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OBJETIVO: descrever os resultados das cirurgias de facectomia via pars plana realizadas em 40 pacientes (71 olhos) com sudescrevebluxação de cristalino. MATERIAL E MÉTODOS: quarenta pacientes com subluxação de cristalino, submetidos a facectomia-vitrectomia via pars plana, no período de Janeiro de 1990 a Dezembro de 2000, foram avaliados quanto ao diagnóstico sistêmico, doenças oculares associadas, idade do paciente na cirurgia, acuidade visual pré e pós-operatória, e complicações da cirurgia. As indicações para a cirurgia foram acuidade visual menor ou igual a 0,3 ou complicações relacionadas a subluxação. RESULTADOS: o seguimento pós-operatório variou de 6 a 120 meses (média 42,3 meses). A acuidade visual melhorou em cinqüenta e sete olhos (80,3%), e em quarenta e sete olhos (66,2%) foi melhor do que 0,5. Em quatro olhos, a acuidade manteve-se a mesma do pré-operatório, e um olho teve piora da acuidade. Complicações ocorreram em dois olhos: um paciente teve descolamento de retina no pós-operatório e outro apresentou sangramento intravítreo no trans-operatório. CONCLUSÕES: Os resultados da série e o tempo de seguimento dos pacientes demonstram que a facectomia-vitrectomia,em um sistema fechado, pode ser um procedimento seguro e efetivo no tratamento da subluxação de cristalino, em crianças, quando o erro refrativo não pode ser corrigido por outros meios, com melhora da acuidade visual e baixo número de complicações.  

Cataract surgery complications as a cause of visual impairment in a population aged 50 and over

Cataract is the major cause of blindness in Campinas. Education on eye diseases, their prevention and treatment must become part of the city's public healthcare policies.

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Purpose: To assess quality of life in keratoconus patients using the Keratoconus Outcomes Research Questionnaire (KORQ) translated and validated to Portuguese language. KORQ is the only validated keratoconus specific questionnaire and has high rating for psychometric properties.Methods: In this cross-sectional study enrolled 100 patients with keratoconus from a tertiary referral eye hospital, from April 2018 to June 2019. Associations between age, gender, allergic conjunctivitis, keratoconus stage, best-corrected visual acuity (BCVA), maximum simulated keratometry (Kmax), steep keratometry (K2), pachymetry, treatments performed, hydrops and KORQ scores were evaluated with univariate (Wilcoxon test and the Kruskal Wallis test) and multivariate linear regression with stepwise backward modeling. Lower scores of KORQ are associated with better quality of life, as well as higher scores are associated with greater impairment of functional activities and symptoms.Results: Out of the 100 patients, mild, moderate and severe keratoconus, was observed in 15%, 46% and 39% of participants, respectively. Univariate analysis showed lower values for function scores with male gender (p<0.05) and both functional and symptoms scores statistically associated with BCVA<0.3 (LogMAR) (p<0.05). Multivariate analysis indicated significantly lower functional scores in individuals with BCVA<0.3 (p<0.001) and those with history of crosslinking treatment (p=0.022), while symptom scores were only statistically associated with BCVA<0.3 (p<0.001).Conclusions: In patients with keratoconus, BCVA in the better eye and history of crosslinkig are factors were associated with better quality of life scores using KORQ.

Purpose: To compare the performance of nylon sutures to that of polyglactin sutures in pediatric patients undergoing cataract surgery.Setting: University of Campinas (UNICAMP), Campinas, São Paulo, BrazilDesign: A prospective, randomized, partially masked, single-site clinical trial. (https://clinicaltrials.gov/ct2/show/NCT03812640).Methods: A total of 80 eyes from 80 patients who underwent pediatric cataract surgery were randomized into two groups in block sizes of four. Group A consisted of 41 patients whose surgical incisions were sutured with polyglactin 10-0 material. Group B consisted of 39 patients whose surgical incisions were sutured with nylon 10-0 material. The primary outcome was frequency of suture-related complications in each group. Secondary outcomes were the frequency with which suture removal was necessary.Results: The incidence of suture-related complications within 6 months of follow up was 0 out of 41 eyes (0.00%) in the polyglactin group and 17 out of 39 eyes (43.59%) in the nylon control group (p &lt; 0.001). In all of the eyes with suture-related complications, the sutures were promptly removed. The most frequent complications were vascularization near the suture (17.95%) and loose sutures (17.95%). No ocular or systemic study-related adverse events were observed.Conclusions: Polyglactin sutures were found to be safe and effective for pediatric patients undergoing cataract surgery. Their lower rate of complications and reduced likelihood of removal (and the subsequent need for general anesthesia) make their use preferrable to that of nylon sutures. This study represents the first controlled randomized clinical trial to compare nylon sutures to polyglactin sutures in pediatric patients undergoing cataract surgery.Clinical Trial Registration: URL: https://clinicaltrials.gov/ct2/show/, Identifier: NCT03812640.

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