Conventional Phacoemulsification Surgery Versus Femtosecond Laser Phacoemulsification Surgery: A Comparative Analysis of Cumulative Dissipated Energy and Corneal Endothelial Loss in Cataract Patients.

Purpose: To analyze whether femtosecond laser-assisted surgery leads to less cumulative dissipated energy (CDE) and decreased endothelial cell loss compared to conventional surgery. Patients and Methods: This non-blinded, non-randomized, quasi-experimental clinical trial was conducted at one center and involved one surgeon. Patients with cataracts and 50-80 years old were included, and the exclusion criteria were radial keratotomy, trabeculectomy, drain tube implant, corneal transplant, posterior vitrectomy, and re-implantation of intraocular lens. In total, 298 patients were recruited between October 2020 and April 2021, and the data collected included sex, laterality, age, ocular comorbidities, systemic comorbidities and CDE. An endothelial cell count was performed before and after surgery. Patients were divided according to femtosecond laser-assisted phacoemulsification or conventional phacoemulsification. The femtolaser patients were submitted to the equipment, and then, immediately after treatment, phacoemulsification surgery was performed. In the conventional method, the "divide and conquer" technique was used. The statistical analysis was made using an analysis of covariance linear model, using SAS version 9.4 (SAS Institute, Inc., 1999). Values with p < 0.05 were considered significant. Results: A total of 132 patients were analyzed. The only statistically relevant predictors of CDE were the severity of the cataract (p < 0.0001) and age of ≥75 years (p = 0.0003). The following factors were not significant: technique with or without laser (p = 0.6862), sex (p = 0.8897), systemic arterial hypertension (p = 0.1658), and diabetes (p = 0.9017). Grade 4 cataracts were associated with higher CDE than grade 3 cataracts, which in turn were associated with higher CDE than grade 2 cataracts. A comparison of pre- and post-operative specular microscopy with and without laser revealed no significant discrepancy (p = 0.5017). Conclusion: Femtosecond laser-assisted cataract surgery did not reduce CDE or endothelial cell loss compared to conventional surgery regardless of severity.

Efficacy of probing for congenital nasolacrimal duct obstruction in a private tertiary hospital: 10-year experience / Eficácia de sondagem para obstrução congênita de ducto nasolacrimal em hospital terciário privado: 10 anos de experiência

ABSTRACT Objetive: To evaluate the success rate of initial and repeated probing as treatment approach for congenital nasolacrimal duct obstruction (CNLDO) in children between 2 and 46 months. Methods: A restrospective review of 73 children diagnosed with CNLDO who underwent probing of the NLD from March 2010 to 2020 was conducted. Data were colected from Hospital Oftalmológico de Anápolis in Anápolis, Goiás. Results: The procedure was performed in 90 eyes. The study sample was constituted of 36 males and 37 females. Bilateral involvement occurred in 18 (24.6%) children whereas 55 (75.3%) of them were unilaterally affected. The age ranges of the patients were divided into 4 groups: A - up to 6 months old (5.5% of the eyes), B - 7 to 12 months (27.5%), group C - 13 to 24 months (39.5%) and group D - older than 24 months (26.4%). The mean age of the sample was 18.6 months. Initial probing obtained an overall success rate of 88.8% and group B showed the best percentage (96%) from all age ranges. The second intervention had a lower outcome, successfuly in 55.5% of the cases. Conclusion: All age ranges showed high success rates for initial probing, although there was a decrease in subsequent procedures outcomes. Our results demonstrate that the success rate for primary probing is not affected by age.

RESUMO Objetivo: avaliar a taxa de sucesso de sondagem inicial e de repetição como abordagem de tratamento para obstrução congênita do ducto nasolacrimal em crianças entre 2 e 46 meses. Métodos: conduziu-se uma revisão retrospectiva de 73 crianças diagnosticadas com obstrução congênita do ducto nasolacrimal que se submeteram à sondagem do ducto nasolacrimal de março de 2010 a 2020. Os dados foram coletados no Hospital Oftalmológico de Anápolis em Anápolis, Goiás. Resultados: o procedimento foi realizado em 90 olhos. A amostra do estudo constitui-se em 36 pacientes do sexo masculino e 37 do sexo feminino. O acometimento foi bilateral em 18 crianças, enquanto 55 (75,3%) delas foram afetadas de forma unilateral. Os pacientes foram divididos em 4 grupos, de acordo com a faixa etária: A- até 6 meses de vida (5,5% dos olhos); B- 7 a 12 meses (27,5%); grupo C- 13 a 24 meses (39,5%) e grupo D- mais que 24 meses (26,4). A média de idade de amostra foi de 18,6 meses. A sondagem inicial teve uma taxa de sucesso global de 88,8%, e o grupo B mostrou a melhor porcentagem (96%) de todas as faixas etárias. A segunda intervenção teve uma taxa de sucesso menor, de 55,5% dos casos. Conclusão: todas as faixas etárias mostraram altas taxas de sucesso na sondagem, embora tenha havido um decréscimo nos resultados dos procedimentos subsequentes. Nossos resultados demonstram que a taxa de sucesso na sondagem primária não é afetada pela idade

Giant frontal lipoma mimicking frontal mucocele / Lipoma frontal gigante mimetizando mucocele frontal

ABSTRACT Lipoma is a usually painless benign adipose tumor. Nevertheless, it can cause compression of adjacent structures, depending on its location. Mucoceles are benign cystic lesions in the frontal-ethmoidal region, caused by chronic obstruction of the paranasal sinus and consequent inflammatory processes. The increase of mucocele diameter caused by inflammation often results in bony degradation and reabsorption, increasing pressure on adjacent structures, including the orbit and the base of the skull, leading to possibly serious consequences. Here we report a case of lipoma mimicking a frontal mucocele, managed surgically at the Ophthalmological Hospital of Anapolis.

RESUMO O lipoma é um tumor do tecido adiposo de caráter benigno, usualmente indolor, porém que pode gerar compressão de estruturas adjacentes, dependendo da sua localização. A mucocele consiste em uma lesão cística de caráter benigno, na região fronto-etmoidal, devido à obstrução crônica dos óstios dos seios paranasais e consequente processo inflamatório. O aumento do diâmetro da mucocele por inflamação muitas vezes causa degradação e reabsorção ósseas, o que pode elevar a pressão em estruturas adjacentes como órbita e base de crânio, causando intercorrências possivelmente graves. Neste estudo relatamos um caso de lipoma simulando mucocele frontal, com propedêutica cirúrgica.

Correlation between increase in margin-crease distance and patient satisfaction after upper blepharoplasty / Correlação entre o aumento da distância margem-sulco e satisfação do paciente após blefaroplastia superior

Abstract Objective: To quantitatively and qualitatively evaluate postoperative outcomes and patient satisfaction after upper blepharoplasty and to correlate the findings with changes between preoperative and postoperative eyelid measurements using a digital imaging system. Methods: A total of 60 eyelids in 30 patients with dermatochalasis who were treated in the ambulatory center of the Department of Oculoplastic Surgery at the Anápolis Ophthalmology Hospital were evaluated. Patients ranged from 40 to 80 years of age. Photographs were taken before the upper blepharoplasty procedure and 90 days after as well. The images were transferred to the ImageJ 1.34n program. The parameters analyzed were palpebral fissure height in primary position and margin-crease distance. The correlations between these measurements and patient satisfaction 90 days after surgery were evaluated. Results: This study revealed an increase in the margin-crease distance after upper blepharoplasty and a high positive correlation (0.64) between the increase in this height and the level of satisfaction that the patients attributed to the surgery. There was no statistically significant difference between preoperative and postoperative palpebral fissure heights. Conclusion: The margin-crease distance may serve as a quantitative measurement of a good cosmetic and functional outcome, since it has been found to be strong correlated with patient satisfaction.

Resumo Objetivo: Avaliar de maneira quantitativa e qualitativa o resultado pós-operatório e a satisfação de pacientes submetidos à blefaroplastia superior e correlacionar com as medidas palpebrais antes e após a cirurgia utilizando o sistema de imagem digital. Métodos: Foram avaliadas 60 pálpebras de 30 pacientes com dermatocálase atendidos no ambulatório de Plástica Ocular do Hospital Oftalmológico de Anápolis, com idade entre 40 e 80 anos. Foram realizadas fotografias antes e 90 dias após blefaroplastia superior. Essas imagens foram transferidas para o programa Image J 1.34n e analisados os parâmetros de altura da fenda palpebral em posição primária do olhar e distância margem-sulco palpebral. Foram avaliadas as correlações dessas medidas com a satisfação do paciente após 90 dias de pós-operatório. Resultados: O estudo mostrou um aumento da distância margem-sulco palpebral após blefaroplastia superior e uma correlação fortemente positiva (0,64) entre o aumento dessa medida e a nota de avaliação atribuída pelo paciente à cirurgia. Não houve diferença estatisticamente significante na altura da fenda palpebral antes e após a cirurgia. Conclusão: A utilização da medida da distância margem-sulco pode servir como parâmetro quantitativo de um bom resultado estético e funcional, apresentando uma forte correlação com a satisfação dos pacientes no pós-operatório.