Navegando por Palavras-chave "Ultraviolet therapy"
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- ItemAcesso aberto (Open Access)Cross-linking e segmento de anel corneano intraestromal(Conselho Brasileiro de Oftalmologia, 2011-02-01) Renesto, Adimara da Candelaria [UNIFESP]; Sartori, Marta [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Corneal cross-linking is a procedure used for stabilizing the cornea in patients with progressive keratoconus by increasing corneal rigidity, and it is also used in corneal inflammatory melting process. The intrastromal corneal ring segments act by flatting the center of the cornea. Originally designed for the correction of mild myopia, the segments are now being used for reduction of keratoconus in order to improve the uncorrected visual acuity, the best spectacle corrected visual acuity, to allow good tolerance to the use of contact lenses and delay the need for corneal grafting procedures. The present text presents a review of corneal cross-linking and insertion of intrastromal corneal ring segments, emphasizing their indications, results and complications related until now.
- ItemAcesso aberto (Open Access)Efeito da riboflavina tópica exposta à irradiação ultravioleta A e inserção de segmentos de anéis corneanos intraestromais para ceratocone(Universidade Federal de São Paulo (UNIFESP), 2012-05-30) Renesto, Adimara da Candelaria [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To report the impression cytologic results after corneal cross-linking and insertion of intrastromal corneal ring segments for keratoconus. Methods: Thirty-nine eyes were distributed into two groups: 1) cross-linking group (patients underwent corneal cross-linking procedure), and 2) riboflavin eyedrops group (patients received riboflavin 0.1% (w/v) eyedrops in 20% dextran solution for 1 month). After 3 months, all patients underwent insertion of intrastromal corneal ring segments. Impression cytologic specimens were obtained from all eyes at baseline, at 1 month and 3 months after cross-linking or riboflavin eyedrops, and again at 6 months, 1 year, and 2 years after intrastromal corneal ring segment insertion. Results: Patients in the cross-linking group demonstrated improvement in the cell-to-cell contact of epithelial cells and the nucleusto- cytoplasm ratio on the temporal conjunctiva after treatment (P = 0.008 and P = 0.047), respectively. On the superior conjunctiva, increases in goblet cell density (P = 0.037) and level of organization of nuclear chromatin (P = 0.010) after treatment were noted. Patients in the riboflavin eyedrops group demonstrated improvement in the cellto- cell contact of epithelial cells on the superior conjunctiva after treatment (P = 0.021). On the temporal conjunctiva, an improvement in the cell-to-cell contact of epithelial cells (P < 0.001) and increases in the nucleus-to-cytoplasm ratio (P < 0.001), goblet cell density (P = 0.001), and less keratinization (P = 0.011) were noted. No changes were identified on the cornea for either group. Fisher’s exact test comparison of the impression cytologic total scores after treatment revealed no difference between groups. Conclusion: Despite changes in some conjunctival parameters (e.g., cell-tocell contact of epithelial cells, nucleus-to-cytoplasm ratio, level of organization of nuclear chromatin , goblet cell density, and keratinization), comparison of the total impression cytologic scores revealed no difference between groups.
- ItemAcesso aberto (Open Access)Eficácia e segurança do 308-nm monochromatic excimer lamp (mel) comparado a outros equipamentos de fototerapia no tratamento do vitiligo: revisão sistemática com metanálise(Universidade Federal de São Paulo (UNIFESP), 2017-04-28) Lopes, Celso [UNIFESP]; Melnik, Tamara [UNIFESP]; Trevisani, Virgínia Fernandes Moça [UNIFESP]; http://lattes.cnpq.br/9054730236021091; http://lattes.cnpq.br/6986710571229801; http://lattes.cnpq.br/3951529851949437; Universidade Federal de São Paulo (UNIFESP)Background: Various phototherapy methods are used to treat vitiligo; however, the recent emergence of new devices has heightened debate concerning the best treatment method. Objective: We aimed to systematically review and metaanalyze published data comparing the efficacy and adverse effects of monochromatic excimer lamps versus excimer laser and narrowband ultraviolet B (NB-UVB) in treating vitiligo. Methods: A systematic search of PubMed, EMBASE, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL), and clinical trials registries identified randomized controlled trials that included vitiligo patients, regardless of age, sex, or study language. We evaluated studies comparing excimer lamps with excimer laser or NB-UVB phototherapy. Results: The review included six studies (411 patients, 764 lesions). No study found significantly different efficacy between excimer lamps and excimer laser using the outcomes of ≥50% repigmentation (RR = 0.97, 95% CI 0.84-1.1; lesions = 412; studies = 3; I² = 0%; moderate quality evidence) and ≥75% repigmentation (RR = 0.96, 95% CI 0.71-1.30; lesions = 308; studies = 2; I² = 20%; moderate quality evidence). Likewise, no study found significant differences between excimer lamps and NB-UVB for ≥50% repigmentation (RR = 1.24, 95% CI 1.00 - 1.54; lesions = 352; studies = 3; I² = 0%; low quality evidence) or for ≥75% repigmentation (RR = 1.81, CI 95% 0.11 - 29.52; lesions = 64; studies = 2; I² = 57%; very low quality evidence). Adverse effects were mild, including pruritus, burning sensation, and dryness, none of which interrupted treatment. Conclusions: Excimer lamps, excimer laser, and NB-UVB are all safe and effective in repigmentation of vitiligo lesions. No significant difference between the equipments was found using the outcomes of ≥50% and ≥ 75% repigmentation. Adverse effects, in short time, were mild. To our knowledge, this is the first systematic review of the efficacy and safety of excimer lamp treatment for vitiligo.
- ItemAcesso aberto (Open Access)Novos conceitos em modelamento corneano(Sociedade Brasileira de Oftalmologia, 2010-04-01) Brocchetto, Daniela Coneglian [UNIFESP]; Dantas, Brunno; Schor, Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Gama FilhoThe cornea has a great influence in the visual process. However, it is liable to distortion, such as flattening. When this flattening is caused by the use of contact lenses, we call corneal warpage. In this case, some symptoms may occur as blurred vision with glasses, conjunctival hyperemia, foreign body sensation, etc… Used to think that the cornea was more rigid and, in time, realized that the cornea has viscoelastic properties. We can say that the cornea has a body biomechanics property and suffers instability when there are some changes, such as keratoconus, which is a progressive corneal degeneration. In order to preserve the cornea more stable, the cross-linking technique was developed to promote covalent bonds between the lamellae of the cornea to make it stronger and less elastic. Other corneal change that may occur is based on the induction in corneal reshaping by using rigid contact lenses (only during sleeping) with high oxygen transmissibility (DK / L). This technique is known as Orthokeratology and its concepts will be addressed in this study.
- ItemAcesso aberto (Open Access)Ultra B2 - Promoção de ligações covalentes do colágeno corneal (Corneal cross-linking) no tratamento de ceratocone: resultados preliminares(Conselho Brasileiro de Oftalmologia, 2008-12-01) Jankov Ii, Mirko R.; Hafezi, Farhad; Beko, Maja; Ignjatovic, Zora; Djurovic, Branislav; Markovic, Vujica; Schor, Paulo [UNIFESP]; Institute of Refractive and Ophthalmic Surgery; US Medical School Medical Academy Milos Eye Hospital; Univerziteta u Beogradu Medicinski Fakultet Ocna Klinika; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To present early visual and keratometric results for corneal cross-linking with riboflavin and UV irradiation in patients with progressive keratoconus. METHODS: Twenty-five eyes of twenty patients (15 males and 5 females) with a progressive keratoconus in the previous 6 months were followed. Unaided visual acuity (UVA), best spectacle corrected visual acuity (BSCVA), spherical equivalent (SEQ), manifest cylinder, and maximal corneal curvature (max K) values were followed at 1, 3 and 6 months. All patients were submitted to corneal cross-linking using riboflavin (vitamin B2) as the photosensitizer and ultraviolet light (UV, wavelength 370 nm). Epithelium was removed with 20% alcohol, cornea was soaked with vitamin B2 for 15 min, and then irradiated with UV light for 30 min, after which a bandage contact lens (BCL) was placed. RESULTS: UVA increased after one month (from 0.15 ± 0.15 to 0.23 ± 0.20), and went on increasing at 3 and 6 months, reaching statistical significance (p=0.025 e p=0.037, respectively). BSCVA increased from 0.41 ± 0.27 to 0.49 ± 0.29 at month six, without reaching statistical significance at any time point. Progression of keratoconus stopped in all patients, in contrast with progression in all of them in the six-month period prior to the surgery. Max K decreased by more than 2 D (from 53.02 ± 8.42 to 50.88 ± 6.05 D), SEQ less that 1 D (from -3.27 ± 4.08 to -2.68 ± 3.02 D), while refractive cylinder decreased less than 0.5 D (from -2.29 ± 1.77 to -1.86 ± 0.92 D), without reaching a statistically significant difference. None of the eyes lost any line of BSCVA, 12 maintained the preoperative BSCVA, 7 gained one line, 5 gained two lines, and 1 patient gained three lines of BSCVA. CONCLUSIONS: Corneal cross-linking with riboflavin and UV light seems to be a safe (no loss of BSCVA) and effective (anatomical and optical properties maintained) procedure, which has shown to stop the progression of the keratoconus: a reduction, although not statistically significant, of the corneal curvature, spherical equivalent and refractive cylinder took place in patients where previous progression of keratoconus had been described.