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1.
Indian J Ophthalmol ; 69(3): 706-708, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33595505

RESUMO

Purpose: The aim of this study was to analyze the impact of COVID-19 lockdown on keratoplasty and Eye Banking in India. Methods: An e-mail survey was conducted among cornea surgeons and eye bankers of India. Participants were asked to report their practice patterns for the management of corneal perforation during lockdown, different preservative media used during and before lockdown, and waiting time and waiting time before COVID-19 lockdown. Results: Eight of 20 eye banks did not collect corneal tissue during April-June 2020; in contrast, 9 eye banks used to collect around 100 corneas per month during pre-COVID-19 time. Two-third of the surgeons (66.1%, n = 41/62) did not perform any corneal tissue transplant between April and June 2020. Cyanoacrylate tissue adhesive application was the most commonly, performed procedure (79%, n = 49/62) for tectonic purpose during this period. Glycerol was the most preferred alternative preservation method considered by both the groups. More than half of the surgeons (64.5%, n = 40/62) had an average waiting time of <1 week for scheduling patients for keratoplasty in pre-COVID-19 period. Conclusion: There is was a significant drop in both corneal tissue retrieval and utilization during during COVID-19 lockdown. There was a felt need for an alternate long term storage media.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/métodos , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Bancos de Olhos/estatística & dados numéricos , Quarentena , Doadores de Tecidos/estatística & dados numéricos , Comorbidade , Doenças da Córnea/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pandemias , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários
3.
PLoS One ; 15(10): e0239939, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33057425

RESUMO

To provide the general information on corneal transplantation (CT) in China, China Cornea Society designed a questionnaire on CT from 2014 to 2018 and entrusted it to 31 committee members for implementation of the survey nationwide. This article presents the results of the survey and compares the indicators used in the survey and those in the annual statistical report released by the Eye Bank Association of America (EBAA). The number of corneal transplantations completed by the 64 hospitals from 2014 to 2018 was respectively 5377, 6394, 7595, 8270 and 8980, totally 36,616 (22,959 male and 13,657 female). The five largest hospitals by the number of corneal transplantations completed 15,994 surgeries in total, accounting for 43.68% of all the surgeries performed in the 64 hospitals. The most common indication for corneal transplantations was corneal leukoma (7683, 20.98%), followed by bacterial keratitis (4209, 11.49%), corneal dystrophies (4189, 11.44%), keratoconus (3578, 9.77%) and corneal perforation (2839, 7.75%). The main surgical techniques were penetrating keratoplasty (PK) (19,896, 54.34%), anterior lamellar keratoplasty (ALK) (13,869, 37.88%). The proportion of PK decreased from 57.97% in 2014 to 52.88% in 2018 while the proportion of ALK increased from 36.04% in 2014 to 37.92% in 2018. The geographical distribution of keratoplasties performed in China is unbalanced. PK and ALK were the main techniques of CT and corneal leukoma, bacterial keratitis and corneal dystrophies were the main indications for CT in China.


Assuntos
Córnea , Doenças da Córnea , Transplante de Córnea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China , Córnea/patologia , Córnea/cirurgia , Doenças da Córnea/epidemiologia , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Transplante de Córnea/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
4.
Ann Afr Med ; 19(2): 119-123, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32499468

RESUMO

Purpose: The cornea is the most significant refractive medium in the eye. Pathologies affecting the cornea usually have a great impact on vision. The etiology of corneal disorder varies from one geographical location to another. The objective of this study was to determine the pattern of corneal disorders at Ekiti State University Teaching Hospital, Ado-Ekiti. Materials and Methods: A retrospective study of case records of patients with cornea disorders over a 5-year period was carried out. Demographic characteristics, presenting visual acuity, and risk factor for cornea disorders were retrieved. Data were entered into the Statistical Package for the Social Sciences version 20, and statistical significance was inferred at P < 0.05. Results: Corneal disorders accounted for 3.3% of the eye disorders seen during the period of study. The median age was 37 years. Males outnumbered females giving a ratio of 1.9:1 and the age range from 0.25 to 92 years. There were more females than males in the 11-20 years' age group. Students (84, 25.4%) and artisans (62, 18.8%) were the two leading occupational groups. Infectious cases constituted 27.2% of the cases. Visual acuity at presentation was <3/60 in 131 (39.7%) cases. Foreign body entry was the leading etiologic agent in 101 (30.6%) cases. Conclusion: Half of the patients were blind at presentation, and many of them presented after more than 1 week of the onset of symptoms. Corneal foreign body, trauma, and vernal keratoconjunctivitis were the leading known predisposing factors. There will be need to emphasize more on the role of protective eye devices among our people, especially those who engage in outdoor activities.


Assuntos
Córnea/patologia , Doenças da Córnea/epidemiologia , Acuidade Visual/fisiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
5.
Eur J Ophthalmol ; 30(5): 966-973, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32340490

RESUMO

BACKGROUND: Lowe syndrome is a rare X-linked disease that is characterized by renal dysfunction, developmental delays, congenital cataracts and glaucoma. Mutations in the oculocerebral renal syndrome of Lowe (OCRL) gene are found in Lowe syndrome patients. Although loss of vision is a major concern for families and physicians who take care of Lowe syndrome children, definitive cause of visual loss is still unclear. Children usually present with bilateral dense cataracts at birth and glaucoma, which occurs in more than half of cases, either concurrently or following cataract surgery. MATERIALS AND METHODS: A retrospective review was conducted on the prevalence and characteristics of ocular findings among families of patients with Lowe syndrome with 137 uniquely affected individuals. RESULTS: Of 137 patients, all had bilateral congenital cataracts. Nystagmus was reported in 69.3% of cases, glaucoma in 54.7%, strabismus in 35.0%, and corneal scar in 18.2% of patients. Glaucoma was reported as the most common cause of blindness (46%) followed by corneal scars (41%). Glaucoma occurred in 54.7% of patients and affected both eyes in the majority of cases. Of these patients, 55% underwent surgery for glaucoma, while the remaining patients used medications to control their eye pressure. Timolol and latanoprost were the most commonly used medications. Although trabeculectomy and goniotomy are commonly used for pressure management, aqueous tube shunts had the best outcomes. CONCLUSION: Ocular manifestations in individuals with Lowe syndrome and carriers with OCRL mutation are reported which may help familiarize clinicians with the ocular manifestations and management of a rare and complex syndrome.


Assuntos
Oftalmopatias/epidemiologia , Síndrome Oculocerebrorrenal/epidemiologia , Catarata/congênito , Catarata/diagnóstico , Catarata/epidemiologia , Extração de Catarata , Criança , Pré-Escolar , Doenças da Córnea/diagnóstico , Doenças da Córnea/epidemiologia , Oftalmopatias/diagnóstico , Feminino , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/epidemiologia , Síndrome Oculocerebrorrenal/genética , Monoéster Fosfórico Hidrolases/genética , Prevalência , Estudos Retrospectivos , Estrabismo/diagnóstico , Estrabismo/epidemiologia
6.
J Fr Ophtalmol ; 43(1): 1-6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31831273

RESUMO

PURPOSE: To observe trends in surgical techniques for corneal transplantation and main indications in our hospital over the past five years. METHODS: Retrospective descriptive study, including all keratoplasties performed at the Hospital Clinic of Barcelona, Spain, between January 2014 and December 2018. RESULTS: In total, 332 keratoplasties were performed. In total, 127 (38.25%) were penetrating keratoplasties (PK), and 205 (61.75%) were lamellar keratoplasties (LK). In 2014, a total of 48 keratoplasties were carried-out, whereas in 2018, the total was 93, which represents a 93.75% increase in corneal transplantation surgeries. Eye bank-delivered precut tissue for DMEK was introduced in 2016, and 3 cases (6.25%), were carried out that year. In 2018, DMEK became the leading technique with 56 cases (60.22%). Fuchs' dystrophy was the leading indication for corneal transplant (37.63%) in 2018. CONCLUSION: Introduction of DMEK in a single center can be implemented in a relatively short period of time, becoming the most popular surgical procedure in corneal transplantation. A possible factor encouraging this change is the availability of eye bank-delivered precut tissue, and standardization of donor preparation and host surgical steps, optimizing surgical time in the operating room. This trend should lead to better visual outcomes, faster recovery times, and eventually to a higher surgical volume per year.


Assuntos
Doenças da Córnea/cirurgia , Transplante de Córnea/tendências , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças da Córnea/epidemiologia , Transplante de Córnea/métodos , Transplante de Córnea/estatística & dados numéricos , Lâmina Limitante Posterior/cirurgia , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos , Epitélio Posterior/cirurgia , Epitélio Posterior/transplante , Feminino , Distrofia Endotelial de Fuchs/epidemiologia , Distrofia Endotelial de Fuchs/cirurgia , Humanos , Ceratoplastia Penetrante/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Espanha/epidemiologia , Doadores de Tecidos
7.
Rev. Soc. Colomb. Oftalmol ; 53(1): 17-23, 2020. ilus., tab.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1128016

RESUMO

Introducción: Queratocono es un término clínico amplio, que describe un estado de la córnea derivado de su adelgazamiento focal y protrusión secundaria central, paracentral y/o periférica. Los reportes epidemiológicos globales revelan un amplio rango en cifras de prevalencia e incidencia que se podría explicar por las diferencias geográficas, factores de riesgo, tipo de población, métodos y criterios diagnósticos utilizados. En Colombia no hay estudios epidemiológicos que evalúen esta enfermedad de manera integral por lo que su frecuencia aún no ha podido ser determinada. Objetivo: identificar la prevalencia de Queratocono y Degeneración Marginal Pelucida (DMP) en el centro oftalmológico privado Clínica Barraquer, durante el periodo de tiempo comprendido entre enero de 2014 y enero de 2019. Diseño del estudio: estudio transversal de fuentes secundarias. Método: revisión de los registros médicos electrónicos de todos los pacientes que consultaron por primera vez; posteriormente, se filtraron por el diagnóstico de Ectasia Corneal y/o Queratocono. Cada una de las historias clínicas fue analizada por un oftalmólogo teniendo en cuenta los diagnósticos preestablecidos. Resultados: del grupo de 91.426 pacientes, 2.647 tenían Queratocono o DMP. Se estableció una prevalencia de Queratocono y DMP del 2.84%. La edad promedio al momento del diagnóstico fue de 29.7±12 años. El 42.8% eran mujeres y el 57.2% hombres. Conclusión: la ectasias corneales de tipo Queratocono y DMP, son enfermedades con una prevalencia significativa en la población colombiana evaluada en la clínica Barraquer; consideramos se requiere de programas de tamizaje visual para su detección y tratamiento oportunos.


Background: Keratoconus is a wide clinical term used to describe a corneal disease characterized by thinning and secondary central, paracentral or peripheral protrusion of the cornea. The global epidemiological reports reveal a wide range of prevalence and incidence, that may be explained by geographical differences, risk factors, kind of population, and methods and diagnostic criteria employed. There are no epidemiological studies to evaluate globally this disease in Colombia, therefore, its frequency has not been determined yet. Objective: to identify the prevalence of Keratoconus and Pellucid Marginal Degeneration (PMD) from January 2014 to January 2019 at the private ophthalmological center Clínica Barraquer. Study Design: cross-sectional study using secondary data. Method: a review of the electronic medical records of all patients who consulted for the first time was performed, and then, filtered by the initial diagnosis of Corneal Ectasia or Keratoconus. Each one of the medical records was analyzed by an ophthalmologist taking into account a series of pre-established diagnostic criteria. Results: of 91.426 patients, 2.647 had Keratoconus or PMD within the time interval of the study. A prevalence of 2.84% was determined in first time patients. The average age at the time of diagnosis was 29.7±12 years. 42.8% were female patients and 57.2% male patients. Conclusion: Keratoconus and PMD are diseases with significant prevalence in the Colombian population evaluated at the Barraquer clinic, thus, visual screening programs are required for accurate detection and treatment.


Assuntos
Ceratocone/epidemiologia , Estudos Epidemiológicos , Fatores de Risco , Córnea , Doenças da Córnea/epidemiologia , Oftalmopatias
8.
Arq. bras. oftalmol ; 82(5): 377-380, Sept.-Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019430

RESUMO

ABSTRACT Purpose: To assess the frequency of corneal astigmatism before cataract surgery in a Brazilian sample. Methods: This clinic-based cross-sectional study was conducted at the Bonsucesso Federal Hospital, Rio de Janeiro, Brazil. Charts of patients who underwent cataract surgery over a two-year period were retrospectively reviewed, and preoperative keratometric measurements were collected and analyzed. Results: A total of 1707 eyes of 1045 patients were enrolled. The corneal astigmatism was less than 1.0 D in 971 eyes (56.9%), 1.0-1.99 D in 496 eyes (29.1%), 2.0-2.99 D in 157 eyes (9.2%), and more than 3.0 D in 83 eyes (4.9%). The mean corneal astigmatism was 0.92 ± (SD) 0.96 D (range 0 - 10.25 D). Conclusion: Over 40% of the patients undergoing cataract surgery enrolled in this study had more than 1.0 D of corneal astigmatism and may benefit from the use of toric intraocular lenses. These data can be useful for planning to make this technology available for patients.


RESUMO Objetivo: Avaliar a prevalência do astigmatismo corneano antes da cirurgia de catarata em pacientes brasileiros. Métodos: Este estudo transversal de base clínica foi realizado no Hospital Federal de Bonsucesso, Rio de Janeiro, Brasil. Os prontuários de pacientes submetidos à cirurgia de catarata durante um período de dois anos foram revisados retrospectivamente, e as medidas ceratométricas pré-operatórias foram coletadas e analisadas. Resultados: Um total de 1.707 olhos de 1045 pacientes foram incluídos. O astigmatismo corneano foi menor que 1,0 D em 971 olhos (56,9%), 1,0-1,99 D em 496 olhos (29,1%), 2,0-2,99 D em 157 olhos (9,2%) e mais de 3,0 D em 83 olhos (4,9%). A média do astigmatismo corneano foi de 0,92 ± (SD) 0,96 D (intervalo 0-10,25 D). Conclusão: Mais de 40% dos pacientes estudados submetidos à cirurgia de catarata incluídos neste estudo tinham mais de 1,0 D de astigmatismo corneano e podem se beneficiar do uso de lentes intraoculares tóricas. Esses dados podem ser úteis no planejar a disponibilização dessa tecnologia para os pacientes.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Astigmatismo/epidemiologia , Catarata/complicações , Extração de Catarata , Doenças da Córnea/epidemiologia , Brasil/epidemiologia , Prevalência , Estudos Transversais , Estudos Retrospectivos , Córnea/fisiopatologia , Hospitais Públicos
9.
Cornea ; 38(12): 1531-1535, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31490270

RESUMO

PURPOSE: To compare the incidence of corneal epithelial ingrowth (EIG) and the visual outcomes of enhancement with laser in situ keratomileusis (LASIK) by flap lift when a bandage soft contact lens (CL) was fitted after the procedure and when it was not. METHODS: This is a multicenter, retrospective, interventional case series in which all patients who underwent LASIK enhancement from January 2005 to January 2015 were included consecutively. Patients were grouped depending on whether a bandage CL was fitted after re-treatment by flap lift (group 1) or not (group 2). RESULTS: A total of 16,702 eyes from 12,485 patients were included. There were statistically significant differences between the groups regarding corrected distance visual acuity (better in group 1) and safety index (better in group 2) although these were not clinically relevant. The incidence of EIG was 0.58% in group 1 and 0.55% in group 2 although, again, the difference was not statistically different. CONCLUSIONS: We found no relevant differences in LASIK enhancement between patients who received a bandage CL and those who did not regarding the incidence of EIG and visual outcomes.


Assuntos
Bandagens , Lentes de Contato Hidrofílicas , Doenças da Córnea/epidemiologia , Epitélio Anterior/patologia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Retalhos Cirúrgicos , Adolescente , Adulto , Idoso , Doenças da Córnea/diagnóstico , Doenças da Córnea/fisiopatologia , Substância Própria/cirurgia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Miopia/cirurgia , Reoperação , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia , Adulto Jovem
10.
Cornea ; 38(12): 1602-1609, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31433359

RESUMO

PURPOSE: This study seeks to review published research on the global epidemiology of corneal blindness, with a specific focus on the available published estimates of incidence, prevalence, and trends in incidence or prevalence, as well as the contribution of corneal causes to overall burden of blindness. METHODS: A scoping review was conducted of the published literature on the global epidemiology of corneal blindness, with emphasis on prevalence and incidence studies. Four databases were searched using both epidemiological and corneal blindness keywords. This review was limited to studies with a primary aim of determining the incidence, prevalence, or trends in corneal blindness or the percentage of blindness due to corneal causes. Only conditions considered to signify current blindness were included, not diseases that eventually could lead to blindness if left untreated. RESULTS: A total of 185 articles met the selection criteria. Of these, 145 articles investigated all-cause blindness prevalence. Only 10 articles specifically aimed to determine estimates of corneal blindness prevalence, 7 articles provided results for all-cause blindness incidence, and no studies focused on obtaining corneal blindness incidence. Data on corneal blindness were most often present in studies investigating all-cause blindness and in trachoma studies. CONCLUSIONS: The results demonstrate the somewhat inconsistent and fragmented information regarding corneal causes of vision loss. A significant outcome of this research is the demonstration of a need for further research into global corneal blindness and the necessary steps to address the problem.


Assuntos
Cegueira/epidemiologia , Doenças da Córnea/epidemiologia , Saúde Global , Humanos , Incidência , Prevalência
11.
Asia Pac J Ophthalmol (Phila) ; 8(4): 324-329, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356367

RESUMO

PURPOSE: The measurement of corneal thickness by corneal pachymetry provides valuable information in the setting of corneal disease; however, spectral-domain optical coherence tomography (SD-OCT)-based assessment of different corneal sectors has been scarce in Pakistan. DESIGN: We aimed to obtain a whole-corneal thickness map using SD-OCT and to evaluate its correlation with age, sex, and axial length. METHODS: Our study included 214 subjects with healthy corneas; each eye was scanned with an SD-OCT covering a 9-mm diameter, and reproducibility was evaluated in a subset of 50 participants by means of an identical scan protocol repeated by 2 different OCT operators. RESULTS: Our analysis revealed corneal thickness to be thinnest inferotemporally whereas thickest in the superior and superonasal quadrants. No statistically significant differences could be detected between male and female participants with respect to corneal thickness, age, intraocular pressure, axial length, and refractive errors. However, we identified a significant negative correlation between age and corneal thickness in all corneal sections, excluding the inner and middle superior, inner superonasal, and inner and middle superotemporal quadrants. Conversely, the correlation between axial length and corneal thickness was found to be positive in the central region (P = 0.03, R = 0.149), the outer inferotemporal quadrant (P = 0.012, R = 0.171), throughout the temporal quadrant (P = 0.024, R = 0.154 for inner; P = 0.025, R = 0.153 for middle; P = 0.006, R = 0.186 for outer), and in the inner superotemporal quadrant (P = 0.018, R = 0.162). CONCLUSIONS: Different corneal sectors may interact heterogeneously with patient-related characteristics. This may provide incentive to evaluate whole-corneal thickness as a distinct parameter for clinical identification of disease processes.


Assuntos
Córnea/diagnóstico por imagem , Doenças da Córnea/diagnóstico , Paquimetria Corneana/métodos , Adulto , Distribuição por Idade , Fatores Etários , Doenças da Córnea/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Prevalência , Estudos Prospectivos , Reprodutibilidade dos Testes , Distribuição por Sexo , Fatores Sexuais , Tomografia de Coerência Óptica , Adulto Jovem
12.
Cornea ; 38(11): 1370-1376, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31335525

RESUMO

PURPOSE: To explore the transition of indications and surgical techniques of pediatric keratoplasty in Eastern China in the past 10 years. METHODS: Medical charts of 1026 pediatric patients (1059 eyes) who underwent keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2017 were retrospectively reviewed. The indications for keratoplasty and the surgical techniques were collected and analyzed. RESULTS: A total of 634 infants (≤3 years) (661 eyes), 207 toddlers and older children (4-12 years) (211 eyes), and 185 adolescents (13-18 years) (187 eyes) were included. The median age at the time of surgery was 2 years. The surgical indications were composed of congenital abnormalities (74.6%), acquired nontraumatic diseases (16.5%), acquired traumatic diseases (3.6%), and regraft (5.3%). Only congenital abnormality had a significant growing trend during this decade (P = 0.023). Keratoconus (67.2%) exceeded infectious keratitis (14.9%) and was the most common acquired nontraumatic cause in our study. The annual number of pediatric keratoplasties increased significantly from 40 cases in 2008 to 190 cases in 2017 (P < 0.001). Although penetrating keratoplasty was performed in 414 eyes (39.1%), its application in the treatment of keratoconus decreased significantly during this decade (P = 0.04). By contrast, deep anterior lamellar keratoplasty showed an increasing trend because of its popularization in the treatment of keratoconus (P = 0.003). CONCLUSIONS: Congenital abnormalities have replaced infectious keratitis and have been the leading indications of pediatric keratoplasty in the past 10 years. Although the using of penetrating keratoplasty was still the predominant procedure to treat pediatric corneal pathologies, the adoption of deep anterior lamellar keratoplasty showed a significant increasing trend during the past decade.


Assuntos
Córnea/cirurgia , Doenças da Córnea/cirurgia , Ceratoplastia Penetrante/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Córnea/patologia , Doenças da Córnea/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Reoperação/tendências , Estudos Retrospectivos
13.
Arq Bras Oftalmol ; 82(5): 377-380, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166427

RESUMO

PURPOSE: To assess the frequency of corneal astigmatism before cataract surgery in a Brazilian sample. METHODS: This clinic-based cross-sectional study was conducted at the Bonsucesso Federal Hospital, Rio de Janeiro, Brazil. Charts of patients who underwent cataract surgery over a two-year period were retrospectively reviewed, and preoperative keratometric measurements were collected and analyzed. RESULTS: A total of 1707 eyes of 1045 patients were enrolled. The corneal astigmatism was less than 1.0 D in 971 eyes (56.9%), 1.0-1.99 D in 496 eyes (29.1%), 2.0-2.99 D in 157 eyes (9.2%), and more than 3.0 D in 83 eyes (4.9%). The mean corneal astigmatism was 0.92 ± (SD) 0.96 D (range 0 - 10.25 D). CONCLUSION: Over 40% of the patients undergoing cataract surgery enrolled in this study had more than 1.0 D of corneal astigmatism and may benefit from the use of toric intraocular lenses. These data can be useful for planning to make this technology available for patients.


Assuntos
Astigmatismo/epidemiologia , Extração de Catarata , Catarata/complicações , Doenças da Córnea/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Córnea/fisiopatologia , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos
14.
BMC Ophthalmol ; 19(1): 137, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248388

RESUMO

BACKGROUND: Uveitis in the pediatric population is uncommon, accounting for 2 to 14% of all uveitis cases, yet resulting in significant ocular morbidity. A number of studies have focused on patterns and complications of uveitis in the pediatric age group (≤ 16 years). In this report, we studied children with uveitis syndromes focusing on demographics, anatomic distribution, etiologies, treatment, and complications. We additionally divided subjects into two age groups to look into any differential characteristics pertaining to the younger age group and the role of amblyopia as a cause of visual loss. METHODS: Retrospective chart review of 80 eyes of 49 uveitis patients aged ≤16 years. Subjects were categorized by age of onset into visually immature (≤8 years) and visually mature group (> 8 years). Data compared between the two age groups included demographics, disease characteristics, visual outcomes and complications. RESULTS: Idiopathic uveitis was the most common diagnosis (51%). Anterior uveitis complications (posterior synechiae and band keratopathy) were more common in the younger group (p = 0.002 and p = 0.03 respectively) while posterior uveitis manifestations (vitreous haze and vasculitis) were more common in the older age group (p = 0.04 and p < 0.001 respectively). Amblyopia was the most common cause of vision loss in the visually immature versus cataract in the visually mature. CONCLUSION: Anterior uveitis and its complications were more common in visually immature group in our cohort. Amblyopia was identified as the main cause of visual loss in the younger population.


Assuntos
Ambliopia/etiologia , Catarata/etiologia , Doenças da Córnea/etiologia , Medição de Risco/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Uveíte/epidemiologia , Acuidade Visual , Distribuição por Idade , Fatores Etários , Ambliopia/epidemiologia , Catarata/epidemiologia , Criança , Pré-Escolar , Doenças da Córnea/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Líbano/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Uveíte/complicações , Uveíte/fisiopatologia
15.
Ann Am Thorac Soc ; 16(8): 957-966, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31091984

RESUMO

Ophthalmic disease encountered in the intensive care unit (ICU) has a wide spectrum of prevalence and severity. Prolonged exposure of the cornea is common and preventable. Trauma, glaucoma, infection, vascular disease, and burns are among the potential causes of vision loss. Patients are predisposed to ocular complications by the ICU environment and critical illness itself. Critically ill patients require prioritization of life-sustaining interventions, and less emphasis is placed on ophthalmic disease, leading to missed opportunities for vision-saving intervention. It is therefore imperative for intensivists, nurses, and other providers to have an increased awareness and understanding of the broad range of ocular conditions potentially seen in the ICU.


Assuntos
Oftalmopatias/etiologia , Unidades de Terapia Intensiva , Oftalmologia , Doenças da Córnea/epidemiologia , Doenças da Córnea/etiologia , Doenças da Córnea/prevenção & controle , Estado Terminal , Oftalmopatias/epidemiologia , Oftalmopatias/prevenção & controle , Oftalmopatias/terapia , Infecções Oculares/epidemiologia , Infecções Oculares/etiologia , Infecções Oculares/prevenção & controle , Humanos , Doença Iatrogênica , Prevalência , Prognóstico
16.
J Fr Ophtalmol ; 42(5): 517-528, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-31005284

RESUMO

The corneal limbus is a privileged region on the border between two quite different microenvironments, where corneal epithelial stem cells, numerous melanocytes, and antigen-presenting cells are all concentrated within a richly vascularized and innervated stroma. This situation within the ocular surface confers on it the key functions of barrier, epithelial renewal and defense of the cornea. As an immunological crossroads and since the corneoscleral limbus is directly exposed to external insults such as caustic agents, ultraviolet radiation, microbial agents, and allergens, it is the potential site of many tumoral, degenerative or inflammatory pathologies and may progress under certain conditions to limbal stem cell deficiency.


Assuntos
Doenças da Córnea/patologia , Limbo da Córnea/anatomia & histologia , Limbo da Córnea/patologia , Córnea/anatomia & histologia , Córnea/diagnóstico por imagem , Córnea/patologia , Doenças da Córnea/diagnóstico , Doenças da Córnea/epidemiologia , Epitélio Anterior/anatomia & histologia , Epitélio Anterior/diagnóstico por imagem , Epitélio Anterior/patologia , Infecções Oculares/diagnóstico , Infecções Oculares/patologia , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/patologia , Humanos , Doenças do Sistema Imunitário/diagnóstico , Doenças do Sistema Imunitário/patologia , Limbo da Córnea/diagnóstico por imagem , Células-Tronco/patologia
17.
Hum Gene Ther ; 30(8): 923-945, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31020856

RESUMO

Corneal diseases are among the most prevalent causes of blindness worldwide. The transparency and clarity of the cornea are guaranteed by a delicate physiological, anatomic, and functional balance. For this reason, all the disorders, including those of genetic origin, that compromise this state of harmony can lead to opacity and eventually vision loss. Many corneal disorders have a genetic etiology, and some are associated with rather rare and complex syndromes. Conventional treatments, such as corneal transplantation, are often ineffective, and to date, many of these disorders are still incurable. Gene therapy carries the promise of being a potential cure for many of these diseases, with solutions and strategies that did not seem possible until a few years ago. With its potential to treat genetic disease by means of deletion, replacement, or editing of a defective gene, the challenge can also be extended to corneal disorders in order to achieve long-term, if not definitive, relief. The aim of this paper is to review the state of the art of the different gene therapy approaches as potential treatments for corneal diseases and the future perspectives for the development of personalized gene-based medicine.


Assuntos
Córnea/metabolismo , Doenças da Córnea/etiologia , Doenças da Córnea/terapia , Terapia Genética , Animais , Terapia Combinada , Doenças da Córnea/diagnóstico , Doenças da Córnea/epidemiologia , Suscetibilidade a Doenças , Terapia Genética/métodos , Terapia Genética/tendências , Humanos , Incidência , Resultado do Tratamento
18.
J Eur Acad Dermatol Venereol ; 33(7): 1358-1362, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30903713

RESUMO

BACKGROUND: Sensitive scalp or irritable bowel syndrome has been previously shown to be associated with sensitive skin. We wondered whether sensitive eyelids and sensitive eyes could also be associated with sensitive skin. METHODS: A cross-sectional epidemiological study was carried out on a representative sample of French people, according to the quota method, using a questionnaire. RESULTS: A total of 2048 subjects were included in the present study. Notably, 52.2% declared sensitive eyes, which was more frequent in women than in men. The subjects who reported sensitive eyes were more numerous according to the severity of skin sensitivity, the severity of sleep disorders and the presence of bright eyes. More than half of the subjects with sensitive eyes thought that they were sensitive to sun exposure, dust, computer or touch pads or dry air. The presence of sensitive eyelids was reported by 18.65% (more frequent in women) and was associated with sensitive skin and sensitive eyes, sun exposure and exposure to dust. CONCLUSION: This study is the first to investigate sensitive eyelids or sensitive eyes. Sensitive eyelids can be considered a localization of sensitive skin. The concept of sensitive eyes is not commonly used by ophthalmologists and remains to be more precisely defined.


Assuntos
Doenças da Córnea/epidemiologia , Doenças Palpebrais/epidemiologia , Dermatopatias/epidemiologia , Adolescente , Adulto , Idoso , Comorbidade , Computadores , Estudos Transversais , Poeira , Feminino , França/epidemiologia , Humanos , Umidade , Masculino , Pessoa de Meia-Idade , Transtornos de Fotossensibilidade/epidemiologia , Fatores de Risco , Fatores Sexuais , Luz Solar , Inquéritos e Questionários , Adulto Jovem
19.
J Refract Surg ; 35(3): 146-152, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30855091

RESUMO

PURPOSE: To investigate the incidence and clinical results of corneal complications after small incision lenticule extraction (SMILE). METHODS: A retrospective cohort study including 3,223 patients (6,373 eyes) who were treated for myopia or myopic astigmatism was conducted. Postoperative corneal complications were recorded. Postoperative follow-up visits were scheduled on days 1 and 7 and months 1, 3, 6, and 12. RESULTS: Of the 6,373 cases, 432 eyes (6.8%) developed at least one corneal complication postoperatively. These included punctate epithelial erosions (3.26%), diffuse lamellar keratitis (DLK) (2.17%), corneal infiltrates (0.39%), interface debris/secretion (0.30%), interface haze (0.17%), interface foreign body (0.24%), corneal striae (0.14%), corneal edema (0.09%), and epithelial ingrowth (0.02%). Of cases with corneal complications, 308 (71.3%) had an uncorrected distance visual acuity (UDVA) of better than 20/25 and 49 (11.3%) eyes lost two or more lines of corrected distance visual acuity (CDVA) on the first day after surgery. By 3 months, only 2 eyes (0.9%) had lost two or more lines of CDVA. At 6 months, 1 eye (1.0%) did not achieve a UDVA of 20/25 as a result of stage 3 DLK, but achieved 20/20 by 1 year. The postoperative spherical equivalent in cases without complications was lower than that in cases with complications at 1 day and 1 and 3 months (P = .001, .011, and .001, respectively), but there was no statistical difference at 6 and 12 months. CONCLUSIONS: In this large cohort study, a variety of corneal complications were noted after SMILE. Although some of these complications may temporarily affect visual recovery, most resolve with appropriate treatment. [J Refract Surg. 2019;35(3):146-152.].


Assuntos
Astigmatismo/cirurgia , Doenças da Córnea/etiologia , Substância Própria/cirurgia , Cirurgia da Córnea a Laser/efeitos adversos , Miopia/cirurgia , Complicações Pós-Operatórias , Adolescente , Adulto , Doenças da Córnea/epidemiologia , Cirurgia da Córnea a Laser/métodos , Feminino , Seguimentos , Humanos , Incidência , Masculino , Microcirurgia , Pessoa de Meia-Idade , Refração Ocular , Estudos Retrospectivos , Acuidade Visual , Adulto Jovem
20.
J Fr Ophtalmol ; 42(3): 295-302, 2019 Mar.
Artigo em Francês | MEDLINE | ID: mdl-30857801

RESUMO

Penetrating keratoplasty is the most commonly performed tissue transplant in the world. However, its success depends on the health of the ocular surface and the intact immune privilege of the eye. In the absence of these two conditions, corneal transplants have an increased failure rate and result in corneal blindness. For more than two hundred years, researchers have been trying to find the best design of the artificial cornea in order to address these cases of severe corneal blindness. Despite previous difficulties, interest in the field has recently been revived, and considerable progress has been made over the last 20 years, to the point where the keratoprosthesis is now considered a primary procedure for some indications and is no longer always a surgery of last resort. In this review, we describe the global and personal experience with Boston keratoprosthesis type 1. It is a relatively new treatment for severe corneal blindness in the context of multiple failed corneal transplants and high-risk conditions. In the last decade, changes in the design, surgical technique, and postoperative management have increased the success rate and popularity of the Boston keratoprosthesis and decreased its complications substantially, making it a safe and effective alternative for certain corneal pathologies. However, some complications persist and require management to improve the visual prognosis of patients with corneal blindness.


Assuntos
Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Ceratoplastia Penetrante/métodos , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/cirurgia , Doenças da Córnea/complicações , Doenças da Córnea/epidemiologia , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Próteses e Implantes , Implantação de Prótese/métodos
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