ABSTRACT
Resumo Objetivo: Comparar as alterações da refração e da biometria ocular na população infantil hipermetrópica com e sem correção óptica total. Métodos: Realizou-se estudo prospectivo longitudinal não randomizado em 41 pacientes com hipermetropia, entre 3 e 6 dioptrias ou/e com esotropia acomodativa pura nos ambulatórios do Hospital Geral Universitário e Oftalmocenter Santa Rosa, com idade inicial entre 4 e 6 anos. Os pacientes foram divididos em dois grupos, em que o Grupo 1 compôs-se pelos pacientes hipermétropes que não necessitavam usar sua correção óptica ou poderiam usá-la parcialmente, e o Grupo 2 por pacientes com esotropia acomodativa pura e pelos hipermétropes que necessitavam usar toda sua correção óptica. Os pacientes submeteram-se a exame oftalmológico completo, incluindo refração objetiva em autorrefrator com cicloplegia, biometria óptica e topografia corneana em uma medida inicial e outra 3 anos mais tarde. Comparou-se a refração e parâmetros biométricos com teste T student. Resultados: A média da idade inicial foi de 5,23 ± 0,81 e 5,36 ± 0,74 anos, a refração inicial foi +3,99 ± 0,92 e +4,27 ± 0,85 D, o diâmetro anteroposterior do globo ocular foi de 21,42 ± 0,84 e 21,22 ± 0,86 mm, e a ceratometria foi de 42,55 ± 1,24 e 42,39 ± 1,22 D, para os Grupos 1 e 2, respectivamente. Em relação à refração, houve redução significativa do poder esférico no Grupo 1, em 3 anos; e não houve no Grupo 2 (p<0,05). Com relação ao diâmetro anteroposterior do globo ocular, ocorreu aumento significativo no Grupo 1 e não houve no Grupo 2 (p<0,05 ). Não se verificou diferença significativa na comparação das ceratometrias em 3 anos nos Grupos 1 e 2. Conclusão: Estes dados permitiram concluir que a correção total da hipermetropia pode prejudicar a emetropização natural em crianças.
Abstract Objective: To compare changes in refraction and ocular biometric parameters in hyperopic children with and without full optical correction. Methods: Non-randomized prospecting study with 41 subjects (21 males and 20 females) aged 4 to 6 years with accommodative esotropia and or hyperopia between 3 to 6 diopters, select in Hospital Geral Universitário and Oftalmocenter Santa Rosa. The patients were divided in two groups: group 1 for hyperopic patients that did not need to use optical correction or could use partial correction, and group 2 for patients with accommodative esotropia or hyperopia who needed to use full optical correction all the time. The patients were examined to a complete ophthalmological examination, including objective cycloplegic refraction with auto refractometer, optical biometry and corneal topography, in baseline measurements and 3 years after that. Refraction and ocular biometric parameters were compared using T student test. Results: The mean initial age was 5.23 ± 0.81 and 5.36 ± 0.74 years; the initial refractive error in average was +3.99 ± 0.92 e +4.27 ± 0.85 D, the initial axial length was 21.42 ± 0.84 and 21.22 ± 0.86 mm, and initial keratometry was 42.55 ± 1.24 e 42.39 ± 1.22 D for group 1 and 2, respectively. In relation to refractive error, there was a significant decrease in group 1 and there was not in group 2 (p < 0.05). In relation to axial length, there was significant increase in group1 and there was not in group 2 (p<0.05). The 3-year comparison showed no statistically significant differences in keratometry for both groups. Conclusion: This study suggests that full optical correction of hyperopia may inhibit natural emmetropization during early and late childhood.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Refraction, Ocular/physiology , Eye/growth & development , Eyeglasses , Hyperopia/therapy , Visual Acuity , Prospective Studies , Follow-Up Studies , Longitudinal Studies , Treatment Outcome , Treatment Failure , Diagnostic Techniques, Ophthalmological , Watchful Waiting , Accommodation, Ocular/physiology , Hyperopia/diagnosisABSTRACT
Thirty - six eyes of 21 patients [age range 23 to 42, mean 35 years] with hyperopia ranging from + 2.0 to +5.0 diopt diopters [D] sperical equivalert [SE] [men +3059D], a best corrected visual acuity of 20/20 and up to 1.50D of astigmatism underwent hexagonal keratotomy as an investigational procedure. A 5.5 mm optical zone [OZ; the transverse diameter of the hexagon] induced a mean change in refraction of 2.69 SE; a 5 mm OZ resulted in an average of 3.11D SE change; and a 4.5 mm OZ gave an average change of 3.44D SE. At the last visit after hexagonal keratotomy [at 6 to 12 months, average 10.9 months], the average remaining hyperopia was + 0.49 D SE [range - 0.62D to + 2.0D]. Additional astigmatic keratotomy was performed in 19 eyes [52.8%] 6 months after hexagonal keratotomy; this reduced mean induced astigmatism for all eyes from 1.25D to 0.21D. At the final visit after either one or two procedures, uncorrected visual acuity was >/= 20/40 in 94.4% of all eyes. Postoperative refraction in 33 eyes [91.7%] was between - 0.62 and + 1.0D SE, and remained at more than + 1.0D hyperopic in the remaining eyes. Best corrected visual acuity decreased by a maximum of one line in 36.1% of eyes. Microperforation occurred in two eyes [5.6%]. The main side effects were persistent glare in three eyes of two patients [8.3%] and starburst in five eyes of three patients [13.9%]. Further follow - up is required to assess the safety, long - term stability and efficacy of hexagonal keratotomy
Subject(s)
Humans , Hyperopia/therapy , Cornea/surgery , Refractive Errors/surgeryABSTRACT
Se reportan los resultados de 194 altas anisometropías tratadas c.c. total mediante lentes de contacto, mayoritariamente en pacientes adultos. El alto porcentaje de éxitos alcanzados en estos pacientes, en cuanto a la curación de la ambliopía y a la restitución de la visión binocular con estereopsia, se oponen a diversos conceptos arraigados en la literatura, que se relaciona con la diferente modalidad de su corrección, con las limitaciones determinadas por la edad del paciente, y al mal pronóstico que se le atribuye tanto a su ambliopía como a la posibilidad en recuperar su visión binocular en el adulto
Subject(s)
Humans , Anisometropia/therapy , Contact Lenses/standards , Vision, Ocular , Astigmatism/therapy , Hyperopia/therapy , Myopia/therapyABSTRACT
In this new procedure for correction if hypermetropia 20 rabbits were subjected to circular lamellar keratectomy in one eye leaving the other eye as a control. Significant correction of Hypermetropia by a mean of 4.19 +/- 0.62 D occurred in the operated eyes. Significant increase of corneal curvature by + 3.12 +/- also occurred