Assuntos
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos , Endotélio Corneano/transplante , Distrofia Endotelial de Fuchs/cirurgia , Rejeição de Enxerto/diagnóstico por imagem , Idoso de 80 Anos ou mais , Ar , Aloenxertos , Lâmina Limitante Posterior/patologia , Lâmina Limitante Posterior/cirurgia , Feminino , Rejeição de Enxerto/diagnóstico , Humanos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Aderências Teciduais/diagnóstico , Aderências Teciduais/etiologiaAssuntos
Antibacterianos/efeitos adversos , Ciprofloxacina/efeitos adversos , Córnea/patologia , Ceratite/tratamento farmacológico , Infecções por Pseudomonas/tratamento farmacológico , Idoso , Antibacterianos/análise , Antibacterianos/farmacocinética , Precipitação Química , Ciprofloxacina/análise , Ciprofloxacina/farmacocinética , Córnea/química , Cristalização , Feminino , Distrofia Endotelial de Fuchs/cirurgia , Herpes Zoster Oftálmico/complicações , Humanos , Concentração de Íons de Hidrogênio , Ceratite/microbiologia , Ceratoplastia Penetrante , Conservantes Farmacêuticos , Tomografia de Coerência ÓpticaRESUMO
INTRODUCTION: To determine outcomes of conjunctival autograft attached with fibrin glue (FG) for primary pterygium, and compare these outcomes in expert versus closely supervised trainee ophthalmologists. METHODS: This was a retrospective, comparative, non-randomized, interventional study. Patients were recruited among those with primary nasal pterygium undergoing FG conjunctival autograft. Surgery was performed by expert (136 eyes) or closely supervised trainee (128 eyes) ophthalmologists. Mean follow-up was 7.82±8.23months. Main outcome measures were recurrence rate, reoperation rate and complications. RESULTS: The study sample comprised 264 eyes of 225 patients. Participants were of mean age 47.09±12.89years; 46.7% were male, 28.4% Caucasian and 70.5% Hispanic. Recurrence was recorded in 6.4%: 5.9% in the expert group and 7% in the trainee group (P=0.704) and reoperation in 1.9%: 0.7% and 3.1% (P=0.202), respectively. Both groups showed similar rates of complications such as transient graft edema, graft dehiscence, hematoma or ocular hypertension. Reoperation was slightly more frequent in patients younger than 40years (P=0.064). CONCLUSIONS: Good outcomes were observed for FG conjunctival autografting in primary pterygium surgery, with no differences recorded between supervised trainee and expert surgeons. Our findings suggest the need to supervise pterygium surgeries during training.
Assuntos
Túnica Conjuntiva/transplante , Adesivo Tecidual de Fibrina/uso terapêutico , Oftalmologistas/educação , Pterígio/cirurgia , Transplante Autólogo/métodos , Adulto , Idoso de 80 Anos ou mais , Autoenxertos , Feminino , Seguimentos , Humanos , Curva de Aprendizado , Masculino , Pessoa de Meia-Idade , Organização e Administração , Complicações Pós-Operatórias/epidemiologia , Recidiva , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
CASE REPORT: A 24 year old woman who complained of maculo-papulo rash, genital and bucal aphthous ulcers, abdominal pain, minor dyspnea and visual loss in both eyes. Funduscopy revealed a bilateral occlusive vasculitis including central vessels. Treatment was initiated with a methylprednisolone bolus (1 g/24h) and infliximab 5mg/kg/day (0-2-6 weeks and every 8 weeks). The treatment prescribed induced a fast remission. Visual acuity improved. The patient did not suffer any other relapse after one year of follow-up. DISCUSSION: An initial treatment with Infliximab should be considered in Behçet disease for serious outbreaks, such as macular occlusive vasculitis with ischemia.
