Biocompatibility of Ferrara intracorneal ring segment with and without chondroitin sulfate coating: clinical and histopathological evaluation in rabbits

PURPOSE: To investigate and compare the biocompatibility of two types of Ferrara intracorneal ring segment: with and without chondroitin sulfate coating by clinical and histopathological evaluation. METHODS: A randomized experimental study was carried out on thirty right-eye corneas from 30 Norfolk albino rabbits allocated into two experimental groups: Group G1 - implanted with Ferrara intracorneal ring segment without coating (FICRS) and Group G2 - implanted with Ferrara intracorneal ring segment with chondroitin sulfate coating (FICRS-CS). Left eyes formed the control group. Clinical parameters analyzed were: presence of edema, vascularization, infection and ring extrusion one, 30, and 60 days after surgery. Histopathological parameters analyzed were: number of corneal epithelial layers over and adjacent to the ring, presence of spongiosis, hydropic degeneration, basement membrane thinning, inflammatory cells, neovascularization and pseudocapsule formation. RESULTS: At clinical examination 60 days after implant, edema, vascularization and extrusion were observed respectively in 20%, 26.7%, 6.7% of FICRS corneas and in 6.7%, 6.7%, and 0% of FICRS-CS corneas. Histopathological evaluation showed epithelial-layer reduction from 5 (5;6) to 3 (3;3) with FICRS and from 5 (5;5) to 4 (3;5) with FICRS-CS in the region over the ring. Epithelial spongiosis, hydropic degeneration, and basement membrane thinning were present in 69.2%, 53.8%, and 69.2% of FICRS and in 73.3%, 73.3%, and 46.7% with FICRS-CS, respectively. Vascularization was present in 38.5% of FICRS and 13.3% with FICRS-CS, inflammatory cells in 75% of FICRS and 33.3% with FICRS-CS, and pseudocapsule in 66.7% of FICRS and 93.3% with FICRS-CS. Giant cells occurred only in the FICRS-CS group (20%). CONCLUSION: Ferrara intracorneal rings coated with chondroitin sulfate (FICRS-CS) caused lower frequency of clinical and histopathological alterations than Ferrara intracorneal rings without the coating (FICRS), demonstrating higher biocompatibility of the FICRS-CS.

Inclusão social do deficiente visual: experiência e resultados de Assis / Social inclusion for visually impaired: experience and results from Assis

OBJETIVOS: Traçar o perfil do usuário da Sala de Recursos para Deficiente Visual na cidade de Assis - SP, avaliar a porcentagem de deficientes visuais empregados e comparar o emprego com idade, gênero, tipo de deficiência e doença causadora da deficiência, entre dois períodos: de 1984 a 1996 e de 1997 a 2009. MÉTODOS: Foi realizado estudo retrospectivo dos prontuários médicos e da ficha escolar dos portadores de deficiência visual que frequentaram a Sala de Recursos para Deficiente Visual, no período de 1984 a 2009 na cidade de Assis - SP, divididos em dois períodos de 1984 a 1996 (G1) e de 1997 a 2009 (G2). Analisaram-se dados demográficos, a doença que provocou a baixa visão, o tipo de deficiência visual (cegueira ou baixa visão), escolaridade, recursos ópticos, frequência à Sala de Recursos para Deficiente Visual e taxa de emprego. Foi feita associação da taxa de emprego com: idade, gênero, raça/cor, tipo de deficiência e doença nos dois diferentes períodos. RESULTADOS: Foram encontrados 149 deficientes visuais sendo: 61,07 por cento homens, 38,9 por cento mulheres, 82,5 por cento brancos e 17,4 por cento não brancos e a mediana da idade foi de 18 anos. Dos 149 deficientes visuais, 63,75 por cento eram portadores de baixa visão e 36,24 por cento portadores de cegueira. As principais doenças que levaram à deficiência visual dos 149 pacientes foram em ordem decrescente: retinocoroidite por toxoplasmose (17,40 por cento), atrofia óptica congênita (12,10 por cento), alta hipermetropia (8,72 por cento), retinose pigmentar e alta miopia (6,71 por cento cada uma) e glaucoma congênito e catarata congênita (6,04 por cento cada uma). A frequência à Sala de Recursos para Deficiente Visual foi boa em mais de 50 por cento dos pacientes. Estavam trabalhando regularmente 44,7 por cento e 12,3 por cento dos maiores de 14 anos respectivamente nos períodos de 1984 - 1996 e de 1997 - 2009. Não houve diferença entre os dois períodos quanto às características...

PURPOSES: To establish the visually impaired resource class users profile in the city of Assis - SP, to estimate the visually impaired employment percentage and to compare employment rate with age, gender, deficiency type and causing disease between two periods:1984 - 1996 and 1997 - 2009. METHODS: Retrospective review of both medical and school records from visually impaired individuals attending visually impaired resource class in Assis - SP between 1984 and 2009. This time period was divided into two intervals: 1984 - 1996 (G1) and 1997 - 2009 (G2). Collected data included demographic features and diseases, type of visual impairment (blindness or low vision), education, optic aids, attendance to visually impaired resource class and employment rate. Employment rate was associated with age, gender, type of visual impaiment and causing disease between both study time intervals. RESULTS: A total of 149 visually impaired individuals were identified - 61.07 percent male, 38.9 percent female, 82.5 percent white, and 17.4 percent non-white. Mean age was 18 years. Of the 149 visually impaired, 63.75 percent had low vision and 36.24 percent were blind. In decreasing order, the more frequent conditions leading to visual impairment were toxoplasmosis retinochoroiditis (17.40 percent), congenital optic atrophy (9.39 percent), high hyperopia (8.72 percent), pigmentary retinosis and high myopia (with 6.71 percent each) and congenital glaucoma and congenital cataract (with 6.04 percent each). Attendance to visually impaired resource class was good by over 50 percent of the patients. Of the individuals >14 years-old, 44.7 percent and 12.3 percent were regularly employed during 1984 - 1996 and 1997 - 2009 periods, respectively. Employment rate only correlated with age (individuals with higher mean age were most frequently employed) and there was not correlation with demographic characteristics, deficiency type and causing diseases...