela Agência Nacional de Vigilância Sanitária sobre a situação do transplante de córnea no Brasil, a fim de nortear governos, gestores em saúde pública e pesquisadores.


Abstract Corneal diseases account for about 4 to 5% of reversible blindness in the world. Corneal transplantation is the most transplanted tissue in the world and the only widely accepted treatment to promote corneal transparency and restore vision. Monitoring was incorporated into the field of Public Health, with the objective of systematically monitoring teams' performance and production data, through the creation of norms, periodic evaluation inspections and monitoring of quality indicators. The critical analyzes of the results aim to point out flaws and risks involved in the process, and to undertake actions capable of modifying the negative findings, in order to improve the quality of the services provided to the population. In Brazil, there are different sources of data on corneal transplants and ocular tissue banks. In this review, the accuracy of the data and the reliability of the information disclosed by the National Transplant System by the Brazilian Organ Transplant Association and the National Sanitary Surveillance Agency on the situation of corneal transplantation in Brazil were evaluated in order to guide governments, public health managers and researchers.

16.
Curr Eye Res ; 43(4): 451-454, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29336614

RESUMO

PURPOSE: To evaluate the cornea of systemic sclerosis (SSc) patients with Dual Scheimpflug Imaging. METHODS: Twenty consecutive SSc patients and 20 age and sex matched controls were enrolled in this cross-sectional study. Corneal measurements were acquired by dual Scheimpflug analyzer. RESULTS: SSc patients had statistically significant steeper corneas than the control group. The mean anterior curvature-average (SimK) was 44.93 ± 1.64 D (mean ± standard deviation) in SSc and 43.61 ± 0.99D in control group, p = 0.01. Posterior curvature was also steeper in SSc patients compared to controls (p = 0.02). There was no statistically significant difference regarding central average pachymetry (p = 0.07), thinnest pachymetry (p = 0.09). CONCLUSIONS: Patients with SSc present with steeper corneas than controls.

17.
Int Ophthalmol ; 38(1): 251-256, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28478533

RESUMO

PURPOSE: To evaluate the relationship between glaucoma diagnosis and the nailfold capillaroscopy pattern in patients with systemic sclerosis. METHODS: An observational study in a cohort of patients with SSc was conducted. Patients with at least one nailfold videocapillaroscopy and one ophthalmology examination at the same year were included. Data collected were: age, sex; type of systemic sclerosis according to the degree of skin impairment, self-reported ethnicity, disease duration, current use and dosage of systemic corticosteroid, current use and dosage of bosentan®, intraocular pressure, central corneal thickness, diagnosis of glaucoma and capillaroscopy pattern. RESULTS: Thirty-one patients with systemic sclerosis were enrolled, 23% had glaucoma. There was no statistically significant association between glaucoma diagnosis and the capillaroscopic pattern (p = 0.86). There was also no significant difference (p = 0.66) regarding intraocular pressure between patients with mild (13.9 ± 3.8 mmHg) and severe capillaroscopic pattern (14.4 ± 2.8 mmHg). The odds ratio of glaucoma for severe capillaroscopic pattern compared to mild was 1.6 (95% confidence interval: 0.3-9.5). CONCLUSION: Up to 23% of patients with SSc have glaucoma. The high prevalence of glaucoma in SSc suggests a possible systemic vascular disturbance as the cause. However, there seems to be no significant association between the capillaroscopy pattern and glaucoma in systemic sclerosis. Further research is required to improve the understanding of glaucoma in the context of systemic sclerosis.


Assuntos
Capilares/diagnóstico por imagem , Glaucoma/etiologia , Angioscopia Microscópica/métodos , Medição de Risco/métodos , Escleroderma Sistêmico/complicações , Adulto , Idoso , Brasil/epidemiologia , Progressão da Doença , Feminino , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Unhas/irrigação sanguínea , Projetos Piloto , Prevalência , Escleroderma Sistêmico/diagnóstico , Tonometria Ocular/métodos
18.
Clinics (Sao Paulo) ; 72(9): 543-546, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29069257

RESUMO

OBJECTIVE: To evaluate the efficiency of long-term cataract surgery using low-cost intraocular lens implantation in community campaigns. METHODS: Fifty-eight randomly selected patients were evaluated four years after phacoemulsification and Ioflex intraocular lens implantation. Causes of low visual acuity related to the intraocular lens were evaluated, and treatment costs were calculated. RESULTS: The mean age of patients was 72±10.2 years. Four years after surgery, 25 eyes (43.0%) had decreased visual acuity related to the intraocular lens: posterior capsule opacification was noted in 24 eyes (41.3%), and intraocular lens opacification was noted in one eye (1.7%). The total cost of the post-surgical complication treatments represented 6.3% of the initial budget of the entire surgical patient group. CONCLUSIONS: The efficiency of cataract surgery with low-cost Ioflex intraocular lens implantation was significantly reduced in a long-term follow-up study because postoperative complications related to intraocular lenses emerged at higher rates than when the gold-standard treatment was used.


Assuntos
Resinas Acrílicas/economia , Resinas Acrílicas/uso terapêutico , Implante de Lente Intraocular/métodos , Lentes Intraoculares/economia , Facoemulsificação/métodos , Idoso , Idoso de 80 Anos ou mais , Opacificação da Cápsula/etiologia , Custos e Análise de Custo , Seguimentos , Humanos , Implante de Lente Intraocular/efeitos adversos , Implante de Lente Intraocular/economia , Lentes Intraoculares/efeitos adversos , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Facoemulsificação/economia , Complicações Pós-Operatórias , Desenho de Prótese , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento , Acuidade Visual
19.
Clinics ; 72(9): 543-546, Sept. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-890729

RESUMO

OBJECTIVE: To evaluate the efficiency of long-term cataract surgery using low-cost intraocular lens implantation in community campaigns. METHODS: Fifty-eight randomly selected patients were evaluated four years after phacoemulsification and Ioflex intraocular lens implantation. Causes of low visual acuity related to the intraocular lens were evaluated, and treatment costs were calculated. RESULTS: The mean age of patients was 72±10.2 years. Four years after surgery, 25 eyes (43.0%) had decreased visual acuity related to the intraocular lens: posterior capsule opacification was noted in 24 eyes (41.3%), and intraocular lens opacification was noted in one eye (1.7%). The total cost of the post-surgical complication treatments represented 6.3% of the initial budget of the entire surgical patient group. CONCLUSIONS: The efficiency of cataract surgery with low-cost Ioflex intraocular lens implantation was significantly reduced in a long-term follow-up study because postoperative complications related to intraocular lenses emerged at higher rates than when the gold-standard treatment was used.


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Resinas Acrílicas/economia , Resinas Acrílicas/uso terapêutico , Implante de Lente Intraocular/métodos , Lentes Intraoculares/economia , Facoemulsificação/métodos , Opacificação da Cápsula/etiologia , Custos e Análise de Custo , Seguimentos , Implante de Lente Intraocular/efeitos adversos , Implante de Lente Intraocular/economia , Lentes Intraoculares/efeitos adversos , Facoemulsificação/efeitos adversos , Facoemulsificação/economia , Complicações Pós-Operatórias , Desenho de Prótese , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento , Acuidade Visual
20.
J Refract Surg ; 33(8): 538-544, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28787519

RESUMO

PURPOSE: To assess visual and refractive outcomes of toric iris-claw phakic intraocular lens (IOL) implantation in patients who had previously undergone deep anterior lamellar keratoplasty (DALK). METHODS: Retrospective case series including 24 eyes of 24 patients implanted with toric Artiflex or Artisan (Ophtec BV, Groningen, Holland) phakic IOL following DALK for keratoconus. During a 12-month follow-up, the main outcome measures were uncorrected and corrected distance visual acuities (UDVA and CDVA), refractive error components, topographic parameters, and endothelial cell count. Alpins vectorial analysis was performed. RESULTS: At the last follow-up, the spherical equivalent (SE) was within ±0.50 diopters (D) in 71% of eyes and within ±1.00 D in 92% of eyes. Mean refractive astigmatism was reduced from -4.92 ± 1.55 D (range: -2.50 to -8.00 D) preoperatively to -0.66 ± 0.61 D (range: -2.00 to 0.00 D) after treatment, and 76.5% of cases were within ±1.00 D. No significant differences (P = .123) were detected in spherical equivalent values between 3- and 12-month follow-up visits. No eyes lost lines in CDVA, and 54% of eyes gained one or more lines. Postoperative UDVA was 20/40 or better in 88% of eyes. Efficacy and safety indexes at 12 months were 0.93 and 1.00, respectively. Mean endothelial cell loss was 6.10% at 12 months postoperatively. No intraoperative or postoperative complications were noted over the follow-up period. CONCLUSIONS: The implantation of a toric iris-claw phakic IOL has shown high efficacy and safety in this series and may be considered as a reasonable option for the management of refractive errors after DALK. [J Refract Surg. 2017;33(8):538-544.].


Assuntos
Astigmatismo/cirurgia , Iris/cirurgia , Ceratocone/cirurgia , Ceratoplastia Penetrante/efeitos adversos , Implante de Lente Intraocular/métodos , Lentes Intraoculares Fácicas , Refração Ocular/fisiologia , Adulto , Astigmatismo/etiologia , Astigmatismo/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Reoperação , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA