Navegando por Palavras-chave "Ceratomileuse assistida por excimer laser in situ"

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    Análise laboratorial das ceratites infecciosas secundárias à cirurgia refrativa
    (Conselho Brasileiro de Oftalmologia, 2005-06-01) Leal, Fernando [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Freitas, Denise de [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To describe the laboratory findings in patients with infectious keratitis, who underwent refractive surgery, correlating the surgical procedure and the time of infection manifestation, and the results of culture and smears. METHODS: The previous samples were obtained from patients submitted to radial keratotomy (RK), photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) at the Ophthalmology Department of UNIFESP. The infections were classified as early, when they occurred up to 30 days after the surgery, and late when diagnosed after 30 days. RESULTS: In 93 samples, 39 (42%) came from patients submitted to radial keratotomy, 14 (36%) being early infections and 25 (64%) late; 38 (41%) of LASIK, 21 (55%) being early and 17 (45%) late; 16 (17%) of photorefractive keratectomy, 10 (62.5%) being early and 6 (37.5%) late. Eighty-six samples were submitted to culture and smears for bacteria, 43 cultures (50%) and 43 smears (50%) were positive. Seventy-two samples were submitted to culture and smears for fungi, 2 cultures (3%) and 4 smears (6%) were positive. CONCLUSION: The agreement between culture and smear results was 80.2%; regarding the type of surgery there was no statistically significant relationship between time of onset of infection and surgery.
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    Anel corneano intra-estromal para baixa miopia: estudo comparativo com a técnica de LASIK
    (Conselho Brasileiro de Oftalmologia, 2004-02-01) Forseto, Adriana dos Santos [UNIFESP]; Schor, Paulo [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Nosé, Walton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Eye Clinic Day Hospital; Universidade Metropolitana de Santos
    PURPOSE: To evaluate the efficacy and safety of intrastromal corneal ring segments (ICRS) for the correction of low myopia, and to compare the obtained results with a control group submitted to laser in situ keratomileusis (LASIK). METHODS: Prospective, nonrandomized and bilateral study. Fourteen patients with preoperative spherical equivalent ranging from -1.00 to -4.50 D received ICRS in one eye and LASIK in the other. Postoperative evaluations were performed at day one and seven and months 1, 3, 6, 12 and 24. RESULTS: At the last follow-up, 64.29% of ICRS eyes (9/14) and 85.71% of LASIK eyes (12/14) were within ± 0.50 D of the predicted refractive outcome (p=0.385). Uncorrected visual acuity of 20/20 or better was observed in four of 14 ICRS eyes (28.57%), and in 12 of 14 LASIK eyes (85.71%) (p=0.002²). No variances of more than 1.00 D in the manifest spherical equivalent refraction between two consecutive examinations or significant loss of best spectacle-corrected visual acuity were observed in both groups. Surgically induced astigmatism was greater in ICRS eyes than in LASIK eyes. At 24 months, the ICRS eyes scored lower in contrast sensitivity testing, especially at higher spatial frequencies (p=0.032² at 18 cpd). The patients reported more subjective complaints in the early postoperative period for the ICRS eyes. CONCLUSIONS: ICRS were considered effective for the correction of low myopia, but their safety was limited by the observed surgically induced astigmatism, and their results were inferior compared to the control group.
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    Aplicação de fórmula corretiva nas alterações da pressão intraocular dos pacientes submetidos a LASIK
    (Conselho Brasileiro de Oftalmologia, 2011-04-01) Silva, Thiago George Cabral; Polido, Júlia Gomes Fernandes; Pinheiro, Maurício Vieira; Silva, André Luís De Freitas; Goldbach, Laerte; Mascaro, Vera Lúcia Degaspare Monte [UNIFESP]; Serracarbassa, Pedro Durães; Araújo, Maria Emília Xavier Dos Santos [UNIFESP]; Hospital do Servidor Público Estadual de São Paulo; Hospital do Servidor Público Estadual de São Paulo - HSPE; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    PURPOSE: To compare the intraocular pressure (IOP) pre and post LASIK, correlating it to changes in central corneal thickness (CCT) and average simulated keratometry (K), as well as verifying the results of a corrective formula previously proposed. METHODS: Longitudinal prospective study conducted in outpatients that underwent to LASIK. Patients underwent complete ophthalmic examination, previously and 2 months after the surgery. Intraocular pressure was evaluated with Goldmann applanation tonometer between 9 am and 11 am, average simulated keratometry was evaluated using corneal topography and central corneal thickness was measured with ultrasound pachymetry, been considered the average of three measurements. Two patients were excluded due to surgery or eye disease, and previous use of topical steroids over the past three months. The surgeries were performed according to standard procedures. The formula [real IOP = IOP measured + (540 - ECC)/71 + (43 - K)/2.7 + 0.75 mmHg] proposed for correcting intraocular pressure was used. RESULTS: Fifteen eyes of eight patients were evaluated, age ranged from 24 to 46 years (mean: 31.37 ± 7.27). There was a statistically significant difference between the measurements of intraocular pressure, central corneal thickness and average simulated keratometry pre and post-LASIK. (p=0.0001). It was observed that each 1D corrected underestimated the IOP 1.06 ± 0.59 mmHg (0.11 a 1.89 mmHg). The use of the corrective formula lead to 80% of eyes within 2.50 mmHg of preoperative intraocular pressure. Although, the two sets of data are statistically different (p=0.0266). CONCLUSIONS: Post LASIK eyes presented lower intraocular pressure than preoperatively. Intraocular pressure was moderately correlated to central corneal thickness and weakly correlated to average simulated keratometry. With the use of the corrective formula, we were able to determine that 80% were within 2.50 mmHg of the preoperative intraocular pressure.
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    Avaliação da função visual por meio de questionário VFQ 25 em relação a ametropia pre-operatória e diâmetro pupilar em pacientes submetidos a cirurgia ceratorrefrativa a laser
    (Universidade Federal de São Paulo (UNIFESP), 2012) Andrade, Eduardo Marcelo Moron de [UNIFESP]; Chamon, Wallace [UNIFESP]
    Esse estudo tem como objetivos avaliar se ametropia pre-operatoria, zona optica, zona de transicao e o comportamento do diametro pupilar sob diferentes condicoes de iluminacao, estao correlacionados com a satisfacao dos pacientes, atraves da utilizacao questionario VFQ 25 no pre e pos-operatorio como ferramenta da medida de satisfacao do paciente. Materiais e metodos: Foram analisados 77 pacientes submetidos a cirurgia ceratorrefrativa a laser (LASIK). Foi utilizado um pupilometro automatizado com captura atraves de camera infravermelha acoplada a cabeca optica de um sistema videoceratografico para avaliacao do diametro pupilar. Os pacientes foram submetidos a avaliacao oftalmologica completa e documentacao do comportamento pupilar sob diferentes intensidades de iluminacao, simulando as situacoes do dia-a-dia. Utilizou-se no pre e pos-operatorio o questionario de funcao visual (VFQ 25) traduzido anteriormente para a lingua portuguesa, como ferramenta para avaliacao da funcao visual em diversas situacoes do cotidiano. Resultados: Todos os pacientes estudados, independentemente do diametro pupilar sob diferentes condicoes de iluminacao (escotopicas, mesopicas e fotopicas), apresentaram melhora em todos os subgrupos do VFQ 25 em maior ou menor intensidade. Conclusoes: Nesse estudo, apesar do pupilometro infravermelho com captura automatizada ter se mostrado uma ferramenta util na documentacao e entendimento do comportamento pupilar, um conjunto de fatores tais como perfil psicossocial dos pacientes, ametropia pre-operatoria tratada e ametropia residual final, contribuiu de forma decisiva para determinar o grau de satisfacao dos pacientes submetidos ao LASIK
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    Avaliação da qualidade de corte do microcerátomo Masyk® na confecção de lamela corneana pediculada em olhos humanos de Banco de Olhos
    (Conselho Brasileiro de Oftalmologia, 2006-08-01) Victor, Gustavo; Alves, Milton Ruiz; Nosé, Walton [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Universidade Metropolitana de Santos Departamento de Oftalmologia
    PURPOSE: To evaluate the cut quality of Masyk® microkeratome in obtaining a corneal flap from human eyes of Eye Banks. METHODS: Prospective study with 20 human eyes from Eye Banks. All flaps were programmed to obtain 160 µm thickness and 9.5 mm diameter. The thicknesses were calculated with P55 pachymeter (Paradigm, USA), and diameter with compass. RESULTS: No complications were observed during the use of the microkeratome. The central corneal thickness average was 160.34±5.10 µm and range from 149 to 181 µm. The vertical diameter average was 9.64±0.16 mm and range from 9.30 to 9.85 mm. CONCLUSION: Masyk® microkeratome showed to be effective for obtention of corneal flap with appropriate thickness and diameter from human corneas of Eye Banks.
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    Avaliação da qualidade de corte do microceratótomo Masyk® na confecção de lamela corneana pediculada em olhos porcinos
    (Conselho Brasileiro de Oftalmologia, 2006-02-01) Victor, Gustavo; Alves, Milton Ruiz; Nosé, Walton [UNIFESP]; Eye Clinic Day Hospital; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Universidade Metropolitana de Santos
    PURPOSE: Evaluation of the cut quality of the Masyk® microkeratome in obtaining corneal flap from porcine eyes. METHODS: Prospective study with 31 porcine eyes divided into two groups: 15 eyes with programmed flap thickness of 160 µm and 9.5 mm diameter (Group 1), and 16 eyes with programmed flap thickness of 140 µm and 8.5 mm diameter (Group 2). Corneal thickness was calculated with a P55 pachymeter (Paradigm, USA) and the diameter with compass. RESULTS: No complications were observed during the use of the microkeratome. In group 1, the central corneal thickness mean was 146.33 ± 15.43 µm, range between 127 and 186 µm, and the vertical diameter mean was 9.39 ± 0.26 mm, range from 8.90 to 9.85 mm. In group 2, the central corneal thickness mean was 128.75 ± 18.83 µm, range from 71 to 178 µm, and the vertical diameter mean was 8.27 ± 0.20 mm, range from 7.95 to 8.65 mm. CONCLUSION: The Masyk® microkeratome showed to be effective and safe to produce corneal flaps with appropriate thickness and diameter in porcine eyes.
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    Avaliação de lâminas cirúrgicas reutilizadas no LASIK pela microscopia eletrônica de varredura
    (Conselho Brasileiro de Oftalmologia, 2006-12-01) Soares, Francisco Seixas; Casanova, Fabio Henrique [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Nishiwaki-Dantas, Maria Cristina [UNIFESP]; Dantas, Paulo Elias Correa; Santa Casa de Misericórdia de São Paulo Departamento de Oftalmologia; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    PURPOSE: To evaluate and compare, by scanning electron microscopy (SEM), the sharpness of the edge of brand new surgical blades and consecutively used surgical blades in laser-assisted in situ keratomileusis (LASIK). METHODS: Tewnty-five AccuGlide® (Bausch & Lomb, USA) surgical blades were evaluated, divided in to 3 groups: Group 1 (control), non-used surgical blades; Group 2, ten surgical blades used twice (simultaneous bilateral procedure); Group 3, ten surgical blades used four times (two consecutive simultaneous bilateral procedures). Each blade was analyzed by SEM at four random points, two central and two peripheral points, with magnification of 50x, 350x, and 1,000x. RESULTS: Blade body irregularities and organic material were observed on all used surgical blades (Groups 2 and 3), but not on new surgical blades (Group 1). In addition, Group 3 revealed more irregularities in both central (p=0.0094) and peripheral points (p=0.0098) than Group 2, as well as organic material deposition (p=0.0204 and p=0.0909, respectively). Neither metalic material nor irregularities in the cutting edge of the blade were observed in any group. CONCLUSION: No difference regarding the cutting edge was observed between new and blades reused up to four times, however irregularities and organic material were observed in all reused blades. Reusing blades for LASIK may produce structural changes and its clinical implications need to be evaluated due to the possible relation with interlamellar postoperative complications.
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    Clinical evaluation of reprocessed blades in LASIK
    (Conselho Brasileiro de Oftalmologia, 2008-04-01) Mallmann, Felipe [UNIFESP]; Murata, Celina [UNIFESP]; Yamazaki, Ester Sakae [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate outcome and complications in LASIK with reprocessed blades. METHODS: Retrospective analysis of patients' charts submitted to complete custom LASIK from January 2004 to June 2005. Inclusion criteria comprised surgical description of blade use and minimum follow-up of 1 month. The blade was reprocessed following a clinic protocol, from 1 to 3 times (reprocessed group) and results compared with patients that underwent LASIK with first-use blades (first-use group). RESULTS: Two hundred fifty-one eyes of 135 patients were analyzed (spherical equivalent of -3.69 (D). There was no statistical differences between first-use group and reprocessed blade group regarding intraoperative (5.5% vs 8.8%), early (50.5% vs 49.5%) and late complications (33% vs 27.5%), respectively. Uncorrected visual acuity > 20/20 (68.1% vs 66.9%), aberrometry analysis (total RMS: 0.62 vs 0.64 µm) and safety (85.7% vs 83.1%) were similar between groups (p>0.05). CONCLUSION: Reprocessed blades following rigid sterilization protocol may have similar outcomes and complications rates in LASIK surgery compared to first-use blades.
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    Coleção fluídica na interface do LASIK causada por glaucoma secundário à ceratouveíte herpética: relato de caso
    (Conselho Brasileiro de Oftalmologia, 2007-02-01) Nakano, Eliane Mayumi [UNIFESP]; Kuchembuck, Márcio; Nakano, Kozo; Oliveira, Marivaldo; Alvarenga, Lenio Souza [UNIFESP]; Portellinha, Waldir; Hospital Santa Cruz; Universidade Federal de São Paulo (UNIFESP); Universidade da Califórnia
    Herpes simplex virus infection is a frequent cause of intraocular inflammation or anterior uveitis. Ocular hypertension is a common feature in herpetic keratouveitis. We describe a fluid accumulation and flap displacement in late postoperative period (28 months) of LASIK associated with ocular hypertension caused by herpetic keratouveitis. This finding supports the theory that flap attachment after LASIK is only partial and the virtual space remains indefinitely. The presence of ocular hypertension may lead to corneal edema and fluid accumulation in the interface.
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    Complicações iniciais do uso de dois microceratótomos automatizados
    (Conselho Brasileiro de Oftalmologia, 2001-06-01) Passos, Monica Do Carmo [UNIFESP]; Takahashi, Ricardo [UNIFESP]; Mori, Edson S. [UNIFESP]; Suzuki, César K. [UNIFESP]; Schor, Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To describe per- and postoperative complications which occurred with the first use of two automated microkeratomes for the performance of LASIK. Methods: Retrospective study of first surgeries performed with two automated microkeratomes. Seventy eyes from 54 patients using Chiron's® microkeratome, Automated Corneal Shaper (ACS) model, from April 1997 to April 1998 and 100 eyes from 82 patients using automated microkeratome Moria® Carriazo-Barraquer (CB), from February 1999 to June 1999. Refractive ablation was performed with the Summit Apex Plus Excimer Laser (193 nm). We evaluated the per- and postoperative complications up to one month of follow-up. Results: Photoablation was not performed in three cases (4.3%) using ACS microkeratome and in one case (1%) using CB microkeratome. Most frequent complications found with ACS were: failure of automated return of microkeratome (7.1%), partial keratotomy (4.3%), presence of stromal folds (14.3%), central de-epithelialization (4.3%). With CB there were: descentered flap (3%), central desepitheliazation (5%), stromal folds (28%) and Sahara Sands syndrome (6%). Conclusions: Initial use of both microkeratomes was related to important per- and postoperative complications, which did not lead to loss of vision. Clinical knowledge of the alterations which occurred with the use of these instruments and a better experience of their utilization may reduce these complications.
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    Correção das aberrações oculares nos retratamentos de LASIK personalizado e convencional
    (Conselho Brasileiro de Oftalmologia, 2009-10-01) Urbano, Andréia Peltier [UNIFESP]; Nosé, Walton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Metropolitana de Santos Departamento de Oftalmologia
    PURPOSE: To compare the correction of ocular aberrations between custom and standard LASIK retreatment. METHODS: Prospective, randomized trial with paired eye control of 74 eyes from 37 patients who underwent LASIK retreatment. Each patient underwent retreatment using Zyoptix LASIK (Bausch & Lomb) in 1 eye and Planoscan LASIK (Bausch & Lomb) in the fellow eye. Correction of ocular aberrations was compared between custom and standard LASIK retreatments. RESULTS: At 6 months, there was a statistically significant reduction in defocus, astigmatism, coma, spherical aberration, second, third, higher-order and total aberration in Zyoptix eyes. There was a statistically significant reduction in defocus, second-order and total aberration in Planoscan eyes. CONCLUSIONS: Custom retreatment was statistically superior than standard retreatment for correction of lower and higher ocular aberrations.
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    Estudo comparativo entre duas plataformas para realização de Lasik personalizado para correção de miopia e astigmatismo: Alcon CustomCornea® versus Bausch & Lomb Zyoptix®
    (Conselho Brasileiro de Oftalmologia, 2009-08-01) Barreiro, Telma Pereira; Forseto, Adriana dos Santos [UNIFESP]; Pinto, Lucila Ferreira Leite; Francesconi, Claudia Maria; Nosé, Walton [UNIFESP]; Eye Clinic; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To compare the visual and clinical outcomes of Wavefront-guided laser in situ keratomileusis (Lasik) with Alcon CustomCornea® and Zyoptix® systems. METHODS: A prospective, randomized, masked and bilateral study was conducted. Fifty patients with preoperative spherical equivalent ranging from -1.00 to -6.50 D were enrolled for customized ablation in both eyes. All of them were submitted to Lasik CustomCornea® treatment in one eye and Zyoptix® in the other eye. Uncorrected visual acuity, best correct visual acuity (BCVA), manifest refraction, wavefront measurements, and contrast sensitivity testing were performed preoperatively and postoperatively at 1, 3 and 6 months. RESULTS: Preoperatively manifest refractive spherical equivalent was -3.29 ± 1.56 D in the CustomCornea® group and -3.22 ± 1.50 D in the Zyoptix® group. At 6 months, 86% of CustomCornea® eyes and 70% of Zyoptix® eyes had UCVA > 20/20. One hundred percent of the CustomCornea® group and 88% of the eyes in the Zyoptix® were within 0.50 D of emmetropia. In both groups, the contrast sensitivity improved. Spherical aberration increased in both groups, with the CustomCornea® group showing lower levels (p<0,001). CONCLUSION: There were no differences between the systems according to safety and effectiveness. The Zyoptix® platform showed greater spherical aberration.
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    O impacto da cirurgia de ceratectomia fotorrefrativa (PRK) e ceratomileuse assistida por excimer laser in situ (LASIK) na qualidade visual e de vida em pacientes com ametropias
    (Conselho Brasileiro de Oftalmologia, 2008-02-01) Belfort, Ricardo [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Hoexter, Marcelo Queiroz [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the quality of life, vision and stress before and after refractive surgery. METHODS: This is a longitudinal, observational study, where 100 patients were evaluated; 54 espectacles wearers, 21 contact lens users before surgery and 25 controls wearers spectacles or contact lenses, who did not want to undergo refractive surgery during one year despite refractive error. The applied questionnaires were Self Reporting Questionnaires SRQ-20 of quality of life and vision and National Eye Institute Visual Function Questionnaire NEI VFQ-25 for the assessment of mental health. The intervention group answered the questionnaires before surgery, three, six and twelve months after follow-up and the control group answered the questionnaires at six and twelve months after the baseline. The questionnaires of the intervention group were applied by an independent person. RESULTS: In the intervention group (54 spectacle wearers), 39 were treated by photorefractive excimer laserkeratectomy (PRK) and 15 by laser in situ keratomileusis (LASIK), of the 21 contact lens users: 12 received photorefractive excimer laser keratectomy and nine were treated by laser in situ keratomileusis (LASIK). The control group remained stable during the study. After three months of follow-up the intervention group showed improvement in quality of life, vision and reduction of stress. After one year of follow-up the assessments of quality of life and mental health were similar to the control group. After three months there was a significant reduction of psychiatric symptomatology in the intervention group. CONCLUSION: Patients operated for correction of ametropia showed a significant improvement in quality of life and mental health assessments.
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    Intrastromal crosslinking in post-LASIK ectasia
    (Conselho Brasileiro de Oftalmologia, 2014-06-01) Moscovici, Bernardo Kaplan [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Descrevemos um caso de ectasia de córnea precoce após cirurgia de LASIK, detectado no primeiro semestre pós-operatório. Nós optamos tratar este paciente com crosslinking embaixo do flap , sem desepitelização com bons resultados. A paciente permaneceu sem progressão da ectasia até o momento atual, dois anos após o procedimento.
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    Keratoconus and corneal stability after radial keratectomy in the fellow eye: case report
    (Conselho Brasileiro de Oftalmologia, 2013-06-01) Sousa, Jacqueline Martins de [UNIFESP]; Hirai, Flávio Eduardo [UNIFESP]; Sato, Elcio Hideo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Keratoconus has usually been described as bilateral but asymmetric disease. Corneal ectasia is one of the long-term complications of modern refractive surgery, especially those submitted to laser in situ keratomileusis (LASIK). We describe a patient with keratoconus in the right eye that was submitted to radial keratectomy (RK) in the left eye 19 years ago with no progression of the ectatic cornea and no complications related to the refractive surgery. Because unilateral keratoconus is rare, we believe that RK was performed on an already ectatic cornea (not clinically detected) or with fruste keratoconus. However, neither corneal ectasia progressed, nor ectasia was induced by RK in the fellow eye.
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    LASIK em programa de treinamento médico: complicações relacionadas a microcerátomos
    (Conselho Brasileiro de Oftalmologia, 2003-12-01) Gonçalves, Eliana Domingues [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Tanaka, Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate microkeratome complications related to laser in situ keratomileusis - LASIK - in a residency program. METHODS: A total of 1,611 eyes were retrospectively evaluated after being submitted to laser in situ keratomileusis - LASIK surgery from January 1998 to June 2000 in the Refractive Surgery Clinic. RESULTS: There were 26 (1.61%) complications on performing the flap with the microkeratome and, described as 9 (34.61%) incomplete flap, 9 (34.61%) thin, 2 (7.69%) free cap, 5 (19.23%) irregular, 1 (3.84%) buttonhole. CONCLUSION: The prevalence of microkeratome complications in a residency program was low and the training of residents and trainees in refractive surgery has shown to be a viable practice.
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    MALKS®: especificações e desenvolvimento
    (Conselho Brasileiro de Oftalmologia, 2006-04-01) Victor, Gustavo; Sousa, Sidney Julio De Faria E; Alves, Milton Ruiz; Nosé, Walton [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Universidade Metropolitana de Santos Departamento de Oftalmologia
    PURPOSE: To describe the characteristics of a new artificial anterior chamber (MALKS®, Loktal, São Paulo, Brasil). METHODS: Characteristics analysis and description of a new artificial anterior chamber MALKS® (Micro automated lamellar keratoplasty system). RESULTS: MALKS®is composed of eight parts: a) artificial chamber; b) cornea's fix ring; c) nut to join the cornea's fix ring; d) rail and adjuster of lamellar diameter; e) flatteners, to pre-determine lamellar diameter; f) infusion system, that allows the digital objective peroperative control of the intracameral pressure; g) automated microkeratome, and h) marker. CONCLUSION: MALKS® uses the same automated microkeratome developed for LASIK, can allow corneal lamella obtention with predetermined thickness and diameter, as well as the digital objective peroperative control of the intracameral pressure. This new artificial anterior chamber can be an important tool for superficial and endothelial keratoplasty.
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    Primeiro censo brasileiro em cirurgia refrativa
    (Conselho Brasileiro de Oftalmologia, 2005-12-01) Victor, Gustavo; Urbano, Andreia [UNIFESP]; Marçal, Sônia; Porto, Ricardo; Francesconi, Claudia Maria [UNIFESP]; Forseto, Adriana dos Santos [UNIFESP]; Barth, Breno; Alves, Milton Ruiz; Nosé, Walton [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Eye Clinic Day Hospital; Universidade Metropolitana de Santos
    PURPOSE: To perform the first Brazilian refractive surgery survey. METHODS: Between August 2001 and February 2002, a questionnaire was mailed to 7890 Brazilian ophthalmologists. The questionnaire presented questions about demographic aspects, technology, instruments, market, trends, practice patterns and cost of refractive surgery. RESULTS: Nine hundred and twenty questionnaires (11.67%) were answered. LASIK is the preferred technique for correction between +5.00 and -7.00 D. The mostly used excimer laser is Nidek® EC 5000, and Hansatome is the mostly used microkeratome. Others aspects like: demographic, techniques, practice patterns, trends, market, and pre-, intra- and postoperative care, were analyzed. CONCLUSION: With this survey, the Brazilian ophthalmologists can observe and monitor these aspects of refractive surgery in Brazil, and compare them with others surveys.
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    Qualidade visual após retratamento de LASIK personalizado versus convencional
    (Conselho Brasileiro de Oftalmologia, 2008-12-01) Urbano, Andréia Peltier; Nosé, Walton [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Metropolitana de Santos Departamento de Oftalmologia
    PURPOSE: To evaluate visual quality after wavefront-guided LASIK versus standard LASIK in retreatment of primary LASIK for myopia and myopic astigmatism. METHODS: A prospective study was performed with paired eye control of 74 eyes with LASIK retreatment. Each patient underwent retreatment using custom ablation (Zyoptix, Bausch & Lomb) in 1 eye and standard ablation LASIK (PlanoScan, Bausch & Lomb) in the contralateral eye. A complete ophthalmologic examination was performed, including evaluation of glare test and contrast sensitivity test, with a follow-up of 6 months. RESULTS: Zyoptix eyes showed better results of glare test and contrast sensitivity test than the contralateral eyes. CONCLUSIONS: Wavefront-guided LASIK produces better visual quality than standard LASIK in the retreatment of refractive errors after primary LASIK.
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    Resultados a curto prazo de ceratotomia lamelar pediculada (LASIK) para correção de hipermetropia com o sistema Ladar Vision de excimer laser
    (Conselho Brasileiro de Oftalmologia, 2004-02-01) Nunes, Larissa Madeira [UNIFESP]; Francesconi, Cláudia Maria [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Schor, Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To analyze the efficacy and safety of hyperopic laser in situ keratomileusis using the Ladar Vision excimer laser system. METHODS: Twenty-eight eyes of 17 patients with hyperopia from +1.00 to +3.00 D (group 1), and 29 eyes of 18 patients with hyperopia from +3.25 to +6.00 D (group 2) that had LASIK for hyperopia with the Ladar Vision, were retrospectively analyzed. Uncorrected visual acuity, best spectacle-corrected visual acuity and cycloplegic refraction were evaluated 1 , 3 and 6 months after surgery. RESULTS: In group 1, the mean preoperative cycloplegic spherical equivalent (SE) was +2.14 ± 0.64 D and 6-month postoperative SE was +0.44 ± 0.38 D. In group 2, the mean preoperative SE was +4.26 ± 0.75 D and the 6-month postoperative SE was +1.14 ± 0.63 D. 3.4% of the eyes in group 2 and none of the eyes in group 1 lost 2 or more lines of best spectacle-corrected visual acuity in the first postoperative month. CONCLUSIONS: LASIK with the Ladar Vision excimer laser system is an effective and safe procedure to correct hyperopia. Patients in group 2 appear to be at greater risk for loss of lines of best spectacle-corrected visual acuity.