ICRS implantation has shown effectiveness and safety in most cases, including combined procedures. In properly selected eyes, it can improve both refraction and vision in patients with keratoconus. [J Refract Surg. 2016;32(12):829-839.].

Down syndrome is the most common chromosomal disorder, affecting 1/700 live births. Among the clinical findings, one constant concern is the high prevalence of visual disorders that, if left untreated, can negatively affect child development. The aim of this study was to determine the prevalence of ophthalmological findings among patients who attended an outpatient clinic for patients with Down syndrome in southern Brazil between 2005 and 2016. A cross‐sectional study including 1,207 patients medical records were done, which 492 (40.8%) had some ophthalmological disorder. These data were subjected to descriptive analysis using Statistica software. Among the 492 patients with any ophthalmological disease, the need for glasses was found in 434 (36%) patients, keratoconus in 254 (42.1%), congenital cataract in 27 (15.1%), nasolacrimal duct obstruction in 25 (2.0%), strabismus in 22 (1.9%), nystagmus in four (0.3%), and juvenile cataract in two (0.2%). Two young adults with keratoconus underwent corneal transplantation. Although the prevalence of an ophthalmological disease among the present sample (40.8%) was lower than described in the current literature, it still reinforced the importance of routine and early evaluations in infants. These should begin at 6 months of age and be repeated half‐year until 2 years old, annually until 7 years old, biennial in adolescents, and triennial in adults and elderly. Our findings of a high frequency of keratoconus support a detailed corneal study in such patients for early detection and treatment.

Ray tracing methods underestimate corneal power as opposed to the overestimation in corneal power after refractive surgery, directly related to the level of myopia, observed in Placido-based systems. They have the potential to overcome the errors in calculations based on anterior curvature alone. However, ray tracing methods need to be validated and optimized before it can be used routinely in IOL calculation.

A patient with bilateral aniridia and progressive congenital cataract was treated at the age of 7 years through phacoaspiration with femtosecond laser capsulotomy, in-the-bag intraocular lens implantation, and pars plana vitrectomy (combined with posterior capsulotomy). The diameter of the planned anterior capsulotomy was 4.7 mm; however, due to elevated tension in the young capsular bag, the capsulotomy diameter increased (to around 6 mm) shortly after release of the tension by the laser. In addition, the patient had a very flat and small cornea, causing the formation of air bubbles in the curved laser interface. This was addressed by filling the gap by using a viscoelastic. A very similar situation was observed in both eyes. Use of the femtosecond laser facilitated a successful outcome in a complex congenital cataract case with a safe capsulotomy that ensured in-the-bag intraocular lens placement.

To compare the results of intrastromal corneal ring segment (ICRS) alone or combined with same-day corneal crosslinking (CXL) and investigate the relationship of preoperative corneal biomechanics data on the outcomes.

No abstract

A meu marido Glauco, A você, que sempre esteve a meu lado, desde meu primeiro contato com a Oftalmologia. Contagiou-me com o amor, a dedicação completa e a sabedoria sem limites por esta especialidade. Obrigada por me inspirar e, sobretudo, incentivar-me a realizar mais esse sonho, dentre muitos já conquistados juntos. Obrigada por entender meus momentos de distanciamento, os quais mesmo que necessários, você se esforçou a todo custo em estar a meu lado.... A meus amores infinitos, meus filhos Theo e Lis, vocês nasceram em meio a esta conquista e foram e sempre serão meu melhor motivo para crescer e aprender mais a cada dia. Obrigada por fazerem meus dias completos e felizes....amando-me incondicionalmente.A meus amados pais Mauri e Zenita, agradeço por todas as renúncias que fizeram em prol de minha educação e formação. Ensinaram-me a importância da dedicação e da perseverança na conquista dos sonhos, sem perder a honestidade e humildade. Mostraram-me a importância dos estudos e do trabalho, sempre com muito amor e carinho, do "tamanho do Universo".A minha querida irmã Cristiane, minha irmã mais velha, meu exemplo, minha companheira. Obrigada pelos fins de semana descontraídos e em família, aliviando meus momentos de estresse e mostrando-me os valores da união e do amor.A minha professora, médica e sogra, Claudete. Não só me ensinou Ginecologia e Obstetrícia na UFPR, mas, ensinou-me o valor da ética, do esforço, da competência e da importância do trabalho na vida de uma mulher. Não foi apenas minha médica, mas a pessoa que trouxe a meu mundo minhas maiores fortunas, Theo e Lis. Obrigada por todos os conselhos, incentivos e suporte, como mãe e profissional.A meus amigos e familiares, por compreenderem minha ausência e mesmo assim permanecerem a meu lado em todas as minhas decepções e conquistas. NORMATIZAÇÃO ADOTADAEsta tese está de acordo com as seguintes normas, em vigor no momento de sua publicação:Referências: adaptado de International Committee of Medical Journals Editors

No abstract