Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Cataract"

Navegando por Palavras-chave "Cataract"

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Acesso aberto (Open Access)
Amblyopia after unilateral infantile cataract extraction after six weeks of age
(Conselho Brasileiro de Oftalmologia, 2009-10-01) Ejzenbaum, Fábio [UNIFESP]; Salomão, Solange Rios [UNIFESP]; Berezovsky, Adriana [UNIFESP]; Waiswol, Mauro; Tartarella, Marcia Beatriz [UNIFESP]; Sacai, Paula Yuri [UNIFESP]; Pereira, Josenilson Martins [UNIFESP]; Santa Casa de São Paulo Setor de Estrabismo e Neuro-Oftalmologia; Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Departamento de Oftalmologia Setor de Catarata Congênita
PURPOSE: To determine interocular grating acuity difference in children treated for unilateral infantile cataract. METHODS: A group of 27 children previously treated for unilateral infantile cataract, had their monocular visual acuity measured by sweep visual evoked potentials. Interocular grating acuity difference was calculated as the absolute subtraction of monocular acuity scores. Lens status, opacity severity and eye alignment were considered for analysis. RESULTS: Mean interocular grating acuity difference obtained from unilateral cataract patients was 0.58 ± 0.20 logMAR. This result was significantly larger than 0.10 logMAR used as normative data. Children with severe opacities had a more pronounced amblyopia than the moderate ones. No significant correlation between amblyopia and strabismus or aphakia was found. CONCLUSIONS: Interocular acuity difference in this group of unilateral congenital cataract was more pronounced than previous reports, mainly because of delay in diagnosis, surgery and optical correction.
Acesso aberto (Open Access)
Anterior capsule staining using 0.025% trypan blue in cataracts without red reflex
(Conselho Brasileiro de Oftalmologia, 2001-08-01) Marback, Eduardo Ferrari [UNIFESP]; Freitas, Lincoln Lemes de [UNIFESP]; Fernandes, Fernanda Pelegrino [UNIFESP]; Branco, Bruno Castelo [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Purpose: To describe the use of anterior capsule staining in cataracts without red reflex using a 0.025% trypan blue solution. Methods: Six eyes of 6 patients with cataracts without red reflex were submitted to phacoemulsification using a direct injection of 0.2 to 0.5 ml of 0.025% trypan blue in the anterior chamber previous to viscoelastic injection. All patients had an ophthalmologic examination prior to surgery, as well as pre and postoperative corneal endothelial cell count. Results: In all cases the capsule became stained with a faint blue color that enabled an adequate visibility of the flap during the continuous curvilinear anterior capsulotomy (CCC). There were no intra-or postoperative complications. The endothelial cell loss varied between 1.8% and 26.6% (mean 12.8%). Conclusion: Staining the anterior capsule with 0.025% trypan blue solution allows a good visibility of the capsular flap and facilitates the confection of CCC in cataracts without red reflex.
Acesso aberto (Open Access)
Application of different scheimpflug-based lens densitometry methods in phacodynamics prediction
(Dove medical press ltd, 2016) Faria-Correia, Fernando; Lopes, Bernardo T.; Ramos, Isaac C.; Monteiro, Tiago; Franqueira, Nuno; Ambrosio, Renato, Jr. [UNIFESP]
Purpose: To evaluate the correlations between preoperative Scheimpflug-based lens densitometry metrics and phacodynamics. Methods: The Lens Opacities Classification System III (LOCS III) was used to grade nuclear opalescence (NO), along with different methods of lens densitometry evaluation (absolute scale from 0% to 100%): three-dimensional (3D), linear, and region of interest (l)l modes. Cumulative dissipated energy (CDE) and total ultrasound (US) time were recorded and correlated with the different methods of cataract grading. Significant correlations were evaluated using Pearson or Spearman correlation coefficients according to data normality. Results: A positive correlation was detected between the NO score and the average density and the maximum density derived from the 3D mode (r-0.624, P<0.001
Acesso aberto (Open Access)
Avaliação da eficácia da facectomia com implante de lente intra-ocular na infância
(Conselho Brasileiro de Oftalmologia, 2005-12-01) Maia, Nubia Cristina de Freitas [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Baikoff, George; Universidade Federal de São Paulo (UNIFESP); Clínica Monticelli
PURPOSE: To evaluate the efficacy of the use of intraocular lenses in the treatment of pediatric aphakia, according to postoperative visual acuity and refraction change. METHODS: A total of 33 eyes in 27 children were studied. Children with either unilateral or bilateral cataracts were submitted to lensectomy surgery via pars plana, with intraocular lens implant, associated with primary posterior capsulectomy and anterior vitrectomy. The intraocular lenses were calculated for emmetropia in the first postoperative month. All children were less than six years old at the time of the surgery and had a 2.9 year average follow-up. They were divided into 3 groups. Group I (10 eyes), children with unilateral cataracts and under three years old at the time of the surgery; group II (11 eyes), children with unilateral cataracts and above three years old; group III (12 eyes), children with bilateral cataracts and above three years old at the time of the surgery. RESULTS: On the last follow-up examination recorded visual acuity was equal to or above 20/40 in 85% of the eyes. A spherical equivalent close to emmetropia in the first postoperative month was obtained in 70% of the children of group III but only in 30% of group I. Regarding postoperative refraction variation, myopic shift was detected in 81.81% of the cases. The younger the children were when undergoing surgery, the greater the refractional alteration. CONCLUSION: Despite the myopic shift that happens with the use of intraocular lenses in the treatment of pediatric aphakia in children under six years old, the visual result is very good and the residual refraction correction is easily performed. A more prolonged postoperative follow-up would be necessary for long-term evaluation of the results.
Acesso aberto (Open Access)
Avaliação da qualidade de vida relacionada à visão em crianças com catarata congênita bilateral
(Conselho Brasileiro de Oftalmologia, 2009-08-01) Lopes, Marcia Caires Bestilleiro [UNIFESP]; Salomão, Solange Rios [UNIFESP]; Berezovsky, Adriana [UNIFESP]; Tartarella, Marcia Beatriz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To assess vision-related quality of life in children with bilateral congenital cataracts, using the recently developed Children's Visual Function Questionnaire (CVFQ). METHODS: CVFQ has two presentations, one for children under 3 years of age and the other for older children, and is divided in six subscales - general health; general vision; competence; personality; family impact and treatment. From those, a composite score can also be calculated. The CVFQ was applied in the hospital setting to parents or other caretakers by personal interview. The subscale scores were compared for control group (n=32 - normal vision) versus congenital cataract group (n=16 no visual impairment, n=10 - mild visual impairment and n=11 - severe visual impairment). For analysis, t-tests and analysis of variance (ANOVA) were performed. RESULTS: All quality of life subscales presented low scores for children with bilateral congenital cataracts. Congenital bilateral cataract scores were lower than those of the control group for all subscales. Competence subscale in the experimental group was significantly lower in the comparison with visual impairment severity (F=5.1, p=0.01; Tukey test p<0.01) as well as the composite score (F=5.4, p=0.01; Tukey test p=0.01/0.05). CONCLUSIONS: Bilateral congenital cataracts influence vision-related quality of life of children as confirmed by low scores in all subscales assessed by the CVFQ with emphasis on the competence subscale. This instrument should be incorporated in the clinical assessment of children with bilateral cataracts as a measure of the impact of visual impairment in their quality of life.
Acesso aberto (Open Access)
Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal
(Conselho Brasileiro de Oftalmologia, 2005-08-01) Oliveira, Filipe de [UNIFESP]; Muccioli, Cristina [UNIFESP]; Silva, Luci Meire Pereira da [UNIFESP]; Soriano, Eduardo Sone [UNIFESP]; Souza, Carlos Eduardo Borges [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The binocular contrast sensitivity test demonstrated that 6 patients (30%) presented 1.80 log units, 13 (65%) 1.65 and in only 1 (5%) the sensitivity was 1.50 log units. By the other hand, the monocular test in right eye showed 17 patients (85%) with 1.65 log units and 3 (15%) with 1.50. In the left eye, the test presented 16 patients (80%) with 1.65 log units and 4 (20%) with 1.50 log units. The average and the standard deviation of the contrast sensitivity were 1.63 (±0.05) for right eye, 1.62 (±0.06) for left eye and 1.69 (±0.08) for binocular test. Stereopsis test disclosed 12 patients (60%) presenting 40, 6 (30%) 50 and only 2 (10%) 60 (average: 45 and standard deviation: 6.88). CONCLUSIONS:The Acrysof Restor® intraocular lens provided results of contrast sensitivity and stereopsis in accordance with the criteria of normality established previously in other studies for phakic and pseudophakic patients. Therefore, this intraocular lens does not decrease visual functionality.
Acesso aberto (Open Access)
Avaliação do desempenho visual da lente intraocular difrativa multifocal - Zeiss AT Lisa 809 MTM
(Sociedade Brasileira de Oftalmologia, 2014-04-01) Vianna, Lucas Monferrari Monteiro [UNIFESP]; Oliveira, Filipe de [UNIFESP]; Pedro, Abujamra [UNIFESP]; Jung, Liang [UNIFESP]; Brenner, Luis Felipe [UNIFESP]; Yogi, Milton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
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).
Acesso aberto (Open Access)
Biometria óptica e ultrassônica guiada pelo modo-B em olhos com catarata e óleo de silicone intraocular
(Universidade Federal de São Paulo (UNIFESP), 2015-12-31) Souza, Paulo Henrique de [UNIFESP]; Allemann, Norma [UNIFESP]; http://lattes.cnpq.br/0956596522261307; http://lattes.cnpq.br/8150216880199905; Universidade Federal de São Paulo (UNIFESP)
Introdução: O preenchimento da cavidade vítrea com óleo de silicone após cirurgias vítreo-retinianas causa frequentemente a opacificação do cristalino. O óleo de silicone gera artefatos que dificultam a biometria modo-A. A biometria óptica tem sido o método de escolha para o cálculo da lente intraocular, porém pode se tornar impossível em opacificações mais densas. Objetivo: Comparar as medidas do comprimento axial utilizando a biometria óptica e a biometria ultrassônica de imersão guiada pelo modo-B em olhos fácicos portadores de óleo de silicone intraocular que serão submetidos à cirurgia de catarata. Métodos: 27 olhos com óleo de silicone intraocular foram submetidos à biometria óptica e à biometria guiada pelo modo-B, realizados pelo mesmo examinador. A biometria óptica (IOLMaster 500, Versão 7.5 Zeiss) foi obtida com a fixação em uma mira central. Foram obtidas 10 medidas com SNR maior que 1,5 mm para determinação do comprimento axial a ser utilizado na análise. A biometria guiada pelo modo-B (Ultrascan, Alcon) foi realizada através da técnica de imersão com o paciente em decúbito dorsal horizontal. Foram obtidas 4 medidas através do corte axial horizontal para determinação do comprimento axial médio a ser utilizado para análise. As medidas obtidas em cada método foram comparadas com teste de Wilcoxon para amostras pareadas e a análise de concordância foi realizada com o gráfico de Bland-Altman. As diferenças de comprimento axial também foram avaliadas considerando-se olhos maiores que 25,00 mm e a presença de interfaces artefatuais geradas pelo óleo de silicone. Resultados: Comprimento axial médio obtido pela biometria óptica: 25,34 mm +/- 2,23 (variação 22,79 a 30,75 mm); e pela biometria guiada pelo modo-B: 25,34 mm +/- 2,17 (variação 22,51 a 30,94 mm), sem diferença estatisticamente significante entre os métodos. Em 20 olhos (74,06%), a diferença de comprimento axial obtida por ambos os métodos foi menor que 0,4 mm, e em 13 olhos (48,14%) a diferença foi menor que 0,2 mm. O grupo que apresentou menor diferença entre os métodos (abaixo de 0,2 mm) incluiu olhos que apresentavam o preenchimento completo da cavidade vítrea por óleo de silicone e não mostravam preenchimento da câmara anterior. Conclusões: A biometria ultrassônica guiada pelo modo-B foi útil na diferenciação das estruturas anatômicas intraoculares na presença do óleo de silicone intraocular, fornecendo medidas de comprimento axial que concordam com as medidas obtidas através da biometria óptica.
Acesso aberto (Open Access)
Biometrias óptica e ultra-sônica: comparação dos métodos usados para o cálculo da lente intra-ocular acomodativa
(Conselho Brasileiro de Oftalmologia, 2004-12-01) Oliveira, Filipe de [UNIFESP]; Muccioli, Cristina [UNIFESP]; Lopes, Yara Cristina [UNIFESP]; Soriano, Eduardo Sone [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To compare reproducibility, level of agreement and correlation of two ultrasonic biometers and one optical biometer for the calculation of accommodative intraocular lens. METHODS: Cataract patients were submitted to the examination with 3 different biometers (IOLMaster, Axis II and Humphrey Mod. 820) before the implant of the C&C Vision AT-45 accommodative silicone intraocular lens. The Axis II biometer was used for both contact and immersion biometry. Axial length, anterior chamber depth and keratometry were the analyzed biometric parameters. RESULTS: Thirty-four patients from 53 to 90 years old (mean 70.6 y) were submitted to the examination with the three different biometers. The lowest mean axial length (23.12 mm) was obtained with the Axis II/contact and the highest (23.21 mm) with the Humphrey biometer. The lowest mean anterior chamber depth (2.97mm) was obtained with the Humphrey and the highest (3.10mm) with the IOLMaster. Reproducibility for axial length was high for all the biometers tested (coefficient of variation: 3.02% for Humphrey and Axis II / immersion; 3.07 % for Axis II/contact and 3.19% for IOLMaster). All biometers presented nearly equal results of the analyzed parameters (99.01% for axial length and 94.77% for anterior chamber depth). Pearson's coefficient showed a high correlation between the biometers, regarding the axial length and anterior chamber depth measurements. CONCLUSION: The devices used in this study showed excellent reproducibility and high level of agreement and of the axial length, anterior chamber depth and keratometry measurements, making it possible to reduce errors of intraocular lens calculation and visual insatisfaction after cataract surgery.
Acesso aberto (Open Access)
Capsulotomia medial
(Conselho Brasileiro de Oftalmologia, 2004-10-01) Gonçalves Neto, Paiva; Belfort, Rubens Junior [UNIFESP]; Hospital da Gamboa Departamento de Oftalmologia; Santa Casa de Misericórdia; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To evaluate the benefits of an alternative technique of anterior capsulotomy created to guarantee the complete implantation of the IOL in the capsular bag, during extracapsular cataract extraction. METHODS: One hundred and nine eyes were operated on through this technique and followed during a period of 1 year. The possibilities of the technique were evaluated regarding two aspects: the guarantee of a perfect placement of the IOL in the capsular bag and ability of providing an effective fixation of the implant through the characteristics of the anterior capsule remains. The first aspect was analyzed considering the number of cases where the two flaps could be properly observed during the implantation. The second aspect was evaluated through the positioning of the lens after 1 year. Specific difficulties and complications of this technique were also investigated. RESULTS: The two flaps could be properly observed during the implantation in 96 (90.6%) cases. One year after the surgery, the lens was centered in 81.9% of the cases, slightly off the center (less than 1 mm) in 13.3% and off the center (more than 1 mm) in 4.8%. CONCLUSION: These results, if compared to those presented in relation to other types of capsulotomy, indicate that this technique is a good alternative to provide the appropriate implantation of the lens in the bag, in extracapsular cataract extraction.
Acesso aberto (Open Access)
Catarata congênita: aspectos diagnósticos, clínicos e cirúrgicos em pacientes submetidos a lensectomia
(Conselho Brasileiro de Oftalmologia, 2004-12-01) Oliveira, Márcia Lima Santos [UNIFESP]; Di Giovanni, Maria Elizabeth [UNIFESP]; Porfírio Neto Jr, Francisco [UNIFESP]; Tartarella, Marcia Beatriz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To analyze the clinical and therapeutic profiles of children with congenital cataract submitted to lensectomy. METHODS: Retrospective study of 89 eyes of 62 children who underwent surgery at the Congenital Cataract Sector - Department of Ophthalmology - Federal University of São Paulo, Brazil. RESULTS: Among the 62 children, 30.64% showed infectious causes, 19.36% genetic causes and 50% idiopathic causes. Strabismus was found in 54.83% of the patients and 27.42% had systemic diseases. Concerning pregnancy conditions, 22.58% of the mothers had no adequate prenatal care. Consanguinity was observed in 17.74% of the cases and congenital cataracts in 6 (9.68%) relatives. The diagnostic suspicion was of the mothers in 72.58% of children. Leukocoria was the main feature. The suspicion age varied from immediately after birth to 15 months (mean = 1.34 months). Age on diagnosis in the department varied from 8 days to 20 months (mean = 5.84 months). Secondary opacification in the visual axis was the most frequent postoperative complication; it occurred in 19.11% of 89 eyes. It was observed that 45.16% of the patients had difficulties in following postoperative treatment. They did not use eyeglasses, eye drops or correct eye patching for amblyopia. CONCLUSION: Rubeola is still one of the most important causes of congenital cataract in our country. This condition shows the necessity of better prevention. The first diagnostic suspicion is mainly by the mothers and within the three first months of age in most children, but there is a considerable delay between suspicion and the patient's presence in a specialized service center. Despite satisfactory surgery results, delay of surgery and difficulties in postoperative treatment impair final visual results.
Acesso aberto (Open Access)
Catarata pediátrica pós-trauma
(Conselho Brasileiro de Oftalmologia, 2004-04-01) Leal, Fernando Antonio de M. [UNIFESP]; Tartarella, Marcia Beatriz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To study the pediatric cataract after trauma, it's relation to the kind of the trauma, the time elapsed between trauma and surgery and the correlation between corrected visual acuity and treatment. METHODS: We reviewed the medical records of all patients who presented diagnosis of traumatic cataract between August 1988 and December 2001 at the Congenital Cataract Service of Federal University of São Paulo. RESULTS: Sixty-six patients with diagnosis of pediatric cataract after trauma were studied, corresponding to an incidence of 4.80% of the total of cases attended in the service. Forty-seven (71.22%) were male and 19 (28.78%) were female. Forty-five (53.03%) sustained a blunt trauma, 21 (31.82%) a penetrating one, and 10 (15.15%) were not classified. The mean time between the injury and the surgery was 7 years and 6 months. The main described postoperative complications were uveitis sequels in 13 patients (21.12%) and posterior capsule opacification in 10 (15.15%). The initial and final visual acuity were obtained in 30 eyes. The mean follow-up was of two years, ranging from 1 to 96 months. CONCLUSION: The improvement of visual acuity was statistically significant (Wilcoxon test p < 0.001), being more intense in the eyes submitted to surgical treatment (p < 0.001) than in the eyes submitted to clinical treatment.
Acesso aberto (Open Access)
Cirurgia da catarata infantil unilateral
(Conselho Brasileiro de Oftalmologia, 2008-04-01) Brandão, Adriana Maria Drummond [UNIFESP]; Tartarella, Marcia Beatriz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow), and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.
Acesso aberto (Open Access)
Comparação a longo prazo entre a facectomia extracapsular combinada à trabeculectomia e à facotrabeculectomia
(Conselho Brasileiro de Oftalmologia, 2002-12-01) Mandia Jr., Carmo; Kasahara, Niro; Seixas, Francisco Soares [UNIFESP]; Paolera, Maurício Della; Almeida, Geraldo Vicente De; Cohen, Ralph; Irmandade da Santa Casa de Misericórdia de São Paulo Faculdade de Ciências Médicas; Irmandade da Santa Casa de Misericórdia de São Paulo Serviço de Glaucoma; Universidade Federal de São Paulo (UNIFESP)
Purpose: To compare the safety and efficacy of extracapsular cataract extraction (ECCE) combined with trabeculectomy and combined phacoemulsification/trabeculectomy. Methods: The records of 46 patients (53 eyes) who underwent combined glaucoma and cataract surgery at the Santa Casa de São Paulo between January 1996 and November 1999 were reviewed. Results: After a mean follow-up of 18 months, visual acuity improved and intraocular pressure decreased in both groups after surgery (P<0.05). In the phacofiltration group 55.5% of eyes achieved intraocular pressure < 22 mmHg without medication as compared to 46.1% in the extracapsular cataract extraction/trabeculectomy group (P=0.3). Conclusion: Both techniques proved to be safe and efficacious in the treatment of glaucoma and cataract. However, the phacofiltration surgery seems to promote lower intraocular pressure without additional medication in a larger number of eyes.
Acesso aberto (Open Access)
Comparação entre diferentes equipamentos utilizados na avaliação do paciente para a cirurgia de catarata
(Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Ventura, Bruna Vieira Oliveira Carvalho [UNIFESP]; Mattos, Rubens Belfort [UNIFESP]; Weikert, Mitchell; http://lattes.cnpq.br/4270399167335564; http://lattes.cnpq.br/6038691930130162; Universidade Federal de São Paulo (UNIFESP)
Purpose: To compare the measurements obtained by the Cassini, the Atlas 9000 and the Galilei G2 in normal and post-refractive surgery eyes. To evaluate the repeatability of corneal power and astigmatism measurements acquired by the Cassini in normal eyes, comparing it to those of the Atlas 9000 and the Lenstar LS 900. Furthermore, to compare the biometry measurements and intraocular lens (IOL) power calculations obtained by the Galilei G6 and the IOLMaster 500. Methods: Retrospectively, data was collected and compared regarding corneal power, astigmatism and aberrations measured by the Cassini (limited edition), the Atlas 9000 and the Galilei G2 in normal and post-refractive surgery eyes. Prospectively, three consecutive exams were done in normal eyes with the Cassini (version 1), the Atlas 9000 e the Lenstar LS 900. The intraclass correlation coefficient (ICC) and the within-subject standard deviation (Sw) were calculated. Tthe astigmatism was evaluated using vector analysis. In a subsequent study, the following data was compared between the Galilei G6 and the IOLMaster 500: axial length (AL), keratometry (K), anterior chamber depth (ACD) and IOL power calculation to achieve emetropia using a SN60WF Acrysof IOL and the Haigis formula. The 95% limits of agreement (LoA) were calculated. Results: In the retrospective analysis, there was no statistically significant difference between the devices in mean corneal power measured in normal eyes and post-refractive surgery eyes, and in mean astigmatism magnitude in post-refractive surgery eyes (all P > 0.05). In both groups of patients, there was no significant difference in mean coma and spherical aberration amongst the devices (P > 0.05). In the prospective analysis, the Cassini, Atlas 9000 and Lenstar LS 900 attained good repeatability (ICC > 0.9) in corneal power and astigmatism measurements, except for the Atlas 9000 with regards to J45 (ICC = 0.721). The Sw evidenced that the Cassini had a worst repeatability than the Lenstar LS 900 regarding corneal power (P < 0.0001) and than the Lenstar LS 900 (P = 0.0002) and the Atlas 9000 (P = 0.002) regarding astigmatism magnitude. The Galilei G6 and the IOLMaster 500 attained statistically similar mean of AL, K, ACD and IOL power chosen to reach emmetropia (95% LoA: 0.27 mm; 1.08 diopters (D); 0.66 mm, and 1.56 D, respectively). Conclusion: In normal and post-refractive surgery eyes, the Cassini, Atlas 9000 and Galilei G2 obtained similar mean corneal power, astigmatism, coma and spherical aberration. The Cassini presented a good repeatability in corneal power and astigmatism measurements; however, its performance was worse than that of the Lenstar LS 900 for corneal power and of the Lenstar LS 900 and the Atlas 9000 for astigmatism magnitude. The Galilei G6 and the IOLMaster 500 obtained similar mean biometric measurements and mean IOL power chosen to reach emmetropia. However, the wide range of differences amongst the devices suggests they should not be used interchangeably.
Acesso aberto (Open Access)
Comparative analysis of the nuclear lens opalescence by the Lens Opacities Classification System III with nuclear density values provided by Oculus Pentacam: a cross-section study using Pentacam Nucleus Staging software
(Conselho Brasileiro de Oftalmologia, 2011-04-01) Magalhães, Fernanda Pedreira [UNIFESP]; Costa, Elaine Fiod [UNIFESP]; Cariello, Angelino Júlio [UNIFESP]; Rodrigues, Eduardo Buchele [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To compare the clinical classification of cataract using the Lens Opacities Classification System (LOCS) III with the mean values of lens density provided by the Pentacam Scheimpflug System in nuclear cataracts. METHODS: One hundred and one eyes from 101 patients with age-related nuclear cataract were submitted to clinical examination for lens grading score using LOCS III. According to LOCS III, nuclear opalescence was divided in six groups. Patients were evaluated by the Pentacam Scheimpflug System for the mean lens density using the Pentacam lens densitometry program (PLDP), the Pentacam Nucleus Staging (PNS) mean value and the PNS cataract grading score. RESULTS: A positive correlation between the mean values of lens density and LOCS III classification, considering groups 1 to 5, could be noticed with PLDP and PNS mean value. The mean values between the groups were similar using the PLDP and the PNS mean value. However, when the PNS cataract grading score was evaluated, there was low correspondence with LOCS III classification. CONCLUSION: Pentacam Scheimpflug device offers an objective measure of the lens nuclear density on nuclear cataracts. PLDP and the PNS mean value were both useful to evaluate age-related nuclear cataract up to LOCS III group 5.
Acesso aberto (Open Access)
Concentração de proteínas no humor aquoso de pacientes com glaucoma primário de ângulo aberto em tratamento clínico
(Conselho Brasileiro de Oftalmologia, 2007-03-01) Prata, Tiago dos Santos [UNIFESP]; Navajas, Eduardo Vitor [UNIFESP]; Melo Junior, Luiz Alberto Soares [UNIFESP]; Martins, João Roberto Maciel [UNIFESP]; Nader, Helena Bonciani [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To compare total protein concentration in the aqueous humor of primary open-angle glaucoma and non-glaucomatous patients. METHODS: Aqueous humor samples were obtained from 22 patients just before trabeculectomy for clinically uncontrolled primary open angle glaucoma (POAG group). Aqueous humor (0.1 mL) was aspirated by inserting a 26-gauge needle into the anterior chamber. The same procedure was performed in 22 non-glaucomatous patients just before cataract surgery (control group). Immediately after collection, the aqueous humor was stored at -20°C. Aqueous humor total protein concentration was determined using a colorimetric assay. RESULTS: The geometric mean of total protein concentration of the aqueous humor samples was 32 mg/dL (range: 8-137 mg/dL) in the primary open angle glaucoma group and 16 mg/dL (range: 2-85 mg/dL) in the control group. The ratio of the protein concentration between the two groups was 2.0 (95% confidence interval: 1.3 to 3.2; p=0.003). CONCLUSIONS: The total protein concentration in primary open-angle glaucoma aqueous humor was approximately two times higher than that in non-glaucomatous subjects.
Acesso aberto (Open Access)
Congenital cataract surgery with intraocular lens implantation in microphthalmic eyes: visual outcomes and complications
(Conselho Brasileiro de Oftalmologia, 2013-08-01) Ventura, Marcelo Carvalho; Sampaio, Virgínia Vilar; Ventura, Bruna Vieira; Ventura, Liana Oliveira; Nosé, Walton [UNIFESP]; Fundação Altino Ventura Department of Congenital Cataract; Hospital de Olhos de Pernambuco Department of Congenital Cataract; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To report the visual outcomes and complications of congenital cataract surgery with primary intraocular lens implantation in microphthalmic eyes of children younger than 4 years of age. METHODS:This retrospective interventional case series included 14 microphthalmic eyes from 10 children who underwent congenital cataract surgery with primary intraocular lens implantation younger than 4 years of age. Seven patients had bilateral cataracts (11 eyes met the study's inclusion criteria) and 3 patients had unilateral cataract. Patients' medical charts were reviewed to obtain information regarding the preoperative and postoperative ophthalmological examination. Main outcome measures were intraocular pressure (IOP), best-corrected visual acuity, and intraoperative and postoperative complications. RESULTS: Mean age at the time of surgery was 21.7 ± 2.9 months. Mean ocular axial length was 19.2 ± 0.9 mm. Mean preoperative IOP was 9.7 ± 1.7 mmHg and 10.3 ± 3.1 mmHg on final follow-up (P=0.18). There were no intraoperative complications. Two (15.4%) eyes developed secondary visual axis opacification, of which only one needed to be reoperated due to significantly decreased vision (0.5 logMAR). Preoperative and postoperative best-corrected visual acuity was 2.09 ± 0.97 logMAR and 0.38 ± 0.08 logMAR in bilateral cases and 1.83 ± 1.04 logMAR and 0.42 ± 0.13 logMAR in unilateral cases, respectively. CONCLUSION: Primary intraocular lens implantation in congenital cataract surgery in microphthalmic eyes resulted in a significant best-corrected visual acuity improvement with no intraoperative complications and minimal postoperative complications.
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Desenvolvimento de software oftalmológico para computação móvel
(Conselho Brasileiro de Oftalmologia, 2006-08-01) Grottone, Gustavo Teixeira [UNIFESP]; Pisa, Ivan Torres [UNIFESP]; Grottone, João Carlos; Debs, Fernando; Schor, Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); SCMS serviço de Oftalmologia; Universidade Lusíadas Faculdade de Ciências Médicas de Santos; Santa Casa de Misericórdia de Santos
INTRODUCTION: The formulas for calculation of intraocular lenses have evolved since the first theoretical formulas by Fyodorov. Among the second generation formulas, the SRK-I formula has a simple calculation, taking into account a calculation that only involved anteroposterior length, IOL constant and average keratometry. With the evolution of those formulas, complexicity increased making the reconfiguration of parameters in special situations impracticable. In this way the production and development of software for such a purpose, can help surgeons to recalculate those values if needed. PURPOSE: To idealize, develop and test a Brazilian software for calculation of IOL dioptric power for handheld computers. METHODS: For the development and programming of software for calculation of IOL, we used PocketC program (OrbWorks Concentrated Software, USA). We compared the results collected from a gold-standard device (Ultrascan/Alcon Labs) with the simulation of 100 fictitious patients, using the same IOL parameters. The results were grouped for ULTRASCAN data and SOFTWARE data. Using SRK/T formula the range of those parameters included a keratometry varying between 35 and 55D, axial length between 20 and 28 mm, IOL constants of 118.7, 118.3 and 115.8. RESULTS: Using Wilcoxon test, it was shown that the groups do not differ (p=0.314). We had a variation in the Ultrascan sample between 11.82 and 27.97. In the tested program sample the variation was practically similar (11.83-27.98). The average of the Ultrascan group was 20.93. The software group had a similar average. The standard deviation of the samples was also similar (4.53). CONCLUSION: The precision of IOL software for handheld devices was similar to that of the standard devices using the SRK/T formula. The software worked properly, was steady without bugs in tested models of operational system.
Somente Metadadados
Does the apodized diffractive intraocular lens Acrysof ReSTOR Natural (TM) interfere with FDT Matrix perimetry results?
(Consel Brasil Oftalmologia, 2009-11-01) Bojikian, Karine Duarte [UNIFESP]; Vita, Joao Brasil [UNIFESP]; Dal Forno, Catia Potira [UNIFESP]; Tranjan Neto, Alfredo [UNIFESP]; Moura, Christiane Rolim de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Purpose: To compare the effect of an apodized diffractive intraocular lens (IOL) (Acrysof ReSTOR Natural (TM)) and its yellow counterpart (Natural IQ (TM)) on frequency doubling technology (FDT) perimetry results. Methods: This study included 37 eyes from 22 patients at the Centro Oftalmologico Tranjan who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR Natural (TM), 20 Natural IQ (TM)) performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. Results: The patients were between 41 to 79 years old (mean, 70.78 +/- 9.83) in the Natural IQ (TM) and 49 to 81 years old (mean, 67.11 +/- 11.48) in the Acrysof ReSTOR Natural (TM) group, and the mean IOP was 13.64 +/- 2.02 mmHg in the Natural IQ (TM) 12.94 +/- 1.39 mmHg in the Acrysof ReSTOR Natural (TM) group. The mean pupillary diameter under scotopic conditions was 6.63 +/- 1.16 mm in the Natural IQ (TM) group and 7.20 +/- 1.8 mm in the Acrysof ReSTOR Natural (TM) group (p = 0.20). The mean deviation was -1.83 +/- 3.46 dB in the Natural IQ (TM) group and -1.77 +/- 3.94 dB in the Acrysof ReSTOR Natural (TM) group (p = 0.28). The pattern standard deviation was 3.49 +/- 0.79 dB in the Natural IQ (TM) group and 3.20 +/- 0.86 dB in the Acrysof ReSTOR Natural (TM) group (p = 0.27). Conclusion: There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant.

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