Navegando por Palavras-chave "Ophthalmic solutions"

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    Alterações da microbiota conjuntival e palpebral após uso tópico de lomefloxacina e tobramicina na cirurgia de catarata e cirurgia refrativa
    (Conselho Brasileiro de Oftalmologia, 2002-01-01) Hofling-Lima, Ana Luisa [UNIFESP]; Farah, Michel Eid [UNIFESP]; Montenegro, Luciano [UNIFESP]; Alvarenga, Lênio Souza; Chalita, Maria Regina Catai; You, Maria Cecília Zorat [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To determine the changes in the conjunctival and palpebral flora after topical use of 0.3% lomefloxacin and 0.3% tobramycin eye drops in the preoperative management of patients submitted to cataract and refractive surgery and to assess the chemosensitivity of bacterial isolates from the conjunctiva and eyelid to these antibiotics. Methods: A prospective study of the conjunctival and palpebral flora of patients submitted to cataract or to refractive (PRK or LASIK) surgery was performed. An analysis of the conjunctival and palpebral flora was carried out in patients before surgery without prophylaxis, after surgery during the use of prophylaxis (0.3% lomefloxacin or 0.3% tobramycin qid) and after discontinuation of the antibiotic. Results: Tobramycin and lomefloxacin reduced the number of positive cultures in specimens from the conjunctiva and eyelid of individuals submitted to cataract and refractive surgery. In both groups, isolated microorganisms displayed a greater resistance to tobramycin. In the group submitted to cataract surgery, patients treated with prophylactic tobramycin showed a slower recovery of the flora after discontinuation of the antibiotic than those treated with lomefloxacin, with the opposite occurring in the group submitted to refractive surgery. Conclusion: Both lomefloxacin and tobramycin were effective in reducing conjunctival and palpebral flora during drug administration. This reduction was more marked in the conjunctiva. Among the various bacterial isolates, there was a greater resistance to tobramycin than to lomefloxacin. The use of antibiotics reduced the incidence of positive cultures more for the conjunctiva than the eyelids.
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    Aqueous humor concentrations of topical fluoroquinolones alone or in combination with a steroid
    (Consel Brasil Oftalmologia, 2017) Rodrigues Gomes, Rachel Lopes [UNIFESP]; Viana, Rodrigo Galvao; Soares Melo, Luiz Alberto, Jr. [UNIFESP]; Cruz, Alessandro Carvalho [UNIFESP]; de Souza Lima Filho, Acacio Alves [UNIFESP]; Suenaga, Eunice Mayumi [UNIFESP]; Campos, Mauro [UNIFESP]
    Purpose: To compare the aqueous humor (AH) concentrations of moxifloxacin 0.5% and gatifloxacin 0.3% solutions alone or when treatment was combined with steroids, and to correlate these concentrations with the minimum inhibitory concentrations (MIC) for the most common endophthalmitis-causing organisms. Methods: Patients undergoing phacoemulsification were enrolled to receive one drop of one of the following solutions: moxifloxacin (G1), moxifloxacin + dexamethasone (G2), gatifloxacin (G3), or gatifloxacin + c (G4), every 15 min, 1h before surgery. AH samples were collected before surgery and analyzed using HPLC-tandem mass spectrometry. Results: The mean antibiotic concentrations in the AH were: G1= 1280.8 ng/mL, G2= 1644.3 ng/mL, G3= 433.7 ng/mL and G4= 308.1 ng/mL. The mean concentrations statistically differed between G1 and G2 (p=0.01), and G3 and G4 (p=0.008). All samples achieved the MIC for Staphylococcus epidermidis 100% of the samples from G1 and G2, and 97% from G3 and G4 reached the MIC for fluoroquinolone-sensitive Staphylococcus aureus 100% of the samples from G1 and G2, 88% from G3, and 72% from G4 reached the MIC for enterococci (p<0.001) and 100% of samples from G1 and G2, 59% from G3, and 36% from G4 reached the MIC for Streptococcus pneumoniae (p<0.001). For fluoroquinolone-resistant S. aureus, 23% from G1, 44% from G2, and no samples from G3 or G4 achieved the MIC (p<0.001). Conclusions: Moxifloxacin + dexamethasone demonstrated a higher concentration in the AH than the moxifloxacin alone. Gatifloxacin + steroids demonstrated less penetration into the anterior chamber than gatifloxacin alone. Moxifloxacin was superior to gatifloxacin considering the MIC for enterococci, S. pneumoniae, and fluoroquinolone-resistant S. aureus.
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    Autologous serum for ocular surface diseases
    (Conselho Brasileiro de Oftalmologia, 2008-12-01) Quinto, Guilherme Goulart; Campos, Mauro Silveira de Queiroz [UNIFESP]; Behrens, Ashley; The Johns Hopkins University School of Medicine Fellow in Cornea and Refractive Surgery at the Wilmer Ophthalmological Institute; Universidade Federal de São Paulo (UNIFESP); The Johns Hopkins University School of Medicine Wilmer Ophthalmological Institute
    Autologous serum has been used to treat dry eye syndrome for many years. It contains several growth factors, vitamins, fibronectin and other components that have been considered important for corneal and conjunctival integrity. Serum eye drops are usually prepared as an unpreserved blood solution. The serum is by nature well tolerated and its biochemical properties are somewhat similar to natural tears. Autologous serum eye drops have been reported to be effective for the treatment of severe dry eye-related ocular surface disorders (Sjögren's syndrome), and also other entities such as superior limbic keratoconjunctivitis, graft-versus-host disease, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, recurrent or persistent corneal erosions, neurotrophic keratopathy, Mooren's ulcer, aniridic keratopathy, filtering blebs after trabeculectomy, and post-keratorefractive surgery. The purpose of this study is to review the recently published literature on ocular surface diseases treated with human autologous serum eye drops.
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    Comparação do uso tópico de cetotifeno com a olopatadina no tratamento de conjuntivites alérgicas
    (Conselho Brasileiro de Oftalmologia, 2001-10-01) Hofling-Lima, Ana Luisa [UNIFESP]; Andrade, Alfredo J. M. [UNIFESP]; Marback, Patrícia M. F. [UNIFESP]; Farah, Michel Eid [UNIFESP]; Mascaro, Vera [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To evaluate and compare the efficacy and tolerance to the topical use of 0.05% ketotifen fumarate and 0.1% olopatadine hydrochloride in the treatment of patients with allergic conjunctivitis. Methods: A masked, randomized clinical study was performed in order to compare the efficacy, safety and side effects of the use of 0.05% ketotifen fumarate and 0.1% olopatadine hydrochloride ophthalmic solutions for the alleviation of symptoms and signs in patients with allergic conjunctivitis. Thirty-four patients, fulfilling the inclusion criteria of the protocol were divided into two groups and received a flask with the masked drug, instilling one drop twice daily in each eye for 30 days. Signs and symptoms of these patients were evaluated on a visit before treatment and on five visits during the treatment (days 1, 2, 7, 14 and 30). Results: Severity of allergic conjunctivitis was the same in both studied groups. Both ketotifen and olopatadine were equivalent and efficient regarding decrease in itching, burning and lacrimation symptoms. Bulbar conjunctival hyperemia was attenuated in both groups. Evaluation of adverse reactions showed the occurrence of burning on administration of both drugs and ketotifen led to occurrence of itching. No hypersensitivity reaction to the studied drugs was observed. Conclusions: This study evidences that 0.05% ketotifen fumarate and 0.1% olopatadine hydrochloride ophthalmic solutions, when instilled twice daily for 30 days, were efficient and safe regarding alleviation of the main symptoms and signs of allergic conjunctivitis.
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    Comparação do volume da gota e custo do tratamento dos genéricos de maleato de timolol 0,5%
    (Conselho Brasileiro de Oftalmologia, 2004-06-01) Prata Junior, João Antonio [UNIFESP]; Prata, João Antonio; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina do Triângulo Mineiro
    PURPOSE: To compare drop volume and treatment cost of generic 0.5% timolol maleate preparations. METHODS: The drop volume of Timoptol® 0.5% (Merck Sharp & Dohme) and its generic preparations (Allergan-Lok, Cristália and Falcon) were determined. Five bottles of each medication were purchased at local drugstores. Using a precision scale, ten drops and one mililiter of each bottle were weighed. Drop volume was calculated by the relation between volume and weight. Duration, in days, of each bottle and annual cost were calculated considering a daily use of 4 drops and maximum price to consumers published May, 2003. RESULTS: Statistically significant differences were observed between drop volumes (p<0.0001%). Allergan-Lok timolol maleate had the largest drop (35.1 µl) and the smallest was Falcon timolol maleate (27.3 µl). Timoptol® drop volume was 27.9 µl. Annual treatment costs were R$ 68.87 for Timoptol, R$ 72.76 for Allergan-Lok timolol maleate, R$ 50.00 for Cristalia timolol maleate and R$ 43.11 for Falcon timolol maleate (p<0.0001). Allergan-Lok timolol maleate was statiscally more expensive than the others and it was 68.8% more expensive than the cheapest. CONCLUSION: There are differences in drop volume among generic medications for glaucoma which are related to their annual cost. Drop volume should be considered in the analysis of quality of generic preparations.
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    Contaminação de frascos de colírios de soro autólogo
    (Conselho Brasileiro de Oftalmologia, 2001-02-01) Hofling-Lima, Ana Luisa [UNIFESP]; Lima Filho, Acácio Alves de Souza [UNIFESP]; Batistoso, José Antonio; Kawamura, Débora; Chalita, Maria Regina Catai [UNIFESP]; Alves, Leandro Siqueira [UNIFESP]; Farah, Michel Eid [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To evaluate bacterial contamination of autologous serum eyedroppers after topical use. Methods: Autologous serum eyedroppers used for ocular surface diseases were submitted to culture after topical use. A total of 127 eyedroppers was cultivated after the patients had used the drops and returned them to the laboratory. Results: We found that 76.03% of the eyedroppers were contaminated. Nine-two microorganisms were found: coagulase-negative Staphy-lococcus (35.86%), Alcaligenes sp (21.73%), Klebsiella sp (20.65%) and Bacillus sp (9.78%). Conclusion: The eye-dropper contamination can be caused by normal flora and by skin and environmental microorganisms. These results show the contamination risk at the moment of instillation. Further research will be done to evaluate fungal contamination and to correlate the patient's normal flora with microorganisms found in the eyedroppers.
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    Efeito do mel e do soro autólogo na cicatrização do epitélio corneano em coelhos
    (Conselho Brasileiro de Oftalmologia, 2005-06-01) Malavazzi, Gustavo Ricci [UNIFESP]; Lake, Jonathan Clive; Dantas, Paulo Elias Correa; Universidade Federal de São Paulo (UNIFESP); Irmandade da Santa Casa de Misericórdia de São Paulo Departamento de Oftalmologia Seção de Córnea e Doenças Externas
    PURPOSE: To evaluate the efficacy of pure honey and 20% autologous serum and BSS® in corneal epithelial healing in rabbits after 48 hours. METHODS: All solutions were applied after an epithelial removal of 13-millimeters diameter area. Areas of epithelial healing were studied at 12, 24 and 48 hours. The eyes were treated every four hours during 2 days. All treated eyes were assigned to a control group (contralateral eye) treated with a balanced saline solution. RESULTS: All studied groups were not significantly differents. In group one, the eyes treated with honey and the control were similar (p<0.87). In the second group the eyes treated with autologos serum and the control presented no difference in the mean score (p<0.072). CONCLUSION: Corneal epithelial healing in rabbits did not show improvement after application of either honey or autologous serum. It was possible to stabilish that the autologous serum treated eyes were clinicaly better than the control group but without statistical significance.
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    Efeito terapêutico da aplicação intra-ocular de ozônio em modelo experimental de endoftalmite por Staphylococcus epidermidis em coelhos
    (Conselho Brasileiro de Oftalmologia, 2004-08-01) Lake, Jonathan Clive; Felberg, Sergio; Malavazzi, Gustavo Ricci [UNIFESP]; Goulart, Denise Atique [UNIFESP]; Nishiwaki-dantas, Maria Cristina; Dantas, Paulo Elias Correa; Santa Casa Departamento de Oftalmologia Seção de Córnea e Doenças Externas; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the anti-inflammatory and antimicrobial effect of intraocular ozone diluted in BSS on experimental Staphylococcus epidermidis endophthalmitis. METHODS: We injected 0.1ml of S. epidermidis colonies (10(5) colonies/ml) to produce experimental endophthalmitis in the right eyes of 17 New Zealand rabbits. Seven rabbits were assigned to a control group and received an intravitreal injection of 0.1ml BSS. Ten rabbits were treated with intravitreal injection of 0.1ml BSS-diluted ozone (2 ppm). Data were distributed according to clinical and histological findings after 24 hours, each rabbit receiving a score. Mean scores and standard deviations were compared using the two-sample t test. RESULTS: Mean clinical score for the control group was 11.14 ± 1.04. Mean clinical score for the treated group was 4.90 ± 1.29, which was significantly lower (p<0.01). Mean histological scores were, respectively, 17.00+ 0.57 and 10.20 ±1.30 for the control group and the treated group. The histological scores were significantly lower for the treated group (p<0.01). All cultures in both control and ozone groups were positive after 24 hours of experiment. CONCLUSION: Treatment with diluted ozone significantly reduced the inflammatory reaction in our model of experimental endophthalmitis. This probably occurred due to a decrease in bacterial content after ozone injection. It is necessary to study other ozone concentrations in different experimental models in order to determine ozone efficacy with a higher precision.
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    A evolução do mercado farmacêutico brasileiro no tratamento do glaucoma nos últimos 30 anos
    (Conselho Brasileiro de Oftalmologia, 2003-12-01) Souza Filho, João Pessoa de [UNIFESP]; Dias, Ana Beatriz Toledo [UNIFESP]; Lima Filho, Acácio Alves de Souza [UNIFESP]; Sartori, Marta Filippi; Martins, Maria Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí
    PURPOSE: To analyze price variations of drugs used to control glaucoma, during the last 30 years, at 10-year intervals. METHODS: Drugs to treat glaucoma, as well as their presentations and laboratories were selected from the 1972, 1982, 1992 and 2002 editions of the Dictionary of Pharmaceutical Specialties. The price of medicines in the Brazilian market were analyzed, in the different decades, using the pharmaceutical guide Brasíndice. For analysis of the data, the prices were converted to American dollars and the relationship between the medicine and the minimum wage was analyzed. As unit of the product, the values per milliliter, oral tablet or gram, depending on the presentation, were considered. RESULTS: The number of laboratories and antiglaucoma medications varied in the last thirty years. Drugs such as acetazolamide and pilocarpine still continue to be used. Parasympathomimetic drugs have predominantly been used in the first years of the study, and the beta-blockers in the last years. The average cost of available medications in the market has increased in the last decade. CONCLUSION: The price of antiglaucoma drugs varied considerably in the studied period as well as the type of drug used in the treatment.
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    Flora bacteriana conjuntival após uso tópico de ciprofloxacino e gatifloxacino em cirurgia de catarata
    (Conselho Brasileiro de Oftalmologia, 2008-04-01) Arantes, Tiago Eugênio Faria e [UNIFESP]; Castro, Célia Maria Machado Barbosa de; Cavalcanti, Ronald Fonseca; Severo, Maiara Santos; Diniz, Maria de Fátima Alves; Urtiga, Ricardo Walber de Deus; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco Departamento de Medicina Tropical; Fundação Altino Ventura Departamento de Córnea e Doenças Externas; UFPE Laboratório de Imunopatologia Keizo-Asami; FAV
    PURPOSE: To evaluate alterations of the conjunctival flora after the use of 0.3% ciprofloxacin and gatifloxacin in the prophylaxis of patients undergoing cataract surgery. METHODS: 40 patients undergoing cataract surgery were distributed into two groups according to the use of antibiotic eye drops: Group A: 0.3% ciprofloxacin and Group B: 0.3% gatifloxacin. Both groups used antibiotic eye drops 1 hour before surgery and 14 days after surgery. Conjunctival material was collected at 5 time points: 1 hour before surgery, without any topical medication (t0); immediately before the application of povidone-iodine (PVPI) (t1), before the beginning of surgery, after povidone-iodine (t2), 14 days (t3) and 28 days after surgery (t4). RESULTS: Preoperative antibiotics reduced the positivity of the cultures before the use of PVPI in both groups, although in Group A this reduction was not significant (Group A - p=0.07 and Group B - p=0.04). The number of positive cultures was reduced in all groups after the use of povidone-iodine and on the 14th postoperative day (p<0.05). In t4 there was a reduction in the frequency of coagulase-negative Staphylococcus in Group A compared with Group B (p<0.05); the susceptibility to ciprofloxacin was also reduced in all groups, when compared with t0. CONCLUSIONS: Gatifloxacin eye drops applied one hour before surgery significantly reduced the number of positive conjunctival cultures. Both antibiotics reduced the conjunctival flora when administered in the postoperative period.
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    Impacto econômico do custo de colírios no tratamento do glaucoma
    (Conselho Brasileiro de Oftalmologia, 2005-02-01) Stillitano, Iane Gonçalves [UNIFESP]; Lima, Manoel Gonçalves De; Ribeiro, Marco Polo; Cabral, Juliana; Brandt, Carlos Teixeira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Clínica de Olhos Dr. Manoel Gonçalves; Wills Eye Hospital-Philadelphia; Hospital de Olhos Leiria de Andrade
    PURPOSE: To evaluate the daily cost of antiglaucoma eyedrops and the economic impact related to the minimal wage; to compare the cost of drug association in the single presentation in relation to separate presentations; to analyze the additional percent antiglaucoma drug cost related to standard therapy (generic timolol maleate). METHODS: Fifteen eyedrop bottles of each one of the twenty antiglaucoma products were used. The number and mean eyedrop size per bottle of drug were measured and the duration and treatment costs calculated. RESULTS: A large variation in the mean daily cost, respectively: R$ 0.077 for generic timolol maleate (cheapest) and R$ 1.910 for Xalacom® (most expensive), was observed. It should be noted that the product of minimal economic impact, as related to the minimal wage, was the standard eyedrop therapy with 1.2% to 1.6%, while the association of Xalatan® with Timoptol XE® showed a variation of 21.7% to 30.0%. The cost of Cosopt® and Xalacom® was greater than the associations of, respectively: Trusopt® + standard eyedrop and Xalatan® + standard eyedrop (p<0.001). Xalacom® represented an additional cost to standard therapy of 1.698.2% to 1.765.1%. CONCLUSIONS: The variation of antiglaucoma eyedrop cost was almost 30 times between the cheapest and the most expensive, which represented an economic monthly impact of 29.1% on the value of the minimal wage. The combined therapy in the separate presentations presented a lower cost than drug association in a single presentation. The use of antiglaucoma drugs represents a high percent additional cost related to standard therapy.
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    Impacto econômico no tratamento do glaucoma: volume de gotas de colírios antiglaucomatosos brasileiros e norte-americanos
    (Conselho Brasileiro de Oftalmologia, 2001-04-01) Roizenblatt, Roberto [UNIFESP]; Freitas, Denise de [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Prata Junior, João Antonio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To assess the volume of each drop of Brazilian commercially available antiglaucomatous eyedrops and to compare the results with North-american equivalents in order to evaluate the economic implications. Methods: Volumetric study of drops and related impact in the cost of treatment. Results: Brazilian Alphagan® drop volume was 18% larger and the bottle had a 15.1% shorter mean duration resulting in a 17.8% higher annual cost. Brazilian Betoptic S® drop volume was 38.4% larger and the bottle had a 27.7% shorter mean duration resulting in 38.1% higher annual cost. Brazilian Iopidine® drop volume was 46.3% larger, the bottle had a 32.1% shorter mean duration resulting in 46.9% higher annual cost. Brazilian Timoptol® drop volume was 14.7% larger, the bottle had a 12.8% shorter mean duration resulting in 14.5% higher annual cost. Conclusions: In all tested medications the Brazilian eyedrop volume was larger, resulting in less duration of each bottle and significant higher cost.
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    Líquido amniótico tópico: uma potencial nova alternativa para doenças da superfície ocular
    (Conselho Brasileiro de Oftalmologia, 2008-12-01) Quinto, Guilherme Goulart [UNIFESP]; Martins, Suy Anne Rebouças [UNIFESP]; Tiemi, Renata [UNIFESP]; Campos, Mauro Silveira de Queiroz [UNIFESP]; Behrens, Ashley; Universidade Federal de São Paulo (UNIFESP); University School of Medicine Wilmer Ophthalmological Institute
    Amniotic fluid bathes the fetus during intrauterine life and is in permanent contact with the fetal ocular surface in this important period of development. It contains a series of growth factors that may have multiple effects on the wound healing process. These factors are thought to accelerate the recovery of corneal sensitivity and nerve regeneration after keratorefractive procedures, and also may control scar formation and balance the ocular surface after topical application. Hundreds of different proteins have been identified in the human amniotic fluid, and the role of each still not quite understood. The outcomes obtained so far with amniotic fluid application to ocular surface diseases suggest a promising therapy. Research is underway to identify the effects of specific factors of the amniotic fluid in ocular inflammation. The purpose of this review is to report the properties and current utilizations of amniotic fluid as well as to summarize the recent studies related to the use of this fluid for ocular surface diseases.
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    Microemulsões como veículo de drogas para administração ocular tópica
    (Conselho Brasileiro de Oftalmologia, 2003-06-01) Cunha Júnior, Armando Da Silva; Fialho, Sílvia Ligório; Carneiro, Luciana Barbosa [UNIFESP]; Oréfice, Fernando; Universidade Federal de Minas Gerais Faculdade de Farmácia; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais Hospital das Clínicas Serviço de Uveítes; Universidade Federal de Minas Gerais
    The conventional ophthalmic dosage forms are relatively simple: usually, water-soluble drugs are delivered in aqueous solution and water-insoluble drugs are prepared as suspensions or ointments. However, these delivery systems currently used present very low corneal bioavailability, systemic exposure because of nasolacrimal drainage and lack of efficiency in the posterior segment of ocular tissue. Recent research efforts have focused on the development of new ophthalmic drug delivery systems. As a result of these efforts, microemulsions are promising dosage forms for ocular use. These delivery systems are dispersions of water and oil that require surfactant and co-surfactant agents in order to stabilize the interfacial area. The microemulsions have a transparent appearance, thermodynamic stability and small droplet size of the dispersed fase (<1,0 mm), providing them with the capacity of being sterilized by filtration. Furthermore, these systems offer additional advantages that include: low viscosity, great ability as drug delivery vehicles, widened properties as absorption promoters and easiness of preparation, which do not require much energy and the use of special equipments. In this review, we present the technology and some preliminary studies of microemulsions in relation to ocular drug delivery systems.
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    Mudanças oculares durante a gestação
    (Conselho Brasileiro de Oftalmologia, 2009-04-01) Gouveia, Enéias Bezerra; Conceição, Paulo Sergio Pereira; Morales, Maira Saad de Avila [UNIFESP]; Hospital São Joaquim da Real e Benemérita Sociedade Portuguesa de Beneficência Serviço de Oftalmologia; Universidade São Paulo Faculdade de Medicina Serviço de Ginecologia-Obstetricia; Universidade Federal de São Paulo (UNIFESP)
    Pregnancy can cause several alterations in human eye function in healthy condition as well in ocular disease; these effects on the eyes are divided into three categories: physiologic alterations, ocular diseases changes already existing before the pregnancy, and pathological alterations. The present text proposes a bibliographical revision on the theme. The authors researched PubMed (MEDLINE) and LILACS databases.
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    Tacrolimus eye drops as monotherapy for vernal keratoconjunctivitis: a randomized controlled trial
    (Consel Brasil Oftalmologia, 2017) Mueller, Eduardo Gayger [UNIFESP]; dos Santos, Myrna Serapiao [UNIFESP]; Freitas, Denise [UNIFESP]; Pereira Gomes, Jose Alvaro [UNIFESP]; Belfort, Rubens, Jr. [UNIFESP]
    Purpose: To assess the efficacy of monotherapy using tacrolimus eye drops versus sodium cromoglycate for the treatment of vernal keratoconjunctivitis (VKC). Methods: Randomized double-masked controlled trial comparing the efficacy of tacrolimus 0.03% eye drops t.i.d. (Group 1) with sodium cromoglycate 4% eye drops t.i.d. (Group 2) for the symptomatic control of VKC at days 0, 15, 30, 45, and 90 of follow-up. Visual acuity, intraocular pressure, and other complications were evaluated to assess safety and side effects. Results: In total, 16 patients were included, with 8 enrolled in each group. Two patients from Group 2 were excluded from the analysis at days 45 and 90 because of corticosteroid use. Most patients were male (81.8%) and presented with limbal VKC (56.3%). There were statistically significant differences in favor of tacrolimus in the following severity scores: itching at day 90 (p = 0.001)
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    Toxicidade córneo-conjuntival do colírio de iodo-povidona: estudo experimental
    (Conselho Brasileiro de Oftalmologia, 2003-06-01) Santos, Namir Clementino [UNIFESP]; Sousa, Luciene Barbosa de [UNIFESP]; Freitas, Denise de [UNIFESP]; Rigueiro, Moacyr Pezati [UNIFESP]; Scarpi, Marinho Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate ocular toxicity of povidone-iodine eye drops at a concentration of 2.5% and 0.5% and to investigate the effects on corneal epithelial wound healing and histopathological alterations. METHODS: Each group (PVP-I 2.5% and 0.5%) consisted of 20 rabbits. A central circular corneal epithelial defect of 6.5 mm diameter was created and the povidone-iodine eyedrops (2.5% and 0.5) instilled in the right eye and distilled water in the left eye (control) of each rabbit, every hour, during 3 days. Biomicroscopical examinations were performed every day, focussing on the corneoconjunctival surface and the diameter of the lesion, using fluoresceine eye drops, photodocumentation, and a computerized image analyzer. After the third day the rabbits were sacrified and the excised corneas histopathologically evaluated. Statistical evaluation was performed using Friedman, Mann-Witney, Wilcoxon, Fisher and Chi-squared tests. RESULTS: Povidone-iodine eye drops, at a concentration of 2.5%, caused an increase in the wound healing time (p= 0.087) and conjuntivitis in 100% of the eyes with mucous secretion in 80%, punctate ceratitis in 40%, and discrete stromal edema in 10% of the cases. The histopathological examination showed corneal ulcers and vacuolic degeneration of the endothelial layer in 100%, as well as an inflammatory infiltrate with eosinophils in 80% of the cases. The eyes treated with povidone-iodine eye drops at a concentration of 0.5% and the control eyes showed complete epithelial wound healing after 72 hours, and histopathologically normal epithelization. Only in one case, a discrete perilimbar leucocytic infiltrate was observed. CONCLUSION: The ocular toxicity of povidone-iodine eye drops is concentration-dependent. The use of the eye drop at a concentration of 2.5% is not adequate for daily and repetitive use. In contrast, at a concentration of 0.5% no toxicity was observed.
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    Transplante de córnea e o conhecimento do procedimento pelos pacientes
    (Conselho Brasileiro de Oftalmologia, 2003-12-01) Moreno, Gerson López [UNIFESP]; Souza, Luciene Barbosa de [UNIFESP]; Freitas, Denise de [UNIFESP]; Sato, Elcio Hideo [UNIFESP]; Vieira, Luis Antonio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the understanding of the patient submitted to corneal transplant regarding the type of surgery, used treatment, rejection signs and final outcome satisfaction, at Cornea and External Disease Sector of the Federal University of São Paulo (UNIFESP). METHODS: 42 patients submitted to corneal transplant were interviewed using a questionnaire that includes multiple variables regarding knowledge on the general procedure, postoperative treatment, rejection signs and satisfaction with the final outcome. We also collected data about the diagnosis and the transplant. The data were tabulated and analyzed. RESULTS: 67% of 42 interviewed patients did not know what a corneal transplant is, 67% did not know about rejection signs, 30% did not know the purpose of postoperative medicines and 71% were satisfied with the final outcome. CONCLUSIONS: Most of transplanted patients do not know the meaning of corneal transplant, rejections signs and the correct use of medicines but are satisfied with the final outcome.
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    Uso ocular de água boricada: condições de manuseio e ocorrência de contaminação
    (Conselho Brasileiro de Oftalmologia, 2007-03-01) José, Andrea Cotait Kara [UNIFESP]; Branco, Bruno Castelo [UNIFESP]; Ohkawara, Lílian Emi [UNIFESP]; Yu, Maria Cecília Zorat [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate use conditions and detect contamination in bottles of boric acid solution. METHODS: A convenience sample of 42 recruited patients using boric acid solution came to the Ophthalmology Emergency Room of the São Paulo Hospital from February to March of 2003. Cultures were taken from material of the conjunctival sac, inner surface of bottle edge, inner part of cap and from 1 ml of boric acid solution of each bottle. RESULTS: Of the 42 boric acid solution bottles, 17 (40.5%) showed contamination: 1 (2.4%) in the solution, 17 (40.5%) in the inner cap and 6 (14.3%) in the inner part of the bottle edge. Of the 17 contaminated bottles, 10 (58.8%) were handled inappropriately and 13 (76.5%) of the bottles were not discharged after first use. The most common microorganisms found in the caps and edges of the bottles were Staphylococcus sp (69.6%), followed by Gram-positive bacillus (26.1%). Sixteen bottles (38.1%) had been opened more than a month ago and 5 (31.3%) of those showed contamination. The boric acid solution bottle directions shown on the labels were incomplete and not clear. The use of boric acid solution was on recommendation of their own, friends or relatives in 26 (61.9%) cases; pharmacists in 8 (19.0%) cases, ophthalmologists in 5 (11.9%) cases and general practitioners in 3 (7.1%) cases. CONCLUSION: In most cases, the topic use of boric acid solution was recommended by non-physicians. The bottles, in general, were handled inappropriately, and hence presented a much higher level of contamination that did the boric acid solution inside. The lower level of contamination in the solution is possibly associated with the anti-septic characteristics of the boric acid solution.