RESUMO
PURPOSE: To analyze the ultrasound biomicroscopy (UBM) features of eyes with chronic hypotony after pars plana vitrectomy (PPV) and compare them with the UBM features of eyes with normal intraocular pressure (IOP) after PPV. METHODS: This comparative (nonrandomized) interventional study included 64 eyes of 64 patients who underwent PPV. Group 1 included 20 eyes with less complex vitreoretinal diseases (VRD) that presented with normal IOP after PPV. Group 2 included 44 eyes with severe proliferative vitreoretinopathy (PVR) managed with PPV and silicone oil tamponade that presented with complete retina reattachment and chronic ocular hypotony. UBM was performed to study the anterior segment, ciliary body (CB), and peripheral retina. The UBM findings of the two groups were compared. RESULTS: In Group 1, 19/20 eyes presented with no CB alterations detected by UBM. In Group 2, 43/44 eyes presented with CB alterations that included tractional CB detachment (n=16); exudative CB detachment (n=11); tractional CB detachment/CB atrophy (n=7); CB hypotrophy (n=5); tractional CB detachment/exudative CB detachment (n=3); and CB edema (n=1). There was a strong relationship between IOP and CB findings revealed by UBM. CONCLUSIONS: Eyes with hypotony following PPV have CB abnormalities that can be detected by UBM. These CB alterations were not found in eyes with normal IOP after PPV in this series.
Assuntos
Corpo Ciliar/diagnóstico por imagem , Pressão Intraocular , Microscopia Acústica , Hipotensão Ocular/diagnóstico por imagem , Doenças da Úvea/diagnóstico por imagem , Vitrectomia/efeitos adversos , Vitreorretinopatia Proliferativa/cirurgia , Adolescente , Adulto , Idoso , Criança , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hipotensão Ocular/etiologia , Decúbito Dorsal , Doenças da Úvea/etiologiaRESUMO
We examined 15 eyes of ten patients with complications of hexagonal keratotomy, which included glare, photophobia, polyopia, fluctuation in vision, overcorrection, irregular astigmatism, corneal edema, corneal perforation, bacterial keratitis, cataract, and endophthalmitis. Wound healing abnormalities and anterior displacement of the central cornea adjacent to the incisions were common. Eight eyes lost best-corrected visual acuity of two or more Snellen lines. Three eyes required penetrating keratoplasty for visual rehabilitation. Histologic analysis of two of these corneas disclosed variations in wound depth and abnormalities of wound configuration, including considerable wound gaping. Hexagonal keratotomy appears to be an unpredictable, unsafe surgical procedure with a high complication rate, and it should be abandoned until well-controlled experimental trials establish its safety and efficacy.
Assuntos
Ceratotomia Radial/efeitos adversos , Ceratotomia Radial/métodos , Procedimentos Cirúrgicos Refrativos , Adulto , Córnea/cirurgia , Córnea/ultraestrutura , Doenças da Córnea/etiologia , Doenças da Córnea/patologia , Epitélio/ultraestrutura , Feminino , Humanos , Ceratoplastia Penetrante , Masculino , Pessoa de Meia-Idade , Transtornos da Visão/etiologia , Transtornos da Visão/patologia , Acuidade Visual , CicatrizaçãoRESUMO
Os autores mostram a importancia da mortalidade perinatal dentro do contexto da mortalidade infantil. Descrevem as vantagens para o processo ensino-aprendizagem; da inclusao de uma nova disciplina no curriculum medico: a Perinatologia.Sugerem os principais objetivos desta nova disciplina demonstrando como a mesma influenciaria na reducao dos indices de mortalidades perinatal
