ABSTRACT
PURPOSE: To compare visual outcomes, corneal astigmatism, and keratometric readings in patients with keratoconus who underwent intrastromal corneal ring implantation (ICRSI) alone with those who underwent ICRSI combined with ultraviolet A riboflavin-mediated corneal collagen crosslinking (CXL). METHODS: Pre- and post-operative best-corrected distance visual acuity (BCDVA), spherical error, cylindrical error, and mean keratometry were retrospectively compared over a period of 2 years in patients with keratoconus who underwent only ICRSI (group 1) versus those in patients who underwent combined ICRSI-CXL (group 2). RESULTS: Thirty-two eyes of 31 patients were evaluated. CXL was performed in 10 cases (31%), and there were no complications or need for ring repositioning. BCDVA improved from 0.54 to 0.18 in the group 1 and from 0.56 to 0.17 in the group 2. Spherical and cylindrical errors and mean keratometry values significantly decreased in both groups. No patient postoperatively had visual acuity (VA) of less than 20/60 on refraction, and 78% exhibited VA better than or equal to 20/40 with spectacles (72% of group 1 and 90% of group 2). Improvement in the spherical equivalent (SE) value was observed in the group 1 (from -5.89 ± 3.37 preoperatively to -2.65 ± 2.65 postoperatively; p<0.05) and group 2 (from -6.91 ± 1.93 preoperatively to -2.11 ± 3.01 postoperatively; p<0.05). CONCLUSION: Both techniques can be considered safe and effective in improving VA and refractive SE values, in decreasing the curvature of the cone apex in the topographical analysis, and in decreasing corrected diopters postoperatively in patients with keratoconus.
Subject(s)
Corneal Stroma/surgery , Corneal Surgery, Laser/methods , Cross-Linking Reagents/therapeutic use , Keratoconus/surgery , Prosthesis Implantation/methods , Adolescent , Adult , Collagen/therapeutic use , Combined Modality Therapy , Corneal Topography , Female , Humans , Male , Middle Aged , Photosensitizing Agents/therapeutic use , Prostheses and Implants , Retrospective Studies , Riboflavin/therapeutic use , Statistics, Nonparametric , Treatment Outcome , Ultraviolet Rays , Visual Acuity/physiology , Young AdultABSTRACT
Purpose: To compare visual outcomes, corneal astigmatism, and keratometric readings in patients with keratoconus who underwent intrastromal corneal ring implantation (ICRSI) alone with those who underwent ICRSI combined with ultraviolet A riboflavin-mediated corneal collagen crosslinking (CXL). Methods: Pre- and post-operative best-corrected distance visual acuity (BCDVA), spherical error, cylindrical error, and mean keratometry were retrospectively compared over a period of 2 years in patients with keratoconus who underwent only ICRSI (group 1) versus those in patients who underwent combined ICRSI-CXL (group 2). Results: Thirty-two eyes of 31 patients were evaluated. CXL was performed in 10 cases (31%), and there were no complications or need for ring repositioning. BCDVA improved from 0.54 to 0.18 in the group 1 and from 0.56 to 0.17 in the group 2. Spherical and cylindrical errors and mean keratometry values significantly decreased in both groups. No patient postoperatively had visual acuity (VA) of less than 20/60 on refraction, and 78% exhibited VA better than or equal to 20/40 with spectacles (72% of group 1 and 90% of group 2). Improvement in the spherical equivalent (SE) value was observed in the group 1 (from -5.89 ± 3.37 preoperatively to -2.65 ± 2.65 postoperatively; p<0.05) and group 2 (from -6.91 ± 1.93 preoperatively to -2.11 ± 3.01 postoperatively; p<0.05). Conclusion: Both techniques can be considered safe and effective in improving VA and refractive SE values, in decreasing the curvature of the cone apex in the topographical analysis, and in decreasing corrected diopters postoperatively in patients with keratoconus. .
Objetivo: Comparar os resultados visuais, astigmatismo corneano e ceratometria em pacientes com ceratocone submetidos a implante de anel corneano intraestromal (ICRSI) e quando em combinação com radiação ultravioleta associado ao crosslinking do colágeno corneano mediada pela riboflavina (CXL). Métodos: Comparou-se retrospectivamente pacientes com ceratocone submetidos somente a implante de anel corneano intraestromal (grupo 1) versus o mesmo procedimento associado ao crosslinking em um período de 2 anos. Avaliou-se acuidade visual com correção, equivalente esférico, ápice do cone na topografia e adaptação com lentes de contato pré e pós operatórios. Resultados: O estudo avaliou 32 olhos de 31 pacientes. Em 10 casos (31%) foi realizado crosslinking corneano, não havendo complicações ou necessidade de reposicionamento do anel. Acuidade visual corrigida pré e pós-operatória, componentes esférico e cilíndrico da refração e valores de ceratometria media diminuíram significativamente em ambos os grupos. Após o implante, nenhum paciente apresentou acuidade visual pior que 20/60 e 78% apresentaram acuidade corrigida melhor ou igual a 20/40 (72% do grupo 1 e 90% do grupo 2). Observou-se diminuição no valor do equivalente esférico no grupo 1 (de -5,89 ± 3,37 pré-operatório para -2,65 ± 2,65 pós-operatório; p<0,05) e no grupo 2 (de -6,91 ± 1,93 pré-operatório para -2,11 ± 3,01 pós-operatório; p<0,05). Conclusão: Ambas as técnicas podem ser consideradas seguras e eficazes na melhora da acuidade visual e equivalente esférico, diminuição do ápice de curvatura do cone na análise topográfica e na redução de dioptrias a serem corrigidas no pós-operatório de pacientes com ceratocone. .
Subject(s)
Humans , Alcohols/pharmacology , Anti-Infective Agents, Local/pharmacology , Enterococcus/drug effects , Hand Disinfection , Colony Count, Microbial , Hand/microbiology , Infection Control , Vancomycin ResistanceABSTRACT
Objetivo: Estudar os motivos pelos quais graduandos de medicina doam ou não sangue, bem como os fatoresassociados à doação de sangue.Métodos: Os dados foram colhidos através de um questionário auto-aplicável, respondido por estudantesmatriculados no primeiro semestre de 2008. Informações sobre os motivos para terem ou não terem doado sangue,idade, sexo, fase do curso, renda familiar, escolaridade dos pais, origem escolar no ensino médio, status dedoação dos pais e tipo sanguíneo foram coletadas. Resultados: A prevalência global de doação sanguínea foi de 39%. Mais de 70% dos estudantes doousangue por vontade de ajudar ao próximo. Entre os motivos para não doação, 33% responderam que nãocumpriam os pré-requisitos e 26% acusaram falta de tempo. Os estudantes com > 24 anos, que cursavam entre 5ª e 8ª fase e cujas mães doavam sangueapresentaram maior prevalência de doação de sangue. Conclusão: A prevalência de doação sanguíneaencontrada pode ser considerada alta. Medidas educativas, flexibilização do atendimento dos hemocentros e ampliação de benefícios aos doadorespodem contribuir para a manutenção ou o aumento da prevalência de doadores nesta população.
Objective: To investigate the reasons why undergraduate medical students donate blood or not, and associated factors with blood donation. Methods: Data were collected through selfcompleted questionnaires, among students during the first semester of 2008. Items probing reasons for blooddonation or not, age, sex, course stage, income, paternal and maternal educational level, type of high school oforigin, blood donation status of fathers and mothers and blood type were collected. Results: The global prevalence of blood donation was 39%. Over 70% of all students donated blood to help a close friend/relative. Among the reasons for not donating blood, 33% stated they were not able to do soand 26% could not donate due to lack of time. Students > 24 years of age, in the 5th to the 8th course stage andwhose mothers were blood donators presented a significantly higher prevalence of blood donation. Conclusion: The prevalence of blood donation may be regarded as high. Educational interventions, improvements in access to blood centers and extensionof benefits to blood donators may contribute to the maintenance or increase in the prevalence of blooddonators.