Corneal involvement in patients with systemic inflammatory disorders may be sight threatening, and it may be associated with a life-threatening disease. Significant systemic inflammatory diseases in this context are autoimmune connective tissue diseases, systemic autoimmune dermatological disorders, and autoimmune diseases of the lacrimal system. Keratoconjunctivitis sicca is usually the most common ocular finding in these patients. Peripheral ulcerative keratitis is a rare condition usually associated with increased ocular morbidity and also mortality, as it might act as an indicator of a more widespread vasculitis. Corneal biomechanical properties may also be altered in connective tissue diseases. Although recent studies suggest that the risk for corneal complications after ocular surgery in patients with quiescent autoimmune disease is minimal, caution is still recommended, as the knowledge about the corneal wound-healing process and the corneal biomechanical properties in these patients is not yet fully understood. This article reviews corneal abnormalities and characteristics in the setting of systemic inflammatory diseases.

A catarata pediátrica é a causa mais comum de cegueira tratável em crianças. Prevalência, etiologia e morfologia variam conforme o desenvolvimento sócioeconômico. O tratamento tem como objetivo diminuir a ambliopia, sendo de difícil manejo principalmente em casos unilaterais. A decisão sobre afacia ou implante primário de lente intraocular deve ser individualizado, assim como a correção com lente de contato ou óculos. As lentes intraoculares acrílicas hidrofóbicas de peça única são as mais implantadas em crianças com preferência de implante no saco capsular. A fórmula biométrica Sanders-Retzlaff-Krafftheoretic (SRK/T) é a mais precisa em pacientes pediátricos, seguida de Holladay I e SRK II, com recomendação de sob correção de +6 a +8.0 dioptrias, devido ao esperado crescimento rápido do globo ocular. A opacidade de cápsula posterior é a complicação mais frequente e varia com o material da lente a ser implantada e o glaucoma é a complicação pós-operatória mais grave e depende da idade da criança na cirurgia, implante primário de LIOs e da duração do acompanhamento pós-cirúrgico. A adesão ao tratamento oclusivo é fundamental para o prognóstico visual, sendo determinado de acordo com a idade da criança e a lateralidade da catarata. Mesmo com a melhora do tratamento cirúrgico e das lentes intraoculares o prognóstico visual final ainda não é o desejável.

OBJECTIVE:To evaluate the efficiency of long-term cataract surgery using low-cost intraocular lens implantation in community campaigns.METHODS:Fifty-eight randomly selected patients were evaluated four years after phacoemulsification and Ioflex intraocular lens implantation. Causes of low visual acuity related to the intraocular lens were evaluated, and treatment costs were calculated.RESULTS:The mean age of patients was 72±10.2 years. Four years after surgery, 25 eyes (43.0%) had decreased visual acuity related to the intraocular lens: posterior capsule opacification was noted in 24 eyes (41.3%), and intraocular lens opacification was noted in one eye (1.7%). The total cost of the post-surgical complication treatments represented 6.3% of the initial budget of the entire surgical patient group.CONCLUSIONS:The efficiency of cataract surgery with low-cost Ioflex intraocular lens implantation was significantly reduced in a long-term follow-up study because postoperative complications related to intraocular lenses emerged at higher rates than when the gold-standard treatment was used.

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OBJECTIVE:To estimate the prevalence of eye diseases in the Amazon region and evaluate the efficacy, efficiency and effectiveness of community projects of visual health in underserved communities. METHODS: Retrospective, observational and ecological study, which covers the underserved communities of the Brazilian Amazon by the Amazon Project Vision 2000. The data were retrieved from a total sample of 1,276 patients. A questionnaire was applied to patients with 22 questions divided into general and health data. All patients were submitted to a complete eye examination. All project data were stored in a database for later evaluation. RESULTS: Of the 1,276 patients evaluated, 65% were female, 51.9% said they had never had an eye examination and 91% believed to have some visual problem. Emmetropia was detected in 3.8% and 47.2% had presbyopia. Cataract (16.2%) and pterygium (23.6%) were the prevalent diseases. During the project, cataract surgeries were performed in 27.6% and pterygium in 6.9% of patients. When asked why they had not operated before, 24.1% said they had no financial conditions and 55.2% because there was no specialized doctor nearby. CONCLUSION: Refractive errors, pterygium and cataract were the most common ocular findings in the population evaluated. The Amazon Project Vision 2000 provided the equipment and resources for the activities proposed, reaching the pre-defined goal. KEYWORDS: