Applications of Bioceramics in the Management of Orbital Floor Fractures and Anophthalmic Cavity: A Review

Biocompatible ceramics, commonly known as “bioceramics”, are an extremely versatile class of materials with a wide range of applications in modern medicine. Given the inorganic nature and physico-mechanical properties of most bioceramics, which are relatively close to the mineral phase of bone, orthopedics and dentistry are the preferred areas of usage for such biomaterials. Another clinical field where bioceramics play an important role is oculo-orbital surgery, a highly cross-and interdisciplinary medical specialty addressing to the management of injured eye orbit, with particular focus on the repair of orbital bone fractures and/or the placement of orbital implants following removal of a diseased eye. In the latter case, orbital implants are not intended for bone repair but, being placed inside the ocular cavity, have to be biointegrated in soft ocular tissues. This article reviews the state of the art of currently-used bioceramics in orbital surgery, highlighting the current limitations and the promises for the future in this field

Ocular and eyelid alterations observed in the medical school of Botucatu - São Paulo, Brazil

Modelo do estudo: observacional retrospectivo. Objetivo: conhecer a freqüência das alterações oculopalpebrais em pacientes atendidos na Faculdade de Medicina de Botucatu,São Paulo. Método: o estudo foi realizado através da análise de fichas de atendimento no Serviço de Plástica Ocular da Faculdade de Medicina de Botucatu, durante o período de 12 anos, avaliando-se a idade, sexo, procedência e diagnóstico principal dos pacientes atendidos. Resultados: no período estudado foram avaliados 3323 pacientes, 58,3% dos indivíduos eram procedentes da região de Botucatu; a faixa etária superior a 60 anos (41,6%) e o sexo feminino foram os prevalentes (55,7%) e as patologias com alteração da posição palpebral foram as mais comuns. Comentários: as alterações mais freqüentes foram as relacionadas com a posição das pálpebras e as lesões benignas; o conhecimento da freqüência das alterações oculopalpebrais é importante para a adoção de medidas preventivas e para planejar o treinamento de novos profissionais.Study model: observational, retrospective.Purpose :to evaluate the oculopalpebral alterations at Faculdade de Medicina de Botucatu, São Paulo State. Methods: a retrospective study in the Oculoplastic Service of the Faculdade de Medicina de Botucatu during the last 12 years was done. The age, sex, place of residence and the patients’ main diagnosis were evaluated. Results: 3323 patients were assisted. 58,3% of them lived in Botucatu area. The older than 60 years( 41.6%) and the females( 55.7%) were the prevalent group of attendance. The eyelid position alterations were the most common pathology observed. Comments: the positional eyelids disorders and the benign lesions were the manly pathologies observed The knowledge of the oculopalpebral alterations frequence is important to prevention and in order to teach new professionals who will act in this Ophthalmology area

Viscoat versus Visthesia during phacoemulsification cataract surgery: corneal and foveal changes

<p>Abstract</p> <p>Background</p> <p>Ophthalmic viscosurgical devices (OVDs) are widely used in phacoemulsification cataract surgery to maintain adequate intraocular space, stabilize ocular tissue during the operation and decrease the possible damage of the corneal endothelium. Our study has the purpose to compare the corneal and foveal changes of Viscoat and Visthesia in patients undergoing uneventful phacoemulsification cataract surgery.</p> <p>Methods</p> <p>Participants in our study were 77 consecutive patients, who were randomized into two groups based on type of OVD used during phacoemulsification: Viscoat or Visthesia. All patients underwent a complete ophthalmological examination i.e., measurement of best corrected visual acuity (BCVA) by means of Snellen charts, intraocular pressure examination by Goldmann tonometry, slit lamp examination, fundus examination, optical coherence tomography, specular microscopy and ultrasound pachymetry preoperatively and at three time points postoperatively (day 3, 15, 28 postoperatively). The differences in baseline characteristics, as well as in outcomes between the two groups were compared by Mann-Whitney-Wilcoxon test and Student's t-test, as appropriate.</p> <p>Results</p> <p>Intraoperatively, there was no statistically significant difference in the duration of the ultrasound application between the two groups, while Viscoat group needed more time for the operation performance. It is also worthy to mention that Visthesia group exhibited less intense pain than patients in Viscoat group. Postoperatively, there was a statistically significant difference in central corneal thickness, endothelial cell count and macular thickness between the two groups, but BCVA (logMAR) did not differ between the two groups.</p> <p>Conclusions</p> <p>Our study suggests that Viscoat is more safe and protective for the corneal endothelium during uneventful phacoemulsification cataract surgery, while Visthesia is in superior position regarding intraoperative pain. Patients of both groups acquired excellent visual acuity postoperative. Finally, this is the first study comparing OVDs in terms of macular thickness, finding that Visthesia cause a greater increase in macular thickness postoperatively than Viscoat, although it reaches normal ranges in both groups.</p

Paracoccidioidomicose genital feminina. Descrição de um caso clínico

A paracoccidioidomicose é doença sistêmica que atinge mais o sexo masculino do que o feminino. Modelos experimentais mostram maior sensibilidade dos machos do que as fêmeas à dsseminação da doença. A literatura médica é rica em relatos de casos de Pbmicose do trato genital masculino. A raridade da Pbmicose sistêmica na mulher devido à ação hormonal tornou inusitada a descrição de um caso com envolvimneto genital. Paciente de 57 anos, branca, procedente de Conchas (SP), queixando-se de dor abdominal há 10 anos, difusa, seguida de eólica periumbelical periódica, com diarréia e obstipação alternadas. Piorou desse quadro e evoluiu para abdome agudo cirúrgico. O anátomo patológico revelou Pbmicose no epiplon e ovário direito. A biópsia do endométrio mostrou endometrite crônica granulomatosa. A radiologia e a planigrafia revelaram nódulo parahilar direito. Os achados clínicos e laboratoriais permitiram explicar a provável origem do envolvimento genital

Presbyopia:Effectiveness of correction strategies

Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states “presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements”. Presbyopia is inevitable if one lives long enough, but intrinsic and extrinsic risk factors including cigarette smoking, pregnancy history, hyperopic or astigmatic refractive error, ultraviolet radiation, female sex (although accommodation is similar to males), hotter climates and some medical conditions such as diabetes can accelerate the onset of presbyopic symptoms. Whilst clinicians can ameliorate the symptoms of presbyopia with near vision spectacle correction, bifocal and progressive spectacle lenses, monovision, translating or multifocal contact lenses, monovision, extended depth of focus, multifocal (refractive, diffractive and asymmetric designs) or ‘accommodating’ intraocular lenses, corneal inlays, scleral expansion, laser refractive surgery (corneal monovision, corneal shrinkage, corneal multifocal profiles and lenticular softening), pharmacologic agents, and electro-stimulation of the ciliary muscle, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is gives on presbyopic correction evaluation techniques

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenge