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1.
Arq Bras Oftalmol ; 74(2): 123-6, 2011.
Article in Portuguese | MEDLINE | ID: mdl-21779669

ABSTRACT

PURPOSE: To compare the efficacy of conjunctival autograft surgery with the attachment to the scleral bed using fibrin tissue adhesive or mononylon 10-0 suture after resection of primary pterygium. METHODS: A comparative, prospective and randomized clinical trial was performed in 47 eyes of 47 patients with primary medial located pterygium. Group 1 (adhesive) was composed by 21 patients that underwent conjunctival autograft closure with fibrin tissue adhesive (Quixil™) and Group 2 (suture) was composed by 26 patients that underwent pterygium surgery with mononylon 10-0 (Ethicon(®)) suture (suture group) after pterygium excision. All surgeries were performed by the same surgeon. Patients were assessed on the preoperative period and on the 1(st), 14(th) and 21(st) postoperative days. They were followed-up with a questionnaire of ocular discomfort and by the surgical time spent, ocular hyperemia, complications and recurrence signals, being the recurrence also evaluated at the 6th postoperative month. Data were submitted to statistical analysis. A value of p<0.005 was considered statistically significant. RESULTS: The average surgical time was 19.05 ± 6.12 minutes in group 1 (glue) and 48.15 ± 7.13 minutes in the group 2 (suture) (p<0.001). The ocular discomfort scale analysis showed a lower score in the 1(st) (p<0.005), 7(th) (p<0.001) and 21(th) (p<0.001) postoperative days in group 1. Ocular hyperemia was less intense in all periods of this study in group 1 (p<0.001). Complications were one in each group and both were managed with clinical treatment until the 21(th) postoperative day. There was one recurrence in group 1 and two in group 2 until the 6(th) postoperative month. CONCLUSION: In the surgical management of primary pterygium, fibrin tissue adhesive attached the conjunctival autograft, decreased the surgical time and diminished the conjunctival hyperemia and ocular discomfort with similar recurrences on the postoperative period, compared to fixation with mononylon 10.0 suture, proving to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.


Subject(s)
Conjunctiva/transplantation , Fibrin Tissue Adhesive/therapeutic use , Pterygium/surgery , Suture Techniques , Adolescent , Adult , Aged , Humans , Hyperemia , Middle Aged , Postoperative Complications , Postoperative Period , Prospective Studies , Statistics, Nonparametric , Time Factors , Transplantation, Autologous/methods , Treatment Outcome , Young Adult
2.
Arq. bras. oftalmol ; 74(2): 123-126, Mar.-Apr. 2011. ilus, tab
Article in Portuguese | LILACS | ID: lil-593135

ABSTRACT

OBJETIVO: Comparar a eficácia da fixação do enxerto autógeno de conjuntiva ao leito escleral após exérese de pterígio primário, utilizando-se adesivo tecidual de fibrina ou sutura de monofilamento de nylon 10-0. MÉTODOS: Estudo comparativo, prospectivo e aleatório foi realizado em 47 olhos de 47 pacientes com pterígio primário de localização medial. O grupo 1 (adesivo) foi constituído de 21 pacientes submetidos à fixação do enxerto conjuntival com adesivo tecidual de fibrina (QuixilTM); enquanto que o grupo 2 (sutura), foi constituído de 26 pacientes, cuja fixação do enxerto foi feita com sutura em pontos separados de monofilamento de nylon 10-0 (Ethicon®) após a excisão do pterígio feita pelo mesmo cirurgião. Os pacientes foram avaliados antes da cirurgia, no 1º, 14º e 21º dia após a cirurgia. Utilizou-se uma escala visual de desconforto ocular e verificou-se o tempo cirúrgico, hiperemia ocular e presença de complicações, além de sinais de recidiva, sendo sua presença também avaliada no 6º mês após a cirurgia. As variáveis foram submetidas à análise estatística. Valores de p<0,05 indicaram significância estatística. RESULTADOS: O tempo cirúrgico médio foi de 19,05 ± 6,12 minutos para o grupo 1 e 48,15 ± 7,13 minutos para o grupo sutura (p<0,001). A escala referente ao desconforto ocular demonstrou um menor escore no 1º (p<0,005), 7º (p<0,001) e 21º (p<0,001) dia após a cirurgia com a utilização do adesivo tecidual. A hiperemia ocular mostrou-se menor em todos os períodos do estudo após a cirurgia (p<0,001) no grupo cola. As complicações encontradas, uma em cada grupo, resolveram-se com tratamento clínico até o 21º dia após a cirurgia. Houve uma recidiva no grupo 1 e duas no grupo 2 até o 6 º mês após a cirurgia. CONCLUSÃO: Em cirurgia de fixação de enxerto autógeno de conjuntiva para tratamento de pterígio primário, adesivo tecidual de fibrina reduziu o tempo do ato cirúrgico, desencadeou menor hiperemia conjuntival e desconforto no período pósoperatório, com índice de recidiva semelhante em comparação com o uso de sutura de mononylon 10.0, demonstrando ser uma excelente opção para a fixação do enxerto conjuntival no tratamento cirúrgico do pterígio primário.


PURPOSE: To compare the efficacy of conjunctival autograft surgery with the attachment to the scleral bed using fibrin tissue adhesive or mononylon 10-0 suture after resection of primary pterygium. METHODS: A comparative, prospective and randomized clinical trial was performed in 47 eyes of 47 patients with primary medial located pterygium. Group 1 (adhesive) was composed by 21 patients that underwent conjunctival autograft closure with fibrin tissue adhesive (QuixilTM) and Group 2 (suture) was composed by 26 patients that underwent pterygium surgery with mononylon 10-0 (Ethicon®) suture (suture group) after pterygium excision. All surgeries were performed by the same surgeon. Patients were assessed on the preoperative period and on the 1st, 14th and 21st postoperative days. They were followed-up with a questionnaire of ocular discomfort and by the surgical time spent, ocular hyperemia, complications and recurrence signals, being the recurrence also evaluated at the 6th postoperative month. Data were submitted to statistical analysis. A value of p<0.005 was considered statistically significant. RESULTS: The average surgical time was 19.05 ± 6.12 minutes in group 1 (glue) and 48.15 ± 7.13 minutes in the group 2 (suture) (p<0.001). The ocular discomfort scale analysis showed a lower score in the 1st (p<0.005), 7th (p<0.001) and 21th (p<0.001) postoperative days in group 1. Ocular hyperemia was less intense in all periods of this study in group 1 (p<0.001). Complications were one in each group and both were managed with clinical treatment until the 21th postoperative day. There was one recurrence in group 1 and two in group 2 until the 6th postoperative month. CONCLUSION: In the surgical management of primary pterygium, fibrin tissue adhesive attached the conjunctival autograft, decreased the surgical time and diminished the conjunctival hyperemia and ocular discomfort with similar recurrences on the postoperative period, compared to fixation with mononylon 10.0 suture, proving to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.


Subject(s)
Adolescent , Adult , Aged , Humans , Middle Aged , Young Adult , Conjunctiva/transplantation , Fibrin Tissue Adhesive/therapeutic use , Pterygium/surgery , Suture Techniques , Hyperemia , Postoperative Complications , Postoperative Period , Prospective Studies , Statistics, Nonparametric , Time Factors , Treatment Outcome , Transplantation, Autologous/methods
3.
Curr Eye Res ; 35(12): 1057-62, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20929291

ABSTRACT

PURPOSE: At least one-year follow-up of a case series of young Stevens-Johnson syndrome (SJS) patients with cicatrizing ocular surface disease and recurrent inflammation (SJS-RI) treated with systemic humanized monoclonal antibody (daclizumab). METHODS: Five patients (median age 16 yr; range 8-34 yr) with SJS, with recurrent inflammation refractory to conventional immunotherapy, were enrolled in a prospective non-randomized case series study. Inclusion criteria were patients with SJS and ocular cicatrizing inflammatory disease with severe visual impairment, using topical or systemic anti-inflammatory and/or immunomodulatory drugs without clinical improvement resulting in persistent inflammation (SJS-RI). Treatment with Daclizumab 1 mg/Kg (intravenous) was scheduled in three cycles. First cycle with concomitant immunotherapy: a total of 5 doses, with 14 days interval between them (total of this cycle: 10 weeks). Second cycle: interval was increased to 3 weeks; the patients received 2 doses (the second cycle had a total of 6 weeks). Third cycle: maintenance phase with 4 weeks interval between each application, until at least 12 months of the total follow up. After the first cycle (5th dose), the patients were kept with preservative-free lubricants and systemic doxycycline. RESULTS: Control of ocular inflammation was observed at a median of 8 weeks (range 6-10 weeks) in all patients, with relapses in two patients at 20-36 weeks. Relapses were controlled with topical steroids at a median of 10 days, and within 2 weeks the steroids were tapered for both patients. CONCLUSION: In this small case series, daclizumab demonstrated to play a beneficial role in the control of the inflammatory process of the recurrent inflammation in SJS, refractory to conventional immunomodulatory therapy.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Cicatrix/drug therapy , Conjunctivitis/drug therapy , Immunoglobulin G/therapeutic use , Immunosuppressive Agents/therapeutic use , Adolescent , Adult , Antibodies, Monoclonal, Humanized , Child , Cicatrix/complications , Cicatrix/etiology , Conjunctivitis/complications , Conjunctivitis/etiology , Daclizumab , Female , Humans , Male , Stevens-Johnson Syndrome/complications , Treatment Outcome
4.
Eye Contact Lens ; 30(1): 40-1, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14722468

ABSTRACT

PURPOSE: To report an uncommon case of bilateral spontaneous corneal perforation in keratoconus. DESIGN: Interventional case report. METHOD: A 63-year-old man with a long history of keratoconus (more than 30 years) experienced acute hydrops and corneal perforation in his right eye. One year later, he had the same clinical features in his left eye. RESULTS: After initial treatment with cyanoacrylate glue and bandage soft contact lenses, therapeutic penetrating keratoplasty was performed with good visual outcome in both eyes. CONCLUSION: Special attention should be paid to the possibility of spontaneous corneal perforation during acute hydrops in patients with severe corneal thinning, biomicroscopic findings of advanced disease, and high keratometry readings.


Subject(s)
Cornea/pathology , Corneal Edema/etiology , Keratoconus/complications , Acute Disease , Contact Lenses, Hydrophilic , Cornea/surgery , Corneal Edema/surgery , Cyanoacrylates/therapeutic use , Humans , Keratoconus/surgery , Keratoplasty, Penetrating , Male , Middle Aged , Rupture, Spontaneous , Tissue Adhesives/therapeutic use , Wound Healing/drug effects
5.
Arq. bras. oftalmol ; 62(2): 127-30, mar.-abr. 1999. tab
Article in Portuguese | LILACS | ID: lil-251240

ABSTRACT

Objetivo: Analisar alteraçöes corneais precoces induzidas por cirurgia de cerclagem, para melhor entender sua influência sobre a curvatura corneal e a reabilitaçäo visual. Método: Doze pacientes com deslocamento de retina regmatogênico periférico sem envolvimento macular foram avaliados quanto à acuidade visual melhor corrigida, biomicroscopia, tonometria, fundoscopia, cumprimento axial por ultrassonografia e topografia de córnea, tanto no periódo pré-operatório. Testes t parteados foram usados para comparar valores pré e pós-operatórios. Resultado Encontramos aplanamento central significante estatisticamente em 11 dos 12 pacientes com média de 1,22 Dioptrias mais ou menmos 1,73 (p <0,05). Houve mínima alteraçäo no comprimento axial, sem significância estatística. Conclusäo: Alteraçöes refrativas após procedimento de cerclagem säo fregüentes e desempenham importante papel na acuidade visual final, especialmente em pacientes que näo apresentaram comprometimento macular. A natureza destas alteraçöes dependem aparentemente do tipo de procedimento feito.


Subject(s)
Humans , Male , Adult , Middle Aged , Astigmatism/diagnosis , Corneal Topography
6.
Arq. bras. oftalmol ; 62(1): 16-21, jan.-fev. 1999. tab
Article in Portuguese | LILACS | ID: lil-251222

ABSTRACT

Objetivo: Relatar experiência clínico-cirúrgica inicial da associaçäo de cirurgia de transplante de córnea e implante de dispositivo de drenagem artificial de humor aquoso (Moleto) no tratamento do glaucoma refratário associado a doença da córnea. Métodos: Quinze olhos de 15 pacientes com glaucoma näo-controlado por medicaçäo máxima e/ou tratamento cirúrgico prévio associado a opacidade corneana foram submetidos à cirurgia combinada de TPC e implante de Moleto. Avaliamos acuidade visual melhor corrigida (AV), tonometria e biomicrospia, correlacionanso-as à efetividade do tratamento quanto à reduçäo da pressäo intra-ocular (PIO) e quanto à transparência do botäo doador durante o periódo de obeservaçäo. Resultados: Houve efetiva diminuiçäo da PIO em 14 (93,3 por cento) dos olhos tratados. AV melhorou em 12 casos (80 por cento), foi mantida em 2 (13,3 por cento) e piorou em 1 (6,6 por cento)...


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Glaucoma Drainage Implants , Molteno Implants , Corneal Transplantation/methods
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