Therapeutic refractive surgery: why we should differentiate?

Universidade Federal de São Paulo (UNIFESP)Pontifícia Universidade Católica do Rio de JaneiroUNIFESPSciEL

A revolução dos lasers de femtossegundo na oftalmologia

Universidade Federal de São Paulo (UNIFESP) Programa de pós-graduação em OftalmologiaPontifícia Universidade Católica do Rio de JaneiroRefracta-RIOFemtoLaser-RIOInstituto de Olhos Renato AmbrósioUNIFESP, Programa de pós-graduação em OftalmologiaSciEL

Cícero e a história

Este artigo propõe-se analisar as reflexões a respeito da história que Cícero elaborou em dois textos de caráter preceptivo: a carta ao historiador Luceio (Ad familiares V,12); e algumas passagens do Livro II do De oratore (Sobre o orador), um tratado dialogal sobre a retórica. A análise aqui empreendida procura situar o papel da retórica na elaboração dessas reflexões ciceronianas sobre a história.The purpose of this article is to analyze Cicero's reflections on history as presented in his two didactic texts: the letter to the historian Luceio (Ad familiares V,12), and some passages of Book II of De oratore (About the Orator), a dialogic treatise on rhetoric. The present analysis seeks to set the role of rhetoric in the development of these Ciceronian reflections on history

The Need For Artificial Tears In Glaucoma Patients: A Comparative, Retrospective Study.

To evaluate the need for artificial tears by glaucoma patients under topical hypotensive treatment and to identify risk factors associated with it. The charts of 175 glaucoma patients under medical treatment and 175 age-matched controls were reviewed. Age, gender, use of artificial tears, number of glaucoma medications used, and duration of treatment were recorded. Significantly more glaucoma patients (n=92; 52.6%) used artificial tears compared to age-matched controls (n=31; 17.7%) (p2 (OR=1.92), and duration of treatment >5 years (OR=2.93) were risk factors for the use of artificial tears (p<0.05). Topical treatment with antiglaucoma medication is a risk factor for the use of artificial tears. Female gender and long-term treatment of glaucoma with two or more medications were aggravating factors for the need for artificial tears.766-

O uso de lágrimas artificiais em pacientes com glaucoma: um estudo retrospectivo e comparativo

PURPOSE: To evaluate the need for artificial tears by glaucoma patients under topical hypotensive treatment and to identify risk factors associated with it. METHODS: The charts of 175 glaucoma patients under medical treatment and 175 age-matched controls were reviewed. Age, gender, use of artificial tears, number of glaucoma medications used, and duration of treatment were recorded. RESULTS: Significantly more glaucoma patients (n=92; 52.6%) used artificial tears compared to age-matched controls (n=31; 17.7%) (p<0.001). Significantly more females (n=81; 39%) than males (n=42; 28.9%) used artificial tears (p=0.036). When the whole population was analyzed, female gender (OR=1.63) and the presence of glaucoma (OR= 5.14) were risk factors for the use of artificial tears (p<0.05). When the glaucoma population was analyzed, female gender (OR=2.57), number of medications &gt;2 (OR=1.92), and duration of treatment &gt;5 years (OR=2.93) were risk factors for the use of artificial tears (p<0.05). CONCLUSIONS: Topical treatment with antiglaucoma medication is a risk factor for the use of artificial tears. Female gender and long-term treatment of glaucoma with two or more medications were aggravating factors for the need for artificial tears.OBJETIVO: Avaliar a necessidade do uso de lágrimas artificiais por pacientes com glaucoma recebendo tratamento medicamentoso e identificar fatores de risco associados ao seu uso. MÉTODOS: Os prontuários de 175 pacientes com glaucoma sob tratamento medicamentoso e de 175 controles pareados por idade foram revistos. Os seguintes dados foram registrados: idade, sexo, uso de lágrimas artificiais, número de medicações antiglaucomatosas e duração do tratamento do glaucoma. RESULTADOS: Um número significativamente maior de pacientes com glaucoma (n=92; 52,6%) usava lágrimas artificiais em relação ao grupo controle (n=31; 17,7%) (p<0,001). Um número significativamente maior de mulheres (n=81; 39%) usava lágrimas artificias em relação aos homens (n=42; 28,9%) (p=0,036). Quando a população foi analisada como um todo, sexo feminino (OR=1,63) e presença de glaucoma (OR=5,14) foram fatores de risco para o uso de lágrimas artificiais (p<0,05). Quando apenas a população de glaucomatosos foi analisada, número de medicações &gt;2 (OR=1,92) e duração do tratamento &gt;5 anos (OR=2,93) foram fatores de risco para o uso de lágrimas artificiais (p<0,05). CONCLUSÕES: O tratamento com colírios antiglaucomatosos é um fator de risco para o uso de lágrimas artificiais. Sexo feminino e tratamento a longo prazo com duas ou mais medicações são fatores de risco adicionais para o uso de lágrimas artificiais.6

Femtosecond laser-assisted Cvintal topoplasty

We present a case of late high progressive astigmatism following penetrating keratoplasty for keratoconus, which was associated with peripheral thinning in the donor-receptor area, which may be recognized as recurrence of ectasia. Treatment was accomplished with Cvintal's Topoplasty assisted by femtosecond laser for a top hat, followed by resuture with peroperative adjustment guided by ceratoscopy.Apresentamos um relato de astigmatismo tardio progressivo pós-transplante de córnea para ceratocone, associado à afinamento periférico na junção doador-receptor, o que presumidamente pode ser considerado como recorrência da ectasia. O caso foi tratado por meio de Topoplastia de Cvintal assistida por laser de femtossegundo para a confecção da incisão com geometria top hat, seguido de sutura com ajuste per-operatório guiado por ceratoscopia.Instituto Benjamin Constant Serviço de OftalmologiaInstituto Benjamin Constant Setor de CórneaInstituto de Olhos Renato AmbrósioUniversidade Federal de São Paulo (UNIFESP) OftalmologiaUNIFESP, OftalmologiaSciEL

Detection of Keratoconus With a New Biomechanical Index

To evaluate the ability of a new combined biomechanical index called the Corvis Biomechanical Index (CBI) based on corneal thickness profile and deformation parameters to separate normal from keratoconic patients

The challenge for ?multilingual? scientists in Brazil

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Oftalmologia Disciplina de OftalmologiaHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Departamento de Ortopedia e TraumatologiaUNIFESP, Depto. de Oftalmologia Disciplina de OftalmologiaSciEL

Combined biomechanical and tomographic keratoconus staging: Adding a biomechanical parameter to the ABCD keratoconus staging system

Purpose This retrospective cross-sectional study evaluated the potential of an additional biomechanical parameter ‘E’ as an addition to the tomographic ABCD ectasia/keratoconus (KC) staging. Methods The Corvis Biomechanical Factor (CBiF) represents the modified linear term of the Corvis Biomechanical Index (CBI) developed based on 448 KC corneas from the Homburg Keratoconus Center (HKC). The CBiF range was divided into five stages (E0 to E4) to create a grading system according to the ABCD stages. Stage E0 was characterized by values smaller than the 2.5 percentile. The thresholds were created by dividing the CBiF range between the 2.5 and 97.5 percentiles into four groups of equal values (E1–E4). The frequency distribution of ‘E’ was analysed and independently validated based on another 860 KC corneas dataset from Milano and Rio de Janeiro (MR). The relationship between ‘E’ and the ABCD staging was analysed by cross-tabulation. The specificity of ‘E’ was assessed based on healthy controls (112|851) from both datasets (HKC|MR). Results ‘E’ was normally distributed with E0 = 37|30, E1 = 86|200, E2 = 155|354, E3 = 101|206, E4 = 69|70 in the KC group and 96.4%|90.5% of the controls classified E0 in the HKC|MR dataset, respectively. Cross-tabulation revealed that ‘E’ was most comparable to posterior corneal curvature (‘B’) in both datasets, while showing a trend towards more advanced stages in comparison to anterior corneal curvature (‘A’) and thinnest corneal thickness (‘C’). Conclusion The novel Corvis-derived parameter ‘E’ provides a biomechanical staging for ectasia/KC potentially enhancing the ABCD staging and may detect abnormalities before tomographic changes, which requires further studies