Cirurgia de catarata no segundo olho: percepção de população atendida em Hospital Universitário

OBJECTIVE: To identify daily life difficulties perceived by patients suffering from senile cataract before and after second eye cataract surgery. METHODS: Longitudinal prospective study with 84 patients consecutively seen within the framework of the Cataract Project, with visual acuity equal to or higher than 20/30 in the pseudophakic eye, and equal to or lower than 20/40 with the best possible optical correction in the cataractous eye. A questionnaire was applied during an interview. RESULTS: Before surgery, 60.7% complained about visual impairment (moderate or marked); after surgery, 92.8% had no difficulty. Routine activities, mobility, and leisure activities were significantly altered after surgery (P =.001). CONCLUSION: According to the patients' perceptions, there was a significant reduction in visual difficulties after second eye cataract surgery.OBJETIVO: Identificar dificuldades na vida diária percebidas por pacientes com catarata senil, antes e após a cirurgia de catarata no segundo olho. MÉTODOS: Estudo longitudinal prospectivo de 84 pacientes consecutivos atendidos por "Projeto Catarata", com acuidade visual maior ou igual a 20/30 no olho pseudofácico e menor ou igual a 20/40 with the best possible optical correction no olho com catarata. Aplicou-se questionário por entrevista. RESULTADOS: Antes da cirurgia 60,7% declararam dificuldade visual (média ou muita); após, 92,8% nenhuma dificuldade. Atividades rotineiras, de mobilidade e lazer alteraram-se significativamente após a cirurgia (p= 0,001). CONCLUSÃO: Na percepção dos pacientes, após a cirurgia de catarata do segundo olho houve redução importante das dificuldades visuais

Efficacy and tolerability of a gatifloxacin/prednisolone acetate fixed combination for topical prophylaxis and control of inflammation in phacoemulsification: a 20-day-double-blind comparison to its individual components

OBJECTIVE: To compare the efficacy and tolerability of a fixed combination of 0.3% gatifloxacin and 1% prednisolone (Zypred®) versus the individual components used separately (Zypred® and Predfort®) for infection prophylaxis and inflammation control after cataract surgery with intraocular lens implantation. METHODS: A prospective, randomized, double-blind, parallel-group study of 108 patients who underwent phacoemulsification and intraocular lens implantation was conducted. After random assignment, 47 eyes received the fixed combination of topical 0.3% gatifloxacin/1% prednisolone drops, and 61 eyes received the same doses of the individual components as separate solutions four times a day for 15 days. Baseline and postoperative assessments were made on postoperative days 1, 7, 15, and 20. RESULTS: All objective (best corrected visual acuity, sign of active ocular inflammation, central and incisional corneal edema, the number of cells per high-power field in the anterior chamber, and intraocular pressure) and subjective (eye pain, photophobia, burning sensation, itching, and foreign body sensation) criteria of efficacy were similar in both groups, with no significant differences. Group I included 47 eyes that received the fixed combination of gatifloxacin/prednisolone acetate eye drops and a placebo eye drop solution. Group II included 61 eyes that were treated with 0.3% gatifloxacin and 1% prednisolone acetate eye drops separately. The intraocular pressure was slightly higher in Group II (

Comparison of the effect on aqueous humor culture of gatifloxacin 0.3% applied three days before phacoemulsification and before preoperative

Purpose: To determine the effect on human aqueous humor cultures of topical gatifloxacin 0.3% applied four times a day three days before phacoemulsification compared to topical gatifloxaxin 0.3% applied and same-day surgery. METHODS: Thirty-seven patients with cataract without other ocular diseases were randomly assigned to Groups A and B before phacoemulsification. Group A received topical gatifloxacin 0.3% same-day surgery and Group B received gatifloxacin 0.3% four times a day three days before phacoemulsification. After the procedure the aqueous humor was aspirated for cultures on agar-blood, agar-chocolate, saboraud and TSB and smeared for bacterioscopy. RESULTS: Group A presented 40% of the bacterioscopies with cocci gram +, Group B presented 17.6% of the bacterioscopies with cocci gram +. These results are not statistically significant (p=0,098). Five cases (25%) from Group A presented positive cultures for S. epidermidis, which was significantly higher than Group B, which did not present positive cultures for any bacteria or fungus (p=0,027). CONCLUSION: Gatifloxacin 0.3% applied three days before phacoemulsification significantly lowered the rate of positive aqueous humor cultures when compared to immediate application of this antibiotic before surgery in this study.OBJETIVO: Determinar o efeito de gatifloxacina 0,3% tópica, nas culturas de humor aquoso humano, instilada quatro vezes ao dia por três dias antes de facoemulsificação comparada a uma gota gatifloxacina 0,3% tópica instilada imediatamente antes da cirurgia. MÉTODOS: Trinta e sete pacientes com catarata sem outras afecções oculares foram distribuídos aleatoriamente nos Grupos A e B antes da facoemulsificação. Os pacientes do Grupo A receberam uma gota de gatifloxacina 0,3% imediatamente antes da cirurgia e o Grupo B recebeu gatifloxacina 0,3% quatro vezes ao dia três dias antes do procedimento. Após a facoemulsificação, o humor aquoso foi aspirado e semeado em meios de ágar-sangue, ágar-chocolate, Saboraud e TSB. Foi realizado esfregaço para bacterioscopia. RESULTADOS: O Grupo B apresentou 40% das lâminas bacterioscópicas com cocos gram +. O Grupo B apresentou 17,6% de cocos gram + na bacterioscopia, estes resultados não foram estatisticamente significativos (p=0,098). Cinco casos (25%) do Grupo A apresentaram culturas positivas para Staphylococos epidermidis, resultado significativamente maior do que o Grupo B, que não apresentou nenhuma cultura positiva para bactérias ou fungos. CONCLUSÃO: Neste estudo, a gatifloxacina 0,3% instilada três dias antes da facoemulsificação diminuiu significativamente o número de culturas do humor aquoso positivas quando comparada à instilação imediata de uma gota.Universidade de São Paulo Faculdade de MedicinaHospital Beneficência Portuguesa de São PauloSanta Casa de Misericórdia de São PauloUniversidade de São Paulo Faculdade de Medicina Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUNIFESP, Depto. de OftalmologiaSciEL

Refractive intra-ocular lens: visual performance and quality of life between unilateral versus bilateral

OBJETIVO: O objetivo desse estudo é comparar acuidade visual, sensibilidade ao contraste, velocidade de leitura e a qualidade de vida pós-operatória de pacientes pseudofácicos unilaterais ou bilaterais com lentes intraoculares multifocais ReZoom. MÉTODOS: Estudo comparativo, prospectivo, não aleatório incluindo 38 olhos de 24 pacientes, separados em um grupo com implante bilateral (14 pacientes) e outro com implante unilateral (10 pacientes). O exame oftalmológico completo incluiu acuidade visual não corrigida pré-operatória para perto, intermediário e para longe, acuidade visual com melhor correção, topografia corneal, sensibilidade ao contraste, velocidade de leitura e escala de satisfação realizado 60 dias após a cirurgia. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis, Mann-Whitney e Qui-quadrado. RESULTADOS: Os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação foram semelhante entre os grupos. CONCLUSÃO: Não houve diferença estatística entre os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação entre os grupos.PURPOSE: The aim of this study is to compare visual acuity, contrast sensitivity, reading speed and quality of life of postoperative pseudophakic patients with unilateral or bilateral ReZoom multifocal intraocular lenses. METHODS: Comparative, prospective, not randomized study including 38 eyes of 24 patients were divided into a group with bilateral implantation (14 patients) and another with unilateral implantation (10 patients). The ophthalmological examination included visual acuity preoperative close, intermediate and far away, best corrected visual acuity, corneal topography, contrast sensitivity, reading speed and level of satisfaction achieved 60 days after surgery. Statistical analysis was performed using the Kruskal-Wallis, Mann-Whitney and Chi-square test. RESULTS: The results comparing visual function, contrast sensitivity, reading speed and scale of satisfaction were similar between groups. CONCLUSION: There was no statistical difference between the results comparing visual function, contrast sensitivity, reading speed and level of satisfaction between the groups

Rescue technique for salvaging toric intraocular lens alignment

Accurate alignment of a toric intraocular lens (IOL) is a requisite to achieving the intended reduction in astigmatism at the time of cataract surgery. However, it requires a reasonably clear view of the limbal vascular anatomy, which is sometimes altered by chemosis from a subconjunctival anesthetic injection or a hemorrhage. We describe a technique that can quickly restore vascular anatomy and facilitate toric IOL alignment