Agreement between corneal diameter measurements obtained with an optical biometer and a Placido-based topographer / Acordo de medições do diâmetro da córnea obtidas por um biômetro óptico e um topógrafo com base em Plácido

ABSTRACT Purpose: The purpose of this study was to compare the white-to-white distance measurements of two devices (IOL Master 500 and Atlas corneal topographer) commonly used in clinical practice to determine if they were interchangeable. Providing information on instrument interchangeability could eliminate several unnecessary tests and consequently reduce the economic burden for the patient and society. Methods: In this prospective, comparative case series, the white-to-white distance was measured by independent examiners using the Atlas topographer (Carl Zeiss Meditec) and the IOL Master 500 (Carl Zeiss Meditec). One eye each of 184 patients was tested. Statistical analyses were performed using a paired t-test, Pearson correlation analysis, and Bland-Altman analysis to compare the measurement methods. Results: The mean white-to-white distance measurements with the Atlas topographer and the IOL Master 500 were 12.20 ± 0.44 mm and 12.12 ± 0.41 mm, respectively (p<0.001). The mean white-to-white difference between the two devices was 0.07 mm (95% confidence interval of mean difference: 0.04-0.11 mm). The Pearson correlation coefficient between the two devices was 0.85 (p<0.0001). The 95% limits of agreement between the two devices were -0.38 mm to 0.53 mm. Conclusions: The Atlas topographer and IOL Master 500 can be used interchangeably with respect to white-to-white distance measurements, as the range of differences is unlikely to affect clinical practice and decision making.

RESUMO Objetivo: O objetivo deste estudo é comparar as medições de diâmetro corneano de dois dispositivos normalmente utilizados na prática clínica (IOL Master 500 e Atlas topógrafo corneal) para ver se são permutáveis. O fornecimento de informações sobre a permutabilidade de instrumentos poderia eliminar vários testes desnecessários e, consequentemente, reduzir a carga econômica para o paciente e para a sociedade. Métodos: Nesta série de casos prospectivos e comparativos, a distância do diâmetro corneano foi medida por examinadores independentes utilizando o Topógrafo Atlas (Carl Zeiss Meditec) e o IOL Master 500 (Carl Zeiss Meditec), em um olho de 184 pacientes. A análise estatística foi realizada utilizando o teste t pareado, a correlação Pearson e a análise Bland-Altman para comparar os métodos de medição. Resultados: As medições médias da distância do diâmetro corneano com o topógrafo Atlas e o IOL Master 500 foram de 12,20 ± 0,44 mm e 12,12 ± 0,41 mm, respectivamente (p<0,001). A diferença média de WTW entre os dois dispositivos foi de 0,07 mm (intervalo de confiança de 95% da diferença média: 0,04 - 0,11 mm). O coeficiente de correlação Pearson entre os dois dispositivos foi de 0,85, p<0,0001. Os limites de concordância de 95% entre os dois dispositivos foram de -0,38 mm a 0,53 mm. Conclusões: O Atlas topographer e o IOL Master 500 podem ser utilizados permutavelmente em relação à medição do diâmetro corneano, uma vez que a gama de diferenças encontradas é pouco susceptível de afetar a prática clínica e a tomada de decisões.

Prevalence of corneal astigmatism in cataract surgery candidates at a public hospital in Brazil / Prevalência de astigmatismo corneano em candidatos a facectomia em hospital público no Brasil

ABSTRACT Purpose: To assess the frequency of corneal astigmatism before cataract surgery in a Brazilian sample. Methods: This clinic-based cross-sectional study was conducted at the Bonsucesso Federal Hospital, Rio de Janeiro, Brazil. Charts of patients who underwent cataract surgery over a two-year period were retrospectively reviewed, and preoperative keratometric measurements were collected and analyzed. Results: A total of 1707 eyes of 1045 patients were enrolled. The corneal astigmatism was less than 1.0 D in 971 eyes (56.9%), 1.0-1.99 D in 496 eyes (29.1%), 2.0-2.99 D in 157 eyes (9.2%), and more than 3.0 D in 83 eyes (4.9%). The mean corneal astigmatism was 0.92 ± (SD) 0.96 D (range 0 - 10.25 D). Conclusion: Over 40% of the patients undergoing cataract surgery enrolled in this study had more than 1.0 D of corneal astigmatism and may benefit from the use of toric intraocular lenses. These data can be useful for planning to make this technology available for patients.

RESUMO Objetivo: Avaliar a prevalência do astigmatismo corneano antes da cirurgia de catarata em pacientes brasileiros. Métodos: Este estudo transversal de base clínica foi realizado no Hospital Federal de Bonsucesso, Rio de Janeiro, Brasil. Os prontuários de pacientes submetidos à cirurgia de catarata durante um período de dois anos foram revisados retrospectivamente, e as medidas ceratométricas pré-operatórias foram coletadas e analisadas. Resultados: Um total de 1.707 olhos de 1045 pacientes foram incluídos. O astigmatismo corneano foi menor que 1,0 D em 971 olhos (56,9%), 1,0-1,99 D em 496 olhos (29,1%), 2,0-2,99 D em 157 olhos (9,2%) e mais de 3,0 D em 83 olhos (4,9%). A média do astigmatismo corneano foi de 0,92 ± (SD) 0,96 D (intervalo 0-10,25 D). Conclusão: Mais de 40% dos pacientes estudados submetidos à cirurgia de catarata incluídos neste estudo tinham mais de 1,0 D de astigmatismo corneano e podem se beneficiar do uso de lentes intraoculares tóricas. Esses dados podem ser úteis no planejar a disponibilização dessa tecnologia para os pacientes.

Prevalence of eye disease in Brazilian patients with psoriatic arthritis

OBJECTIVES: The aim of this study was to report the type and frequency of ocular manifestations in Brazilian psoriatic arthritis patients. METHODS: We conducted a cross-sectional study in a Brazilian tertiary hospital. The test group included 40 patients who had psoriatic arthritis according to the Classification Criteria for Psoriatic Arthritis. A control group of 40 individuals was matched for age and gender. All of the patients underwent ophthalmic evaluation, which included best-corrected visual acuity, slit lamp and fundus examinations, and dry eye diagnostic tests (Schirmer I, tear breakup time and rose bengal). Demographic parameters were also evaluated. RESULTS: The mean age of the patients was 53.9±13.1 years; the mean disease duration was 8±10.5 years. Most of the patients were women (60%), and the majority had polyarticular disease (57.5%). Several ocular abnormalities were found, including punctate keratitis, pinguecula, blepharitis, pterygium, cataract, glaucoma, uveitis, and retinal microvascular abnormalities. There were no significant differences in the rates of these abnormalities compared with the control group, however. The Keratoconjunctivitis sicca and dry eye diagnostic tests were more often positive in the patients with psoriatic arthritis than in the control group. CONCLUSIONS: In this study, keratoconjunctivitis sicca was the most common ocular finding related to psoriatic arthritis. Therefore, we recommend early ophthalmologic evaluations for all psoriatic arthritis patients who complain of eye symptoms.