No abstract

Capsular block syndrome is a rare complication of phacoemulsification surgery with continuous curvilinear capsulorhexis and intraocular lens implantation. Here, we report a case of very late-onset capsular block syndrome that developed 13 years after cataract extraction and present the surgical approach used for its successful treatment.

Tonometry is fundamental to routine ophthalmological evaluation, and Goldmann applanation tonometry (GAT) is the gold standard method. Several devices, including the Perkins tonometer, Tono-Pen, Pascal tonometer (dynamic contour), and non-contact tonometer, can provide reliable values in adults (1)(2)(3)(4) . However, in general practice, intraocular pressure (IOP) measurement can be difficult in children due to a lack of cooperation. ABSTRACTPurpose: High intraocular pressure (IOP) is an important risk factor for a variety of pediatric ophthalmic conditions. The purpose of this study is to evaluate the feasibility, length of examination, and corneal epithelial damage induced by rebound tonometry (RBT) versus Goldmann applanation tonometry (GAT) in school children. Methods: Healthy children (n=57) participated in a randomized, transversal study with IOP measurement by GAT followed by RBT (study arm 1) or RBT followed by GAT (study arm 2). The number of attempts to acquire a reliable IOP measurement and the length of the examination were quantified. Corneal epithelial damage induced by tonometry was evaluated. Bland-Altman analysis was performed to establish the level of agreement between the two techniques. Results: The IOP was measured in all children with at least one of the devices. In both study arms, more children failed to be examined with GAT than with RBT (26% vs. 4%, and 16% vs. 6%, p<0.001, in study arm 1 and 2, respectively). The length of examination was shorter for RBT than for GAT (67.81 s ± 35.20 s vs. 126.70 s ± 56.60 s; p<0.0001); IOP measurements with RBT in both study arms were higher than those with GAT (15.20 ± 2.74 mmHg vs. 13.25 ± 2.47 mmHg, p=0.0247 and 16.76 ± 3.99 mmHg vs. 13.92 ± 2.08 mmHg, p=0.003, respectively). No difference was observed between RBT and GAT regarding the corneal epithelial damage caused by tonometry. Conclusion: IOP measurement is feasible in a greater number of children with RBT, and the examination was faster than that for GAT. Compared with GAT, RBT tended to overestimate the IOP. None of the methods induced marked corneal epithelial defects.

Background:The elderly population is increasing all over the world. Several chronic diseases are observed in such aging group, including kidney diseases, and their histological patterns are not widely documented. Methods: We retrospectively reviewed native kidney biopsies (bx) evaluated in the Department of Pathology of the Federal University of Sao Paulo from 2000 to 2005, selecting 222 of patients > 65 years (ys); 128 bx had diagnosis of glomerulonephritis (GN), and 94 of renal tumors. Results: Fifty-five per cent of the patients were males, and median age was 70 ± 5 ys (range 65-90). The most frequent bx indication was hematuria (50%), followed by acute kidney injury (AKI) (20%), nephrotic syndrome (NS) (19%) and non nephrotic proteinuria (11%). Among patients with GN, mean age was 69 ± 5 ys, and 74/128, males; main bx indications were AKI (35%) and NS (33%), without statistical differences between genders for all clinical presentations. Conclusion: In this study, it was reinforced the important role of renal biopsy in elderly patients, defining main histological patterns of glomerulopathies (membranous nephropathy, amyloidosis) and other renal diseases in this age range in a Brazilian population. Besides being a useful tool for diagnosis, kidney biopsy certainly contributes to the best management of such patients.