Navegando por Palavras-chave "Keratoplasty, penetrating"
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- ItemAcesso aberto (Open Access)Comparação entre os resultados pós-operatórios de pacientes submetidos ao procedimento tríplice e transplante de córnea combinado a fixação secundária de lente intra-ocular(Conselho Brasileiro de Oftalmologia, 2006-08-01) Leão, Daniela Maggioni Pereira; Sousa, Luciene Barbasa De [UNIFESP]; Universidade de Alfenas; Hospital Oftalmológico de Sorocaba setor de Córnea e Doenças Externas; Universidade Federal de São Paulo (UNIFESP); Hospital Oftalmológico de SorocabaPURPOSE: To compare the outcomes of two surgical techniques of penetrating keratoplasty with different surgical time, regarding the crystalline and the intraocular lens. METHODS: This retrospective study included 37 patients' eyes divided into 2 groups: extracapsular cataract extraction, posterior chamber intraocular lens implantation and penetrating keratoplasty (Group 1, G1) and transscleral fixation of posterior chamber lens and penetrating keratoplasty (Group 2, G2). The following parameters were recorded: visual acuity, intraocular pressure, refractive astigmatism, complication and keratometric astigmatism. RESULTS: Visual acuity improved in the two groups (G1 p<0.001 and G2 p=0.008). In G2 a significant change for the worse of intraocular pressure outcome was observed when compared with the other group (p=0.014). Regarding refractive and keratometric astigmatism no significant differences between the groups were found. The follow-up was 11 months. CONCLUSION: The most important negative prognostic factor affecting visual acuity was the postkeratoplasty corneal curvature which can not be predicted accurately and the most important negative factor affecting intraocular pressure was the loss of integrity of the anterior and posterior segments.
- ItemAcesso aberto (Open Access)Contaminação de halos doadores córneo-esclerais em ceratoplastia penetrante no Hospital de Clínicas de Porto Alegre(Conselho Brasileiro de Oftalmologia, 2008-02-01) Borowsky, Cláudia Martins; Wallau, Anelise Dutra [UNIFESP]; Reetz, Aline; Kwitko, Sérgio [UNIFESP]; Rymer, Samuel; Locatelli, Claudete Inês; Universidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto Alegre; Universidade Federal de São Paulo (UNIFESP); Universidade de Passo Fundo; Hospital de Clínicas de Porto Alegre; UFRGS Faculdade de Medicina; UFRGS Hospital de Clínicas de Porto Alegre; UFRGSPURPOSE: To determine the incidence of positive corneoscleral rim cultures preserved in Optisol GS medium, to identify pathogens involved and possible recipient eye infection. METHODS: A hundred sixty-three corneoscleral rim cultures penetrating keratoplasties performed from January 2001 to January 2003 in the Hospital de Clínicas de Porto Alegre were reviewed. Enucleations and corneal storage were done as aseptic as possible and gentamicin 0.3% was instilled. Corneoscleral rim was divided into two segments, half was inoculated into Sabouraud broth and the other half into thioglycolate broth; inoculation into blood agar, chocolate agar and MacConkey agar was done later if necessary for pathogen identification. The receiver's eye data were reviewed. RESULTS: There were eleven positive cultures (6.7%) out of 163 evaluated corneoscleral rim cultures. Of these, four were Staphylococcus epidermidis, one was Staphylococcus aureus, one was Serratia sp., one was Pseudomonas aeruginosa and the other four were different subtypes of Candida (two Candida sp., one Candida albicans and one Candida parapapilosis). All pathogens were resistant to gentamicin. None of the eleven cases of positive corneoscleral rim cultures resulted in ocular infection at the receiver's eyes (six months follow-up). CONCLUSIONS: We found low rates of positive corneoscleral rim cultures after penetrating keratoplasty at the Porto Alegre Clinical Hospital. The most frequent involved pathogens were Staphylococcus sp and Candida sp. Although we did not identify any postoperative infection at the receiver's eyes, we recommend corneoscleral rim culture for guidance of postoperative infection, a rare but possible devastating ocular event.
- ItemAcesso aberto (Open Access)Endoftalmite por Candida albicans após transplante penetrante de córnea: relato de caso(Conselho Brasileiro de Oftalmologia, 2004-04-01) Godoy, Glaucio De; Wahab, Sâmia Ali; Hofling-Lima, Ana Luisa [UNIFESP]; Moreira, Hamilton [UNIFESP]; Hospital de Olhos do Paraná; Instituto de Pesquisas Médicas; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Paraná; Faculdade Evangélica do ParanáThe authors report a case of a patient submitted to penetrating corneal graft for keratoconus with an exaggerated inflammatory response during the postoperative period. The patient was suspected of having an atypical rejection to the donor button. There were periods of improvement, followed by periods of worsening of the inflammation at each attempt of reducing the topical corticosteroid. After initiating immunosuppressive therapy with cyclosporin and high doses of topical corticosteroid, the patient developed Candida albicans endophthalmitis affecting the anterior segment of the eye and the vitreous body, but sparing the chorioretina. The patient improved after three injections of 5 µg intravitreal amphotericin B, 400 mg oral ketoconazole daily and topical clotrimazole every four hours. The authors also discuss the main possibilities of contamination of the patient, the infectious picture probably being related to the surgical procedure.
- ItemAcesso aberto (Open Access)Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium(Consel Brasil Oftalmologia, 2016) Prazeres, Tatiana Moura Bastos [UNIFESP]; Muller, Rodrigo; Rayes, Tatiana; Hirai, Flavio Eduardo [UNIFESP]; Sousa, Luciene Barbosa de [UNIFESP]Purpose: The optical quality of the interface after deep anterior lamellar keratoplasty (DALK) using the big-bubble technique has been shown to be excellent, leading to results comparable to penetrating keratoplasty. However, there is little in the literature with respect to the controversy surrounding the preparation of the donor cornea. The purpose of this study was to evaluate visual acuity (VA) in patients with keratoconus who underwent DALK without removal of the donor graft endothelium. Methods: The records of 90 patients who underwent DALK without the removal of the Descemet membrane (DM) and endothelium were retrospectively reviewed. Data collected included uncorrected VA (UCVA) and spectacle-corrected VA (SCVA) at 7, 30, 180 days, and 1 year postoperatively. Contact lens-corrected visual acuity (CLVA) was evaluated after 1 year of the procedure. Results: UCVA was significantly better than preoperative values at 7 days (p<0.001), 30 days (p<0.001), 180 days (p<0.001), and 1 year (p<0.001) after surgery. The 1-year postoperative mean SCVA and CLVA also improved when compared with preoperative SCVA (p<0.001 for both). Conclusions: DALK utilizing donor corneas with attached Descemet membrane and endothelium results in satisfactory VA in patients with keratoconus.