Corneal Posterior Curvature Changes After Phacoemulsification Cataract Surgery with 2.75 mm Corneal Incision.

The aim of this study was to evaluate the corneal posterior curvature changes after phacoemulsification cataract surgery, with intraocular lens implantation, with a temporal limbal self-sealing 2.75 millimeters (mm) corneal incision, using a Placido-dual rotating Scheimpflug device. In this prospective intervention study, corneal posterior curvature changes were evaluated in fifty-six patients (56 eyes). All patients underwent corneal tomography using the Galilei G2 (Ziemer Ophthalmic System AG, Port, Switzerland) preoperatively (PRE) and with two weeks (RP15), one month (RP30), and three months (RP90) after phacoemulsification cataract surgery with a temporal limbal self-sealing 2.75 mm incision. Tomographic parameters analyzed in the posterior cornea were the steep curvature (K2), flat curvature (K1), mean curvature (average K), and posterior corneal astigmatism. We did not observe any statistically significant change in the K2, K1, average K, and posterior corneal astigmatism in any postoperative follow-up measurements (RP15, RP30, RP90), showing that the postoperative values tend to be the same as the preoperative ones when measured with the Galilei G2 tomography. In conclusion, the 2.75 mm temporal limbal self-sealing corneal incision in phacoemulsification cataract surgery does not induce significant changes in the posterior corneal curvature parameters of K2, K1, average K, and astigmatism.

Interface blood after descemet stripping automated endothelial keratoplasty.

The authors report a case of a Descemet stripping automated endothelial keratoplasty that was complicated by intraoperative bleeding from the iridotomy site. Slit-lamp examination on postoperative day 1 revealed significant amount of retained blood at the donor-recipient interface and a best-corrected visual acuity (BCVA) of 20/400. The patient was managed with periodic observation and a topical fluoroquinolone and 1% prednisolone. By postoperative month 8, the interface had cleared, and the BCVA improved to 20/50. The patient remained with a clear cornea and stable BCVA of 20/50 at her most recent 1-year postoperative follow-up examination. Performing an intraoperative peripheral iridotomy to reduce the risk of air-associated pupillary block introduces the risk of its inherent complications, including intraoperative bleeding, retained blood cells at the interface, and delayed visual recovery. In this case, periodic observation and conservative management with topical steroids resulted in the resolution of the interface debris, associated keratitis, and improved postoperative visual acuity.

Phase I study of subconjunctival ranibizumab in patients with primary pterygium undergoing pterygium surgery.

PURPOSE: To evaluate the safety and tolerability of ranibizumab given via subconjunctival injection in patients with primary pterygium undergoing pterygium surgery with autograft placement. DESIGN: Prospective, open-label pilot study. SETTING: Single-center, academic practice. STUDY POPULATION: Ten patients with primary pterygia. OBSERVATIONAL PROCEDURE: Subconjunctival ranibizumab (0.5 mg/0.05 mL) administered at the limbus, adjacent to pterygium either 3 days prior to surgery (Group 1, n = 5) or at the time of surgery (Group 2, n = 5). Patients prospectively followed for 6 months after injection. MAIN OUTCOME MEASURES: Safety and tolerability of subconjunctival ranibizumab as determined by patient reporting, clinical examination, and masked observer interpretation of slit-lamp photographs. RESULTS: The median age at presentation was 59 years (range 33 to 71 years); 60% of patients were male. Five patients were randomly assigned to be injected with 0.05 mg ranibizumab via subconjunctival injection 3 days prior to surgery; an additional 5 patients were injected with ranibizumab at the time of surgery. All 10 patients tolerated the injection well. The conjunctival autograft remained intact in the 9 patients whose grafts were secured with sutures. There was dehiscence of the autograft in the 1 patient whose graft was secured with fibrin glue. No other safety concerns arose after 6 months of follow-up. Three pterygium recurrences were noted at 6 months (all patients in Group 1). All remaining patients had a normal surgical bed appearance. CONCLUSIONS: The data from this small pilot study suggest that 1 subconjunctival injection of ranibizumab in conjunction with pterygium surgery is well tolerated.

The aggregation behaviour of protein-coated particles: a light scattering study.

The different mechanisms involved in the aggregation of spherical latex particles coated with bovine serum albumin (BSA) have been studied using static and dynamic light scattering. These techniques assess the fractal dimension of the aggregates and their mean hydrodynamic radius. Particles with different degrees of surface coverage have been prepared. The net charge of the covered particles has been modified by varying the pH of the aqueous phase. The aggregation rate was measured and used to determine the importance of the different aggregation mechanisms that are responsible for these types of flocculation processes. At low and intermediate degrees of surface coverage, bridging flocculation is the principal aggregation mechanism irrespective of the electrical state of the protein-particle complexes. At high degree of surface coverage, however, weak flocculation is important only when the BSA molecules are at their isoelectric point.

Neurorretinite associada à ceratite intersticial: relato do primeiro caso de doença de Lyme no Estado do Paraná / Neuroretinitis associated with interstitial Keratitis: the first case report of Lyme disease in the State of Paraná

Objetivo: Descrever o primeiro caso da doença Lyme (DL com manifestação predominantemente ocular no Paraná. Local: Departamento de Oftalmologia da Faculdade de Medicina da Universidade Federal do Paraná - Brasil. Método: Relato de caso de uma paciente, com 31 anos, que inicialmente apresentou baixa acuidade visual e presença de papiledema bilateral; inicialmente disgnosticado como neurite óptica de causa desmielinizante. Resultados: Exame oftalmológico revelou a presença de neurorretinite bilateral associada a ceratite intersticial de ambas as córneas. Exames laboratoriais posteriores, com a presença de sorologia positiva para anticorpos IgM anti-Borrelia burgdorferi, confirmaram o diagnóstico da DL. Conclusões: A paciente, após o tratamento com ceftriaxona e doxiciclina, apresentou melhora da acuidade visual e diminuição da ceratite intersticial. Por se tratar de entidade desconhecida no Paraná e que, se diagnosticada precocemente possui tratamento com antibióticos, urge que a classe médica realize precocemente o diagnóstico, possibilitando assim ajudar os pacientes. A associação entre neurorretinite e ceratite intersticial nessa paciente constitui, até o presente momento, o primeiro caso no Brasil. Os principais diagnósticos diferenciais com a DL, o quadro clínico e a metodologia para se realizar o seu diagnóstico são discutidos.

Glaucoma de pressão normal e espessura corneana central / Normal tension glaucoma and central corneal thickness

Objetivo: Este estudo tem como objetivo investigar a existência de diferença da espessura corneana central (ECC) em pacientes com glaucoma de pressão normal (GPN), glaucoma crônico simples (GCS) e pacientes normais (Controle). Métodos: Foram avaliados 113 pacientes dos quais 40 apresentavam GPN, 51 eram normais (Controles) e 22 apresentavam GCS. Todos os pacientes foram submetidos a exame oftalmológico completo e tiveram aferidas sua Po (Goldmann) e ECC (Topcon SP-2000P). Resultados: A média da espessura corneana central (ECC) dos pacientes com GPN foi de 500,95 p (d.p. 28,65 g), o grupo controle teve média de 521,11 p (d.p. de 43, 30 p) e o grupo de GCS apresentou média de 522, 23 p (d.p. de 27, 87 p. ). O grupo de GPN apresentou uma ECC significativamente menor quando comparado com os grupo controle (p = 0,01) e GCS (p=0,006). Entre os grupos controle e GCS não houve diferença estatística significativa (p = 0,91). Conclusão: Observou-se que numa amostra da população brasileira a ECC dos olhos com GPN é significativamente menor do que a ECC dos pacientes com GCS e do grupo controle.