Análise do perfil epidemiológico dos pacientes submetidos a transplante de córnea no Espírito Santo / Analysis of the epidemiological profile of patients submitted to corneal transplantation in the Espirito Santo

Resumo Objetivo: Descrever o perfil epidemiológico dos pacientes submetidos a transplante de córnea no estado do Espírito Santo. Métodos: Estudo transversal e descritivo realizado entre o período de janeiro de 2017 a janeiro de 2018, com o total de 1310 cadastrados na Central de Notificação, Captação e Distribuição de Órgãos do Espírito Santo (CNCDO/ES) por meio do Sistema Nacional de Transplantes (SNT) e que foram submetidos a transplante de córnea. Os dados foram apresentados em estatística descritiva como frequências e mediana e a análise dos dados foi realizada com o software SPSS versão 23. Resultados: em relação à frequência, obteve-se 54,3% do gênero feminino, 57,33% (751) provenientes da Região Metropolitana de Vitória. Os pacientes do Espírito Santo correspondem a 86% da frequência na fila, seguidos por Rio de Janeiro, Minas Gerais e Bahia, que juntos correspondem a 6,3%. O principal diagnóstico na indicação de transplante foi a Ceratopatia Bolhosa (25,9%), seguido por Ceratocone (16,5%) e Ceratite Intersticial (15,5%). A média de tempo de espera foi de 195 dias, sendo no máximo 1345 dias. Verificou-se que 1310 pacientes foram transplantados de córnea, a faixa etária dos transplantados é de 57 anos, sendo a maioria destes da Região Metropolitana de Vitória. Conclusão: Os diagnósticos mais prevalentes nos pacientes transplantados no Espírito Santo foram Ceratopatia Bolhosa e Ceratocone, em pacientes majoritariamente do sexo feminino, 57 anos em média, da região metropolitana da grande Vitória e provenientes do próprio estado. O estudo permite traçar estratégias de prevenção, cuidado e ações sociais de conscientização de doação de córnea.

Abstract Objective: To describe the epidemiological profile of patients submitted to corneal transplantation in state of Espirito Santo, Brazil. Methods: Transversal and descriptive study, with 1301 patients, in the period of January 2017 until to January 2018, the patients were registered in the Central Notification, Captation and Distribution of Organs of Espirito Santo (CNCDO/ES) through the National Transplant System (SNT) and submitted to corneal transplantation. The data were shown as descriptive statistics (frequencies and medians) and analysis of the data was performed using SPSS software, 23 version. Results: In relation to frequency, it was obtained 54.5% female, 57.33% from the metropolitan area of Vitória. Eighty-six percent were patients from Espirito Santo and the others 6.3% were from Rio de Janeiro, Minas Gerais and Bahia. The main indications for corneal transplantation were Bullous Keratopathy (25.9%), Keratoconus (16.5%) and interstitial keratitis (15.5%). The average of waiting time was 195 days and the longest was 1345 days. It was found that 1301 patients underwent corneal transplantation, they are in the 57-year age group, and the biggest part of them are from the metropolitan area of Vitória. Conclusion: The most prevalent diagnoses in patients submitted to corneal transplantation in state of Espirito Santo were Bullous Keratopathy and Keratoconus, in patients mostly female, 57 years old on average, from the metropolitan region of greater Vitória and from the state itself. The study allows to outline prevention strategies, care and social actions to raise awareness of corneal donation.

Impact of different clear corneal incision sizes on anterior corneal aberration for cataract surgery / Impacto de diferentes tamanhos de incisões em córnea clara nas aberrações da córnea anterior em cirurgia de catarata

ABSTRACT Purpose: To investigate the impact of different sizes of steep meridian clear corneal incisions for phacoemul sification on anterior corneal higher-order aberrations. Methods: Medical records of patients who underwent 2.2-mm coaxial micro-incision cataract surgery or 2.75-mm coaxial small-incision cataract surgery were retrospectively reviewed. Only patients with preexisting anterior corneal astigmatism <2.00 diopters (D) and ≥0.50 D who underwent a steep meridian clear corneal incision were included. Primary outcomes were 3rd- to 6th-order anterior corneal higher-order aberrations with an 8-mm pupil. Anterior corneal astigmatism and effective phaco time were evaluated as secondary outcomes. Preoperative and 3-month postoperative outcomes were evaluated. Results: Anterior corneal astigmatism significantly decreased after both procedures; however, there was no significant difference found in surgically induced anterior corneal astigmatism between the two procedures (p=0.146). Although the total higher-order aberrations did not significantly change after both procedures, the group comparison showed a significant difference in surgically induced total higher-order aberrations (a decrease of 0.337 ± 1.156 mm in 2.2-mm coaxial micro-incision cataract surgery and an increase of 0.106 ± 0.521 mm in 2.75-mm coaxial small-incision cataract surgery, p=0.046). Spherical aberrations significantly decreased after 2.2-mm coaxial micro-incision cataract surgery (p=0.001), whereas they did not change significantly after 2.75-mm coaxial small-incision cataract surgery (p=0.564). Coma did not significantly change after either of the procedures. Trefoil did not significantly change after 2.2-mm coaxial micro-incision cataract surgery (p=0.361), whereas it significantly increased after 2.75-mm coaxial small-incision cataract surgery (p<0.001). There was no significant difference shown in effective phaco time between the procedures. A significantly positive correlation was shown between surgically induced anterior corneal astigmatism and coma in 2.75-mm coaxial small-incision cataract surgery (r=0.387, p=0.006). There was no significant correlation found between any surgically induced higher-order aberration changes and effective phaco time. Conclusions: The results showed that 2.2-mm coaxial micro-incision cataract surgery and 2.75-mm coaxial small-incision cataract surgery did not significantly degrade the total higher-order aberrations of the anterior cornea. However, the surgically induced changes in total higher-order aberration showed a significant difference between the two procedures, with a slight reduction after 2.2-mm coaxial micro-incision cataract surgery and a slight increase after 2.75-mm coaxial small-incision cataract surgery. Phaco time and power used during surgery had no impact on corneal aberrations.

RESUMO Objetivo: Investigar o impacto de diferentes ta manhos de incisões em córnea clara com meridiano íngreme para facoemulsificação com aberrações de mais alta ordem da córnea anterior. Métodos: Foram retrospectivamente revisados os prontuários médicos de pacientes que se submeteram a cirurgias de catarata com microincisões coaxiais de 2,2 mm ou com incisões coaxiais pequenas de 2,75 mm. Foram apenas incluídos pacientes com astigmatismo preexistente da córnea anterior <2,00 dioptrias (D) e ³0,50 D, e submetidos a incisões em córnea clara com meridiano íngreme. Os desfechos primários foram aberrações da córnea anterior da 3ª à 6ª ordem com uma pupila de 8 mm. O astigmatismo da córnea anterior e o tempo efetivo de facoemulsificação foram avaliados como desfechos secundários. Os desfechos pré-operatório e pós-operatório aos 3 meses também foram avaliados. Resultados: O astigmatismo da córnea anterior diminuiu significativamente após ambos os procedimentos, mas não se encontrou nenhuma diferença significativa entre os dois procedimentos quanto ao astigmatismo da córnea anterior, induzido pela cirurgia (p=0,146). Embora as aberrações totais de mais alta ordem não se tenham alterado significativamente após ambos procedimentos, a comparação entre os grupos revelou uma diferença significativa nas aberrações totais de mais alta ordem, induzidas pela cirurgia (uma diminuição de 0,337 ± 1,156 mm na cirurgia de catarata por microincisão coaxial de 2,2 mm e um aumento de 0,106 ± 0,521 mm na cirurgia de catarata por incisão coaxial pequena de 2,75 mm; p=0,046). A aberração esférica diminuiu significativamente após cirurgia de catarata por microincisão coaxial de 2,2 mm (p=0,001), mas não se alterou significativamente após cirurgia de catarata por incisão coaxial pequena de 2,75 mm (p=0,564). A aberração de coma não mudou significativamente após qualquer dos procedimentos. O trifólio não se alterou significativamente após cirurgia de catarata por microincisão coaxial de 2,2 mm (p=0,361), mas aumentou significativamente após cirurgia de catarata por incisão coaxial pequena de 2,75 mm (p<0,001). Nenhuma diferença significativa se evidenciou quanto ao tempo efetivo de faco-emulsificação entre os dois procedimentos. Houve uma correlação positiva significativa entre o astigmatismo da córnea anterior, induzido pela cirurgia e a aberração de coma na cirurgia de catarata por incisão coaxial pequena de 2,75 mm (r=0,387, p=0,006). Não foi encontrada correlação significativa entre as alterações nas aberrações totais de mais alta ordem, induzidas pela cirurgia e o tempo efetivo de faco-emulsificação. Conclusões: Nem a cirurgia de catarata por microincisão coaxial de 2,2 mm, nem aquela por incisão coaxial pequena de 2,75 mm degradaram significativamente as aberrações totais de mais alta ordem da córnea anterior. Porém, as alterações nas aberrações totais de mais alta ordem, induzidas pela cirurgia mostraram uma diferença significativa entre os dois procedimentos, com uma ligeira redução na cirurgia de catarata por microincisão coaxial de 2,2 mm e um pequeno aumento na cirurgia de catarata por incisão coaxial pequena de 2,75 mm. O tempo de facoemulsificação e a potência utilizada durante a cirurgia não tiveram impacto nas aberrações corneanas.

Centration in refractive surgery / Centralização em cirurgia refrativa

ABSTRACT The point of centration for refractive surgery is a theme of great importance that generates considerable discussion among specialists and surgeons in the field. Notably, any changes in light can alter the size of the pupil, and the visual axis of the fixation line to the fovea is unique in each patient. A variety of options have been described in the literature with respect to centration in refractive surgery, and the results differ among these methods. No consensus has been established regarding the ideal refractive surgery technique for evaluation of centration in each patient that will yield a satisfactory surgical result.

RESUMO O ponto de centralização da cirurgia refrativa é tema de grande importância e gera muita discussão entre especialistas e cirurgiões da área. Afinal, qualquer alteração na luz pode alterar o tamanho da pupila, além disso, o eixo visual da linha de fixação para a fóvea é particular em cada paciente. Existem opções para centralização em cirurgia refrativa com resultados diferentes na literatura. Ainda não há consenso sobre a melhor técnica em cirurgia refrativa que avalie cada caso específico visando um resultado cirúrgico final satisfatório.

Urrets-Zavalia Syndrome following cataract surgery in a case of anterior megalophthalmos / Síndrome de Urrets-Zavalia após cirurgia de catarata em um caso de megaloftalmo anterior

ABSTRACT Intraoperative and postoperative cataract surgery in eyes with anterior megalophthalmos are challenging procedures. Herein we describe the case of a 53-year-old male with anterior megalophthalmos who developed unilateral Urrets-Zavalia Syndrome following cataract surgery.

RESUMO O intraoperatório e o pós-operatório de cirurgia de catarata em olhos com megaloftalmo anterior é desafiador. Descrevemos o caso de um homem de 53 anos com megaloftalmo anterior que desenvolveu a Síndrome de Urrets-Zavalia unilateral após cirurgia de catarata.

Long-term outcomes with Boston type 1 keratoprosthesis in ocular burns / Resultados a longo prazo com o implante da ceratoprótese de Boston tipo 1 em queimaduras oculares

ABSTRACT Purpose: To evaluate the long-term outcomes of Boston type I keratoprosthesis (B-Kpro) in the management of patients with ocular burn injuries. Methods: This prospective study included all patients with ocular burns who underwent B-Kpro implantation at a tertiary eye care center between February 2008 and November 2015. Twelve patients (12 eyes) were enrolled. The procedures performed for managing ocular injury were identified, and information on ocular history, surgical procedures performed, and postoperative outcomes was collected. The main outcome measures were visual acuity, prosthesis retention, postoperative complications, and required surgical procedures. Results: Twelve eyes from 12 patients met the inclusion criteria for B-Kpro implantation, including nine eyes with alkali burns and three eyes with thermal burns. A total of 13 B-Kpro devices were implanted in the 12 eyes. The mean follow-up period was 60.8 months (range, 13-91 months). Preoperative best-corrected visual acuity ranged from counting fingers to light perception. Postoperative best-corrected visual acuity was better than 20/200 in 83.3%, 66.6%, and 57.1% of patients at 12, 48, and 60 months, respectively. The initial keratoprosthesis was retained in 10 (83.3%) eyes and was successfully replaced in one eye. The major cause of worsening of initial visual acuity was advanced glaucoma (four of 12 eyes). Conclusion: The anatomical and functional results support the use of B-Kpro for managing bilateral limbal stem cell deficiency secondary to ocular burns. However, glaucoma should be carefully evaluated, as it is a continuous threat that may result in irreversible visual loss in this population.

RESUMO Objetivo: Avaliar os resultados em longo prazo do implante da ceratoprótese de Boston tipo 1 (B-Kpro) no tratamento de pacientes vítima de queimadura ocular. Métodos: Trata-se de um estudo prospectivo envolvendo todos os casos de implante de B-Kpro 1 para queimadura ocular em um centro de oftalmologia terciário durante o período de fevereiro/2008 e novembro/2015. Doze pacientes (doze olhos) foram incluídos no estudo. Os procedimentos realizados para o manejo da queimadura ocular foram identificados, e os dados foram coletados com relação à história oftalmológica do paciente, procedimentos cirúrgicos realizados, e resultados pós-operatórios. Os principais parâmetros avaliados foram acuidade visual, retenção da prótese, complicações pós-ope ratórias e intervenções cirúrgicas necessárias. Resultados: Doze pacientes preencheram os critérios de inclusão para implante da B-Kpro, incluindo 09 olhos vítimas de queimadura por álcali e 03 olhos pós queimadura térmica. Um total de 13 B-Kpro tipo 1 foram implantadas em 12 olhos de 12 pacientes. O tempo de seguimento médio foi de 60,8 meses (variando, 13-91 meses). Melhor acuidade visual corrigida pré-operatória variou de conta dedos à percepção luminosa. Melhor acuidade visual corrigida pós-operatória foi melhor que 20/200 em 83,3%, 66,6% e 57,1% dos pacientes em 12 meses, 48 meses e 60 meses, respectivamente. A ceratoprótese inicialmente implantada permaneceu retida em 10 (83,3%) dos olhos e foi re-implantada com sucesso em um olho. A principal causa de piora da acuidade visual inicialmente atingida foi glaucoma avançado (4 de 12 olhos). Conclusão: Os resultados anatômicos e funcionais reportados neste estudo dão suporte ao uso da B-Kpro para o tratamento da deficiência límbica bilateral secundária a queimadura ocular. Glaucoma é o principal fator limitante e pode causar perda visual irreversível nesses pacientes.

Descemet's membrane endothelial keratoplasty with a simplified technique and low complication rate: the samba technique / Ceratoplastia endotelial da membrana de Descemet com técnica simplificada e baixa taxa de complicação: a técnica de samba

ABSTRACT Purpose: We report a simplified Descemet's membrane endothelial keratoplasty (DMEK) technique that involves safe and effective preparation and introduction, correct orientation, and easy unfolding of the donor graft inside the recipient anterior chamber. Methods: In this retrospective study, we assessed the surgical outcomes of 26 eyes of 23 consecutive patients (mean age, 61.2 ± 11.4 yr; range, 39-82 yr) with Fuchs endothelial corneal dystrophy (n=19) or bullous keratopathy (n=7) who underwent the Samba technique, a simplified DMEK method, at the Sorocaba Ophthalmology Hospital, Sorocaba Eye Bank, Sorocaba, Brazil, between August 2011 and July 2012. Results: Of the 26 operated eyes, only two (7.7%) experienced partial graft detachment requiring rebubbling, and in those eyes, the graft was reattached successfully with one air bubble. There were no cases of primary graft failure, tissue loss, or pupillary block. All patients with good visual potential achieved a best-corrected visual acuity of 20/30 or better at 6 months, and 82.6% achieved a best-corrected visual acuity of 20/30 or better 1 month postoperatively. Conclusion: In this retrospective study, the Samba technique, a simplified DMEK procedure, was safe and effective, with an acceptably low rebubbling rate and no incidence of primary graft failure or pupillary block. Moreover, rapid and nearly complete visual recovery was achieved. This simplified DMEK technique can be adopted by corneal surgeons worldwide as a primary treatment for endothelial dysfunction with a less steep learning curve and low rate of postoperative complications.

RESUMO Objetivo: Relatar uma técnica simplificada de ceratoplastia endotelial da membrana de Descemet (DMEK) que envolve a preparação e a introdução seguras e eficazes, a orientação correta e o fácil desdobramento do enxerto doador dentro da câmara anterior receptora. Métodos: Neste estudo retrospectivo, foram revisados e avaliados os resultados cirúrgicos de 26 olhos de 23 pacientes consecutivos (idade média: 61,2 ± 11,4 anos, intervalo: 39 a 82 anos) com distrofia corneana endotelial de Fuchs (n=19) ou ceratopatia bolhosa (N=7) submetidos à técnica "Samba", método de DMEK simplificado, no Hospital Oftalmológico de Sorocaba, Banco de Olhos de Sorocaba, Sorocaba, Brasil, entre agosto de 2011 e julho de 2012. Resultados: Dos 26 olhos operados, apenas 2 olhos (7,7%) apresentaram descolamento parcial do enxerto que necessitou de nova injeção de ar na câmara anterior "re-bubble", e nesses olhos o enxerto foi posicionado com sucesso com o procedimento de "re-bubble". Nenhum dos 26 olhos apresentaram falência primária do enxerto ou perda de tecido, ou bloqueio pupilar. Todos os pacientes com bom potencial visual obtiveram a acuidade visual melhor corrigida de 20/30 ou melhor e 82,6% tinham acuidade visual melhor corrigida de 20/30 ou melhor com 1 mês de cirurgia. Conclusão: Neste estudo retrospectivo, a técnica de Samba, um procedimento de DMEK simplificado, mostrou-se segura e eficaz, com uma taxa de "re-bubble" aceitavelmente baixa e nenhuma incidência de falência primária ou complicação com bloqueio pupilar. Além disso, a recuperação visual rápida e completa foi rapidamente alcançada. Esta técnica DMEK simplificada pode ser adotada por cirurgiões de córnea em todo o mundo como um tratamento primário para disfunção endotelial com uma curva de aprendizado rápida e baixa taxa de complicações pós-operatórias.

Satisfação de pacientes após cirurgia refrativa de monovisão avançada / Satisfaction of patients after advanced mono-refractive surgery

Resumo Objetivo: Monovisão é um conceito que descreve a correção propositadamente desigual da visão de em um olho para longe e outro olho para perto, sendo utilizada principalmente para correção da presbiopia. O objetivo principal foi avaliar a satisfação dos pacientes com a cirurgia refrativa de monovisão avançada. Os objetivos secundários foram avaliar a necessidade de uso de óculos após a cirurgia, e analise do perfil dos participantes. Métodos: Foi realizado um estudo transversal observacional de série de casos baseado na revisão de prontuários de participantes submetidos a cirurgia refrativa de monovisão em uma clínica oftalmológica privada. A população estudada foi do tipo não-probabilistica com n de 50 participantes. A amostragem foi por conveniência, sendo selecionados os prontuários dos últimos 50 participantes que retornaram para consulta de revisão após a cirurgia refrativa realizada até novembro de 2016. Resultados: Foram analisados 50 prontuários. Quando questionados sobre a satisfação com o procedimento, a nota média atribuída foi 9,4 ± 0,6 dentro de uma escala de 0 a 10. Sobre a necessidade do uso de óculos após o procedimento, 92% dos pacientes referiram não necessitar. Os demais 8% que referiram utilizar eventualmente óculos para perto eram hipermetropes antes da cirurgia Conclusão: Concluímos que o índice de satisfação com a cirurgia de monovisão na amostra estudada foi alto e a maioria dos participantes referiu não necessitar de óculos após o procedimento. A amostra foi composta majoritariamente por mulheres com média de idade de 52 anos, hipermetropes, que realizaram a cirurgia em ambos os olhos. Nossa amostra foi distinta de outros estudos devido ao fato de incluirmos maior parte de participantes hipermetropes.

Abstract Objective: Monovision is a concept that describes the purposely unequal correction of vision from one eye to the other and eye to eye, and is mainly used to correct presbyopia. The main objective was to evaluate patients' satisfaction with advanced monovision refractive surgery. The secondary objectives were to evaluate the need for glasses after surgery, and to analyze the profile of the participants. Methods: A cross-sectional observational study of a series of cases was carried out based on the review of medical records of participants submitted to refractive surgery of monovision in a private ophthalmologic clinic. The population studied was of the non-probabilistic type with n of 50 participants. Sampling was for convenience, and the medical records of the last 50 participants who returned for revision consultation after refractive surgery performed until November 2016 were selected. Results: Fifty patients were analyzed. When questioned about satisfaction with the procedure, the mean score assigned was 9.4 ± 0.6 on a scale of 0 to 10. Regarding the need for glasses after the procedure, 92% of the patients reported not needing it. Conclusion: We concluded that the satisfaction index with monovision surgery in the sample studied was high and most of the participants reported that they did not require glasses after the procedure. The sample consisted mainly of women with mean age of 52 years, hypermetropes, who underwent surgery in both eyes. Our sample was different from other studies due to the fact that we included most participants with hypermetropes.

Controlling optical complications after corneal refractory surgery and improving visual quality / 中华实验眼科杂志

In recent years,corneal refractive surgery continues to develop with becoming to be one of the most prevalent utilizations of correction of many patients and brings about better visual quality for ametropic patients.Meanwhile,some patients are subjected to optical complications,and poor night vision is one of the most serious problems which are complained by sufferers after refractive surgery,such as glare,halo and reduce of contrast sensitivity,and the affective factors include age,pupil diameter,high order aberation,scattering,pre-estimated diopter,corneal healing,individual sensitivity to surgery,which are supposed to attract the attention of the majority of clinicians and researchers,at the same time.Ophthalmic clinical doctors and researchers only fully understand the mechanism of the above factors and explore the corresponding measures in order to purposefully treat these complications.In addition,ophthalmologists should be aware of the interaction of these factors and their relationship with individual sensitivity and explore the impact of postoperative visual impairment and the way to avoid them in clinical practice inorder to improve the visual quality by controlling the postoperative optical complications.

Assessment of corneal optical quality following small incision lenticule extraction for myopia / 中华实验眼科杂志

Background The current evaluation of corneal optical quality after small incision lenticule extraction (SMILE) is based on the single factor,such as scattering,diffraction or aberration,and all of them are not comprehensive and objective methods.Modulation transfer function (MTF) and Strehl ratio (ST) are novel parameters of corneal optical quality,which can be used to assess the optical quality comprehensively.Objective This study was to evaluate the change of MTF and SR under the photopic and scotopic environment (3 mm and 6 mm pupil size,respectively) after SMILE procedure.Methods The study protocol was approved by Ethic Committee of Tianjin Eye Hospital,and written informed consent was obtained from each patient before any medical procedure.A series cases-observational study with self-control design was carried out.Sixty-three eyes of 32 myopia or myopic astigmatism patients who underwent SMILE surgery in Tianjin Eye Hospital were included from December 2013 to March 2014.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) (LogMAR),the effective index (postoperative UCVA/preoperative BCVA) and refractive diopter were examined,and the MTF,SR and root mean square (RMS) on the anterior corneal surface were measured under the 3 mm and 6 mm pupil size at different spatial frequencies (10,20,30,40,50 and 60 c/d) by Sirius anterior analyzer before surgery and 1 week,1 month and 3 months after surgery,respectively.Results UCVA was ≥0.8 in 59,62 and 63 eyes in 1 week,1 month and 3 months after SMILE,with the percentage of 93.65％,98.41％ and 100％,and the effective index was 1.104± 0.128,1.126±0.145 and 1.158±0.208,respectively.The refractive diopter was normal in the eyes at postoperative 3 months.The MTFs of various spatial frequencies on the vertical and horizontal meridian under the 3 mm pupil size after SMILE were significantly higher than those before SMILE,while under the 6 mm pupil size,the MTFs were higher only on vertical meridian and 10,20,30 and 40 e/d,and there were not significant differences on the horizontal meridian (all at P＜0.05).The SRs under the 3 mm and 6 mm pupil size showed increasing softly after surgery in comparison with before surgery,and the SRs were higher under the 3 mm pupil size than those under the 6 mm pupil size at various time points (all at P＜0.05).There were not significant differences in RMS among different time points under both 3 mm pupil size and 6 mm pupil size (3 mm pupil size:F =1.348,P =0.184;6 mm pupil size:F=1.990,P=0.137).Conclusions SMILE provides a great improvement in corneal optical quality for myopia or myopic astigmatism patients,which is more distinct in photopic condition than that in scotopic condition.

Dynamic observation of corneal reinnervation after small incision lenticule extraction at cap by confocal microscope / 中华实验眼科杂志

Background Corneal reinnervation of subbasal nerve plexus have been found after small incision lenticule extraction(SMILE).However,there were few reports about corneal reinnervation mode and dynamic changes at the corneal cap in different time points postoperation.Objective The aim of this study was to evaluate the corneal reinnervation at the cap margin after SMILE.Methods The clinical data of 32 myopic eyes of 16 patients who received SMILE incision lenticule extraction surgery in Affiliated Eye Hospital of Shandong Medical College from April 2014 to April 2015 were retrospectively analyzed.The following-up was carried in 1 week,1 month,3 months and 6 months after surgery,and in-vivo confocal microscopy was used to acquire images of the central corneal subbasal nerve plexus before and after surgery,with the scan range of 0.4 mm×0.4 mm,from which nerve density and nerve tortuosity were evaluated using Image-Pro Plus imaging analysis software.The overall length of nerve fibers at the central cornea was measured to assess the subbasal nerve density,and the repair of nerve fibers at cap was observed.Results The corneal subbasal nerve density was (19 687.45 ± 1 147.59),(10 500.46 ± 1 056.22),(12 833.40-± 1 047.98),(13 564.04-± 1 173.01) and (14 661.35-±941.92) μm/mm2 in preoperation and postoperative 1 week,1 month,3 months,6 months,respectively,with a significant difference among different time points (F =319.44,P=0.000),and the corneal subbasal nerve densitis in postoperative time points were significantly reduced in comparison with the preoperation,and corneal subbasal nerve densities were gradually increased after surgery as the extending of time,showing significant differences between different time points (all at P＜ 0.01).Abundant corneal subbasal nerve fibers were seen with the near normal morphology after surgery.However,the fragments and disaggregation of nerve fibers were found at the incision of cap margins,and some nerve fibers extended toward the inner cap at the non-incision of cap margins 1 week after surgery.In 3-6 months after SMILE,the continuous extension of nerve fibers was exhibited under the confocal microscope.Conclusions Six months after surgery,less invasive SMILE technique can remain the superficial corneal nerve fibers.Corneal innervation shows a radiate mode from peripheral cornea outside toward inside of the cap.The subbasal never fiber density is gradually increased with the extending of time after SMILE.

Effect of corneal biomechanical properties on surgically-induced astigmatism and higher-order aberrations after cataract surgery / Efeito das propriedades biomecânicas da córnea no astigmatismo induzido cirurgicamente e nas aberrações de alta ordem após a cirurgia de catarata

ABSTRACT Purpose: To investigate the relationship between biomechanical properties of the cornea and postoperative refractive changes in patients with low-level astigmatism after cataract surgery. Methods: This prospective study recruited patients undergoing cataract surgery involving 2.8-mm superior incisions. Biomechanical properties of the cornea were evaluated preoperatively using the Ocular Response Analyzer, and corneal profiles were evaluated using a Scheimpflug system (Pentacam HR). Topographic astigmatism, total corneal aberrations (TCA) and higher-order corneal aberrations (HOCA) analyses were performed preoperatively and during 1- and 3-month postoperative exams. The incidences of surgically-induced astigmatism (SIA) and HOCAs were calculated using vector analyses. Associations of the preoperative biomechanical properties of the cornea with SIA and HOCAs were evaluated. Results: This study included 28 eyes of 28 patients. The preoperative corneal hysteresis (CH) was 8.68 ± 1.86 mmHg, and the corneal resistance factor (CRF) was 8.66 ± 1.61 mmHg. At the 1-month postoperative evaluation, significant changes were observed in HOCAs (p=0.023), TCAs (p=0.05), astigmatism (p=0.02), and trefoil (p=0.033); in contrast, differences in coma (p=0.386) and spherical aberration (SA) were not significant (p=0.947). At the 3-month visit, significant changes were only observed in TCAs (p=0.02) and HOCAs (p=0.012). No relationships between the preoperative corneal hysteresis and corneal resistance factor and postoperative SIA and HOCA were identified, other than a positive correlation between the 3-month postoperative incidence of corneal hysteresis and spherical aberration. Conclusions: Despite the observed lack of relationships of preoperative biomechanical properties of the cornea with SIA and postoperative aberrations (except for SA), further studies involving larger patient groups are needed to explore the unexpected refractive deviations after cataract surgery.

RESUMO Objetivo: Investigar a relação entre as propriedades biomecânicas da córnea e as mudanças refrativas pós-operatórias em pacientes com baixa astigmatismo após a cirurgia de catarata. Método: Neste estudo prospectivo, recrutamos os pacientes submetidos a cirurgia de catarata com incisões superiores de 2,8 mm. As propriedades biomecânicas da córnea foram avaliadas no pré-operatório pelo Ocular Response Analyzer (ORA, Reichert, EUA) e o perfil corneano foi avaliado por um sistema Scheimpflug (Pentacam HR, Oculus Optikgeräte, GmbH). As avaliações do astigmatismo topográfico e das aberrações corneanas de alta ordem (HOCA) foram feitas no pré-operatório e no 1º e 3º mês pós-operatório. O astigmatismo induzido cirurgicamente (SIA) e aberrações corneanas de alta ordem foram calculados pela análise vetorial. Associações das propriedades biomecânicas da córnea no pré-operatório com astigmatismo induzido cirurgicamente e aberrações corneanas de alta ordem foram avaliadas. Resultados: O estudo foi realizado em 28 olhos de 28 pacientes. A histerese corneana (CH) pré-operatória foi 8,68 ± 1,86 mmHg, e o fator de resistência da córnea (CRF) foi de 8,66 ± 1,61 mmHg. No pós-operatório de 1 mês houve mudanças significativas aberrações corneanas de alta ordem (p=0,023), aberração total (p=0,05), astigmatismo (p=0,02) e trifóglio (p=0,033), mas as diferenças em coma (p=0,386) e aberração esférica (SA) foram insignificantes (p=0,947). No terceiro mês, a única mudança significativa foi em RMS total (p=0,02) e aberração total (p=0,012). Não houve relação entre histerese corneana e o fator de resistência da córnea pré-operatórios e astigmatismo induzido cirurgicamente e aberrações corneanas de alta ordem pós-operatórios, além de uma correlação positiva entre o histerese corneana e o aberração esférica do 3º mês pós-operatório. Conclusões: Apesar de não haver relação entre as propriedades biomecânicas pré-operatórias da córnea e astigmatismo induzido cirurgicamente e aberrações (exceto SA) após a cirurgia em nosso estudo, são necessários mais estudos com grupos de pacientes maiores de explicar os erros refrativos inesperados após a cirurgia de catarata.

Vector analysis and comprison of small incision lenticule extraction versus laser in-situ keratomileusis for low to moderate myopic astigmatism / 中华实验眼科杂志

Background Small incision lenticule extraction (SMILE) is lack of eye-tracking system and there is controversy in the treatment of astigmatism.It is very important to understand its correction effctiveness for myopic astigmatism.Objective This study was to evaluate the clinical outcomes in the correction of myopic astigmatism between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK).Methods In this retrospective study,95 eyes of 51 patients and 69 eyes of 40 patients with myopic astigmatism underwent the SMILE surgery and FS-LASIK surgery respectively in Tianjin Eye Hospital from December 2013 to July 2014 under the informed consent.No significant differences were found in spherical power,astigmatic power and spherical equivalent (SE) between the SMILE group and FS-LASIK group before surgery (all at P＞0.05).The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest refraction,slit-lamp microscopy,intraocular pressure and corneal topography were measured before surgery and 1 day,1 week,1 month,3 months after surgery.Vector analysis was used to calculate the components of astigmatism before and after surgery.Correction index (CI),index of success (IOS),angle of error (AofE) and flattening index (FI) were used to evaluate the correction effectiveness of astigmatism.Safety index and efficacy index were used to evaluate the recovery status of visual acuity.The corrected effectiveness was compared between the two groups,and the correlations of kappa angle with measured parameter were assessed by Spearman rank correlation analysis.Results The mean spherical power,astigmatic power and SE were (0.003±0.106),(-0.063 ± 0.126) and (-0.029 ± 0.101) D in the SMILE group,which were significantly lower than (0.112 ± 0.212),(-0.091 ± 0.142) and (0.067 ± 0.198)D in the FS-LASIK group (Z =-4.328,-3.197,both at P＜0.05).Vector analysis showed the postoperative with-the-rule astigmatism in the SMILE group and oblique astigmatism in the FS-LASIK group respectively,and the CI and F1 in the SMILE group were significantly lower than those in the FS-LASIK group (Z =-3.051,-3.126,both at P ＜ 0.05).The insignificant reduce in IOS and AofE were seen in the SMILE group compared with the FS-LASIK group (Z=-1.557,P=0.119;Z =-1.923,P =0.054).In addition,the safety index and efficacy index were not significantly different between the two groups (both at P ＞ 0.05).Negative correlations were found between safety index or efficacy index and preoperative kappa angle in the SMILE group (r =-0.258,-0.257,both at P＜0.05).Conclusions Both SMILE and FS-LASIK surgeries are effective and safe in correcting myopic astigmatism with good postoperative visual acuity.SMILE surgery shows less axis rotation and higher accuracy than FS-LASIK because of small incision and flapless procedure.The correction of cylinder can adjust based on experience of surgeon.

Localized flap melt after Nd-YAG laser treatment in recurrent post-LASIK epithelial ingrowth / Derretimento localizado de flap após o tratamento por Nd-YAG laser para crescimento epitelial recorrente pós-LASIK

ABSTRACTNeodymium: Yttrium-Aluminum-Garnet (Nd-YAG) laser treatment of epithelial ingrowth was found promising with high success rates in cases of primary post-LASIK epithelial ingrowth. However, the application range of this procedure is not well-known. For the first time, the authors report the outcome of a patient treated with Nd-YAG laser for multiple recurrences of post-laser in situ keratomileusis epithelial ingrowth.

RESUMOO tratamento com laser de neodímio: Ítrio-Alumínio-Granada (do inglês, Nd-YAG Laser) para o crescimento epitelial primário pós-LASIK demonstrou altas taxas de sucesso. No entanto, os limites deste procedimento não são completamente conhecidos. Pela primeira vez, os autores relatam os resultados de um olho tratado com Nd-YAG laser para múltiplo crescimento epitelial pós-LASIK recorrente que desenvolveu um derretimento localizado do flap.

Intrastromal corneal ring segment implantation for ectasia after refractive surgery / Implante de segmento de anel intraestromal de córnea para ectasia pós-cirurgia refrativa

ABSTRACTPurpose:To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS) implantation to correct ectasia in eyes with prior refractive surgery.Methods:Forty-one eyes of 25 patients (13 men, 12 women; mean age, 28.66 years) with ectasia after refractive surgery [photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK)] were included in a nonrandomized, retrospective, observational case series. Corneal tunnels were created by mechanical dissection in all eyes. Main outcome measures included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), refraction, keratometry, and computerized analysis of corneal topography. Patients were divided into two groups by the type of refractive surgery (Group A: PRK, Group B: LASIK).Results:The mean preoperative manifest astigmatism decreased from -1.88 to -0.84 D in Group A (p=0.096) and -3.18 to -1.77 D in Group B (p=0.000). The mean keratometric astigmatism decreased from -2.58 to -1.66 D in Group A (p=0.010) and -4.80 to -2.78 D in Group B (p=0.000). The mean spherical equivalent decreased from -2.97 to -2.05 D in Group A (p=0.065) and -3.31 to -2.42 D in Group B (p=0.014). No significant between-group differences were noted on the comparison of preoperative and postoperative results. No intraoperative or postoperative complications were observed.Conclusion:ICRS implantation is a useful treatment option for ectasia following refractive surgery, and it has significantly reduced the refractive cylinder and increased best spectacle-corrected visual acuity.

RESUMOObjetivo:Avaliar os resultados do implante de anel intraestromal de córnea para correção de ectasia pós-cirurgia refrativa.Métodos:Quarenta e um olhos de 25 pacientes, 13 homens e 12 mulheres, com ectasia pós-cirurgia refrativa (PRK ou LASIK) foram incluídos em um estudo não randomizado, retrospectivo e observacional. A média de idade no momento do implante do anel é de 28,66 anos. Em todos os olhos, o túnel corneano foi criado através da dissecção mecânica da córnea. Os resultados avaliaram acuidade visual sem correção (AVSC) e acuidade visual com correção (AVCC), refração, ceratometria e topografia corneana computadorizada. Os pacientes foram divididos em dois grupos de acordo com a cirurgia refrativa. Grupo A: PRK, Grupo B: LASIK.Resultados:A média do astigmatismo pré-operatório foi reduzida de -1,88 D para -0,84 D no grupo A (P=0,096) e de -3,18 D para -1,77 D no grupo B (P=0,000). A média do astigmatismo ceratométrico foi reduzida de -2,58 D para -1,66 D no grupo A (P=0,010) e de -4,80 para -2,78 D no grupo B (P=0,000). A média do componente esférico foi reduzida de -2,97 D para -2,05 D no grupo A (P=0,065) e de -3,31 D para -2,42 D no grupo B (P=0,014). Nenhuma diferença estatisticamente significativa foi observada entre os grupos, quando se comparou os resultados do pré e pós-operatório. Não ocorreram complicações intra ou pós-operatórias.Conclusão:O implante de anel intraestromal de córnea é uma boa opção para o tratamento de ectasia pós-cirurgia refrativa, tendo resultado na redução significativa do astigmatismo refracional e melhora da acuidade visual com correção.

Treatment of astigmatism during phacoemulsification / Tratamento do astigmatismo durante a facoemulsificação

Purpose: To compare the effectiveness of limbal relaxing incisions (LRI) with that of toric intraocular lens (IOL) implantation for the treatment of astigmatism during phacoemulsification using nonvectorial (predictability, safety, and efficacy) and vectorial analyses. Methods: This longitudinal observational case series assessed 62 eyes of 31 consecutive cataract patients with preoperative corneal astigmatism of 0.75-2.50 diopters (D) in both eyes. Patients were randomly assigned to 2 groups: a toric IOL group, which received toric IOLs in both eyes, and an LRI group, which received spherical IOLs associated with LRI placement in both eyes. All patients were evaluated at 1, 3, and 6 months after surgery, when refractive astigmatism analysis was performed using both nonvectorial and Alpins vectorial methods. Outcomes were assessed within each group and compared between groups. Results: The proportion of eyes within ±0.50 D of the intended correction at 3 and 6 months after surgery was 75% and 71.88%, respectively, in the LRI group and 40% and 66.67%, respectively, in the toric IOL group. In the remaining period, the proportion was greater in the toric IOL group. The safety index showed no difference at any time point. The efficacy index at 1 and 3 months after surgery was significantly higher in the toric IOL group (0.43 and 0.44, respectively) than in the LRI group (0.31 and 0.36, respectively). At 6 months after surgery, the status of eyes in the LRI group was as follows: 53.13% were undercorrected, 43.74% achieved the intended correction, and 3.13% were overcorrected. In the toric IOL group, 16.76% eyes were undercorrected, 76.67% achieved the intended correction, and 6.67% were overcorrected. The success rates for astigmatic surgery, astigmatism reduction at the intended axis, and astigmatism corrected were 43%, 62%, and 64%, respectively, in the LRI group and 57%, 81%, and 94%, respectively, in the toric IOL group. Conclusions: ...

Objetivo: Comparar incisões relaxantes limbares (IRL) e lentes intraoculares (LIO) tóricas tanto em termos não-vetoriais (efetividade, segurança e eficácia), quanto vetoriais no tratamento do astigmatismo por ocasião da facoemulsificação. Métodos: Estudo observacional longitudinal (série de casos) no qual foram avaliados 62 olhos de 31 pacientes consecutivos de catarata com astigmatismo corneano pré-operatório entre 0,75 e 2,50 dioptrias (D) para ambos os olhos. Os pacientes foram aleatoriamente distribuídos entre 2 grupos: "1" submetido a implante de lentes intraoculares AcrySof ToricTM em ambos os olhos e "2" com implante bilateral de lentes intraoculares tóricas AcrySof NaturalTM complementada por incisões relaxantes limbares. Todos os pacientes foram reavaliados com 1, 3 e 6 meses de pós-operatório, sendo feitas análises do astigmatismo refracional por métodos não-vetoriais, como pela análise vetorial de Alpins, interessando os resultados dentro de cada grupo e entre os grupos. Resultados: O porcentual de olhos entre ±0,50 D da correção pretendida no grupo incisões relaxantes limbares foi de 75 e 71,88%, respectivamente, em comparação aos 40 e 66,67% do grupo lentes intraoculares tóricas aos 3 e 6 meses de pós-operatório. Nos outros períodos avaliados, os porcentuais foram favoráveis ao grupo lentes intraoculares tóricas. O índice de segurança não demonstrou diferença em nenhum dos períodos. O índice de eficácia foi estatisticamente maior para o grupo lentes intraoculares tórica com 1 e 3 meses de pós-operatório (0,43 e 0,44), em comparação ao grupo incisões relaxantes limbares (0,31 e 0,36). Aos 6 meses, o porcentual de olhos, para o grupo incisões relaxantes limbares, foi: hipocorreção ...

Finite element modelling of cornea mechanics: a review / Modelagem de elementos finitos da mecânica da córnea: uma revisão

The cornea is a transparent tissue in front of the eye that refracts light and facilitates vision. A slight change in the geometry of the cornea remarkably affects the optical power. Because of this sensitivity, biomechanical study of the cornea can reveal much about its performance and function. In vivo and in vitro studies have been conducted to investigate the mechanics of the cornea and determine its characteristics. Numerical techniques such as the finite element method (FEM) have been extensively implemented as effective and noninvasive methods for analyzing corneal mechanics and possible disorders. This article reviews the use of FEM for assessing the mechanical behavior of the cornea. Different applications of FEM in corneal disease studies, surgical predictions, impact simulations, and clinical applications have been reviewed. Some suggestions for the future of this type of modeling in the area of corneal mechanics are also discussed.

A córnea é um tecido transparente na parte frontal do olho, que refrata a luz e torna a visão possível. Uma ligeira alteração na geometria da córnea notavelmente afeta a sua potência óptica. Devido a essa sensibilidade, o estudo biomecânico da córnea pode revelar muito sobre o seu desempenho e funcionalidade. Estudos in vivo e in vitro foram realizados para investigar a mecânica da córnea e para determinar suas características. Técnicas numéricas como o método dos elementos finitos (FEM) foram amplamente implementadas como métodos eficazes e não invasivos de análise mecânica da córnea e seus possíveis transtornos. Este artigo analisa o uso de FEM para avaliar o comportamento mecânico da córnea. Diferentes aplicações da FEM no estudo de doenças da córnea, previsões cirúrgicas, simulações de impacto e aplicações clínicas foram revistos. São discutidas algumas sugestões para o futuro deste tipo de modelagem na área de mecânica de córnea.

Causes of increased corneal aspherical index following LASIK for myopia / 中华实验眼科杂志

Background Laser assisted in situ keratomileusis (LASIK) for myopia will change corneal asphericity and further affect the quality of vision.However,how operating parameters such as ablation depth and optic zone diameter affect corneal asphericity is still rarely reported.Objective Aim of this study was to investigate the influence of corneal ablation depth and optic zone diameter on corneal asphericity after LASIK for myopia.Methods This prospective study comprised 175 eyes of 89 patients with the spherical equivalent of (-5.93± 1.98)D and the best corrected visual acuity (BCVA) ≥ 1.0.The flap creation with the femtosecond laser combine iris recognize guided LASIK was performed on the patients who were available for the evaluation at postoperative 6 months.Corneal aspherical index (Q value) at the central corneal 6.0 mm were measured with Orbscan IIz-corneal topography before and 6 months after operation.Corneal ablation depth and optic zone diameter were recorded in operation.The changes of visual acuity and spherical equivalent before and after surgery were compared by self-control method,and the correlations between corneal ablation depth or optic zone diameter with alteration of Q value (AQ) after LASIK were assessed using multiple regression analysis.Results The mean spherical power,cylinder diopter and spherical equivalent were (-5.57 ± 1.89) D,(-0.71 ±0.55) D and (-5.93 ± 1.98) D before surgery,and those after surgery were (-0.25 ±0.30),(-0.14±0.22)D and (-0.32±0.37)D,showing significant differences between before and 6 months after LASIK (t=-32.39,-23.91,-35.18,all at P＜0.01).The Q values at the central corneal 6.0 mm were -0.13 ± 0.09 (-0.47-0.08) in preoperation and 1.09 ± 0.54 (0.22-2.51) in postoperation,with a significant increase in postoperation (t=29.37,P＜0.01).Corneal ablation depth was (95±28) μm and optic zone diameter was (6.32±0.26)mm.Ablation depth appeared to be positive correlation with AQ (β =0.803),and optic zone diameter showed a negative correlation with AQ (β =-0.149),with a multiple regression formula AQ =1.517+0.015×ablation depth-0.3 ×optic zone diameter.Conclusions LASIK for myopia increase corneal Q value.The increase of corneal ablation depth and decrease of optic zone diameter contribute to enlargement of corneal Q value.

Experimental comparison between corneal and conjunctival autogenous grafts in the repair of superficial keratectomies in dogs (Canis familiaris, Linnaeus, 1758). Clinicai and morfological study / Comparação experimental entre enxertos autógenos de córnea e conjuntiva no reparo de ceratectomias superficiais em cães (Canis familiares, Linnaeus, 1758). Estudo clínico e morfológico

Lamellar keratoplasty using fresh autologous grafts of cornea and conjunctiva was studied in thirty one healthy, adult, male and female dogs. Lamellar keratectomies were accomplished removing corneal lamellar bottoms composed of epithelium and half thickness corneal stroma using a 0.5 cm diameter punch (trephine). Grafts were taken from the cornea and autogenous bulbar conjunctiva. They were sutured at the host cornea using an interrupted suture with a number eight ophthalmic silk thread. The graft evolution was evaluated at 1, 2, 7, 15, 30 and 60 days postoperatively. Transplanted corneas showed edema, neovascularization, congestion, hemorrhage, polymophonuclear and mononuclear cells infiltration, and delayed fibrosis. There was a decrease in inflammatory cell infiltrate at the latter evaluation times. By the sixtieth day, the graft areas began to show points of transparency. There were no differences between the procedures studied. The scanning electron microscopy showed epithelization of graft zones within two days of graft implantation. Fifteenth days after surgery, pavement cells were presentat the host areas. By the thirtieth day, the grafted areas were  morphologically similar to the normal cornea with granulomatoustissue around the suture lines. Cytoplasmatic projections similar to that of the normal cornea surface were present at grafted area. The clinical and morpholo

Foram estudadas ceratoplastias lamelares por enxertos autógenos frescos de córnea e de conjuntiva. Utilizaram-se 31 animais da espécie canina, adultos, machos ou fêmeas, clinicamente sadios. Realizaram-se ceratectomias superficiais com trépano de 5 mm de diâmetro na consecução de botões lamelares que incluíram epitélio e metade da espessura do estroma. Obtiveram-se os tecidos para as enxertias, a partir da córnea e da conjuntiva bulbar contralateral, que foram fixados à córnea trepanada com fio de seda oftálmica número 8-0, em pontos simples separados. A evolução dos enxertos foi avaliada aos 1, 2, 7, 15, 30 e 60 dias após a cirurgia. Os resultados mostraram edema, vasos neoformados, congestão, hemorragia, infiltrado de células polimorfo e mononucleares, que tenderam a ser tornar exíguos no decurso do tempo, e fibrose tardia. Aos 60 dias, as áreas de enxertia começaram a exibir transparência em pontos distintos. Não houve diferenças entre as técnicas estudadas. A microscopia eletrônica de varredura mostrou epitelização na zona dos enxertos, já aos dois dias da implantação. Aos 15 dias, notaram-se células pavimentosas nas regiões enxertadas. Aos 30 dias, as áreas mostraram-se morfologicamente similares às da córnea normal. Neste período, foram também encontrados granulomas de ponto. Aos 30 dias, puderam-se visualizar projeções citoplasmáticas semelhantes às da superfície da córn

Experimental and clinical studies on heteroepikeratophakia / 眼科

In the experimental study 5 cases of heteroepikeratophakia (HEP) (human to monkey) were done. The results showed that 4 HEP of experimental monkeys were found to be transparent in 6～24 months after operation. One of five experimental monkeys failed to have a transparent HEP because of epithelia implantation between donor lenticule and host cornea in the 3rd month after operation. In clinical study, HEP (monkey to human) was performed on 2 patients with aphakia. The visual acuity of these patients were improved because the transparent HEP was achieved. Either in experimental or in clinical study the immunological rejection was not found.

Evaluation of the effects of a new adhesive for biological purpouse (Colagel) in experimental keratoplasty in dogs / Avaliação dos efeitos de um novo adesivo para fins biológicos (Colagel) na ceratoplastia experimental em cães

In the aim to avaluate the effects of a new biological adhesive (Colagel) in experimental Keratoplasty, were used 21 healthy mongrel dogs, males and females. Studies were done to evaluation al 1, 3, 7, 14, 21, 30 and 60 days after surgery by means of clinical and histopathological parameters. The results showed that the gel-adhesive mixture in the formulation of the concentrations presented, caused a great inflammatory reaction and it was inefficient in the cicatricial process.

Com o objetivo de se avaliar os efeitos de um novo adesivo para fins biológicos (Colagel) na ceratoplastia experimental, empregaram-se 21 animais da espécie canina, sem raça definida, machos e fêmeas e considerados sadios. Adotaram-se protocolos de estudo para avaliação aos 1, 3, 7, 14, 21, 30 e 60 dias de pós-operatório, segundo parâmetros clínicos e histológicos. Os resultados obtidos no decurso e ao término da pesquisa mostraram que a mistura gel-adesiva, na formulação e concentrações apresentadas, possibilitou o surgimento de quadro inflamatório de grande significado clínico e não contribuiu com a evolução do processo cicatricial.