Lente intraocular multifocal refrativa: a performance visual e qualidade de vida em implantes bilaterais versus unilaterais / Refractive intra-ocular lens: visual performance and quality of life between unilateral versus bilateral

OBJETIVO: O objetivo desse estudo é comparar acuidade visual, sensibilidade ao contraste, velocidade de leitura e a qualidade de vida pós-operatória de pacientes pseudofácicos unilaterais ou bilaterais com lentes intraoculares multifocais ReZoom. MÉTODOS: Estudo comparativo, prospectivo, não aleatório incluindo 38 olhos de 24 pacientes, separados em um grupo com implante bilateral (14 pacientes) e outro com implante unilateral (10 pacientes). O exame oftalmológico completo incluiu acuidade visual não corrigida pré-operatória para perto, intermediário e para longe, acuidade visual com melhor correção, topografia corneal, sensibilidade ao contraste, velocidade de leitura e escala de satisfação realizado 60 dias após a cirurgia. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis, Mann-Whitney e Qui-quadrado. RESULTADOS: Os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação foram semelhante entre os grupos. CONCLUSÃO: Não houve diferença estatística entre os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação entre os grupos.

PURPOSE: The aim of this study is to compare visual acuity, contrast sensitivity, reading speed and quality of life of postoperative pseudophakic patients with unilateral or bilateral ReZoom multifocal intraocular lenses. METHODS: Comparative, prospective, not randomized study including 38 eyes of 24 patients were divided into a group with bilateral implantation (14 patients) and another with unilateral implantation (10 patients). The ophthalmological examination included visual acuity preoperative close, intermediate and far away, best corrected visual acuity, corneal topography, contrast sensitivity, reading speed and level of satisfaction achieved 60 days after surgery. Statistical analysis was performed using the Kruskal-Wallis, Mann-Whitney and Chi-square test. RESULTS: The results comparing visual function, contrast sensitivity, reading speed and scale of satisfaction were similar between groups. CONCLUSION: There was no statistical difference between the results comparing visual function, contrast sensitivity, reading speed and level of satisfaction between the groups.

Wavefront analysis and modulation transfer function of three multifocal intraocular lenses.

Purpose: To evaluate wavefront performance and modulation transfer function (MTF) in the human eye after the implantation of diffractive or refractive multifocal intraocular lenses (IOLs). Materials and Methods: This was a prospective, interventional, comparative, nonrandomized clinical study. Uncorrected distance and near visual acuity, and wavefront analysis including MTF curves (iTrace aberrometer, Tracey Technologies, Houston, TX, USA) were measured in 60 patients after bilateral IOL implantation with 6 months of follow-up. Forty eyes received the diffractive ReSTOR (Alcon), 40 eyes received the refractive ReZoom (Advanced Medical Optics) and 40 eyes, the Tecnis ZM900 (Advanced Medical Optics). The comparison of MTF and aberration between the intraocular lenses was performed using analysis of variance (ANOVA), followed by the Dunn test when necessary. Results: The mean uncorrected distance visual acuity was similar in all three groups of multifocal IOLs. The ReSTOR group provided better uncorrected near visual acuity than the ReZoom group (P < 0.001), but similar to the Tecnis group. Spherical aberration was significantly higher in the ReZoom group (P = 0.007). Similar MTF curves were found for the aspheric multifocal IOL Tecnis and the spheric multifocal IOL ReSTOR, and both performed better than the multifocal IOL ReZoom in a 5 mm pupil (P < 0.001 at all spatial frequencies). Conclusions: Diffractive IOLs studied presented similar MTF curves for a 5 mm pupil diameter. Both diffractive IOLs showed similar spherical aberration, which was significantly better with the full-diffractive IOL Tecnis than with the refractive IOL ReZoom.

Comparative study of the blinking time between young adult and adult video display terminal users in indoor environment / Estudo comparativo do tempo de piscadas entre adultos jovens e adultos usuários de monitor de microcomputador em ambiente climatizado

OBJECTIVE: Investigate the average blinking time in conversation and in Video Display Terminal use of young adults and adults in the presbyopic age group. METHODS: A transversal analytical study in a readily accessible sample consisting of Volkswagen do Brasil - Curitiba, Paraná employees was performed. The cohort group consisted of 108 subjects divided into two age groups: Group 1, the young adult group (age range 20-39): 77 employees, mean age of 30.09 ± 5.09; Group 2, the presbyopic adult group, (age range 40-53): 31 employees, mean age of 44.17 ± 3. Subjects under 18 years of age, with a history of ocular disorders, contact lens wearers and computer non-users were excluded. The subjects had their faces filmed for 10 minutes in conversation and VDT reading. Student's t-test was used and the statistical significance level was 95 percent. RESULTS: The average time between blinks in Group 1 for conversation and VDT reading was 5.16 ± 1.83 and 10.42 ± 7.78 seconds, respectively; in Group 2. 4,9 ± 1.49 and 10.46 ± 5.54 seconds. In both age groups, the time between blinks in VDT reading situations was higher (p<0.0001). There was no statistically meaningful difference for conversation and VDT reading situations when the two studied age groups were compared (p>0.05). CONCLUSION: There was an increase in the blinking time between young adults and the presbyopic group in VDT use situations when compared with reading situations. The difference in the blinking frequency between young adults and the presbyopic group in VDT use and reading situations was not statistically significant.

OBJETIVOS: Investigar o intervalo entre as piscadas em adultos jovens e em présbitas, durante conversação e leitura no monitor do computador. MÉTODOS: Realizou-se estudo transversal, analítico, em amostra prontamente acessível, composta por funcionários da Volkswagen do Brasil, em Curitiba (Paraná-Brasil). A amostra foi dividida em dois grupos de acordo com a idade: grupo 1 (20-39 anos); grupo 2 (40-53 anos). Foram excluídos menores de 18 anos, portadores de doenças oculares, usuários de lentes de contato e não usuários de computador. Os participantes tiveram suas faces filmadas por 10 minutos durante atividades de conversação e leitura no monitor do computador. Utilizou-se teste t de Student,com nível de significância de 95 por cento. RESULTADOS: A amostra compôs-se de 108 indivíduos, sendo o grupo 1 com 77 indivíduos, com idade média 30,09 ± 5,09 anos e grupo 2 com 31 indivíduos, com idade média 44,17 ± 3 anos. O tempo médio entre as piscadas, no grupo 1, em conversação foi de 5,16 ± 1,83 e leitura no monitor de 10,42 ± 7,78 segundos; no grupo 2, em conversação foi de 4,9 ± 1,49 e leitura no monitor de 10,46 ± 5,54 segundos. Encontrou-se distância maior entre as piscadas, durante a leitura no monitor (p<0,0001) nos dois grupos etários. Conferindo os resultados encontrados nos dois grupos, nas situações de conversação e leitura no monitor, não houve diferença estatisticamente significativa (p>0,05). CONCLUSÃO: Houve um aumento no intervalo entre as piscadas, em adultos jovens e em présbitas, durante a leitura em monitor quando comparada com situação de conversação. Não se evidenciou diferença estatisticamente significativa entre os participantes dos dois grupos, nas situações de conversação e leitura no monitor.

A contralateral eye study comparing apodized diffrative and full diffrative lenses: wavefront analysis and distance and near uncorrected visual acuity

PURPOSE: To evaluate intraindividual visual acuity, wavefront errors and modulation transfer functions in patients implanted with two diffractive multifocal intraocular lenses. METHODS: This prospective study examined 40 eyes of 20 cataract patients who underwent phacoemulsification and implantation of a spherical multifocal ReSTOR intraocular lens in one eye and an aspheric Tecnis ZM900 multifocal intraocular lens in the other eye. The main outcome measures, over a 3-month follow-up period, were the uncorrected photopic distance and near visual acuity and the defocus curve. The visual acuity was converted to logMAR for statistical analysis and is presented in decimal scale. The wavefront error and modulation transfer function were also evaluated in both groups. RESULTS: At the 3-month postoperative visit, the mean photopic distance uncorrected visual acuity (UCVA) was 0.74 ± 0.20 in the ReSTOR group and 0.76 ± 0.22 in the Tecnis group (p=0.286). The mean near UCVA was 0.96 ± 0.10 in the ReSTOR group and 0.93 ± 0.14 in the Tecnis group (p=0.963). The binocular defocus curve showed measurements between the peaks better than 0.2 logMAR. The total aberration, higher-order aberration and coma aberration were not significantly different between the groups. The spherical aberration was significantly lower in the Tecnis group than in the ReSTOR group. (p=0.004). Both groups performed similarly for the modulation transfer function. CONCLUSION: The ReSTOR SN60D3 and Tecnis ZM 900 intraocular lenses provided similar photopic visual acuity at distance and near. The diffractive intraocular lenses studied provided a low value of coma and spherical aberrations, with the Tecnis intraocular lens having a statistically lower spherical aberration compared to the ReSTOR intraocular lens. In the 5 mm pupil diameter analyses, both intraocular lens groups showed similar modulation transfer functions.

Comparação entre o uso tópico do fumarato de cetotifeno 0.025 por cento e do cloridrato de olopatadina 0.1 por cento no tratamento da ceratoconjuntivite primaveril / Comparative study between 0.025 percent ketotifen fumarate and 0.1 percent olopatadine hydrochloride in the treatment of vernal keratoconjunctivitis

OBJETIVO: O objetivo desse estudo foi comparar as soluções oftálmicas de fumarato de cetotifeno 0,025 por cento e de cloridrato de olopatadina 0,1 por cento em pacientes portadores de ceratoconjuntivite primaveril. MÉTODOS: Avaliação realizada em um único centro, simples-cega, comparando-se paralelamente cetotifeno e olopatadina. As medicações foram avaliadas em 4 momentos (dias 1, 7, 14 e 21) por meio de tabelas de graduações padronizadas. A freqüência de eventos adversos foi a principal variável de segurança. RESULTADOS: Na avaliação da evolução do prurido ocular, ardor, lacrimejamento, hiperemia conjuntival, secreção e fotofobia observou-se que o uso tópico do cetotifeno proporcionou melhora significante deste sintoma em relação a olopatadina (p>0,05). Observou-se que a partir do 7° dia de tratamento os pacientes em uso da olopatadina tinham menos ardor, em relação aos que fizeram uso do cetotifeno, mas após o 21° dia essa relação inverteu. Na comparação da sensação de corpo estranho, papilas e pontos de Horner-Trantas evidenciou-se equivalência sem significância estatística. CONCLUSÃO: Concluímos que ambas são drogas equivalentes e atuaram de forma eficaz e segura na remissão dos sintomas relacionados à conjuntivite alérgica primaveril. Houve diferença a favor do cetotifeno (p<0,05) na melhora do prurido, lacrimejamento, hiperemia conjuntival, presença de secreção e fotofobia.

PURPOSE: To compare the topical use of 0.025 percent ketotifen fumarate and 0.1 percent olopatadine hydrochloride in the treatment of patients with vernal keratoconjunctivitis. METHODS: A study performed in one center, simple masked, parallel-group compared ketotifen and olopatadine. These patients were evaluated on four visits during the treatment (days 1, 7, 14 and 21), defined by ratings scores. Adverse events were the main variable of safety rating. RESULTS: On evaluating ocular itching, burning, tearing, conjunctival hyperemia, mucous discharge and photophobia, the ketotifen group showed a significant improvement of total signs and symptoms (p<0.05). Between the baseline and the 2nd visit, treatment with olopatadine resulted in decreased burning, but after the 4th visit, ketotifen was slightly better. Sand sensation, papillae and Horner-Trantas dots were not significantly different in both groups. CONCLUSION: Both drugs were efficient and safe relieving the main symptoms and signs of vernal keratoconjunctivitis. Between the same timepoints, there was a significant difference in favor of ketotifen-treated patients (p<0.05), showing improvement of itching, tearing, conjunctival hyperemia, mucous discharge and photophobia.