Carlos Eduardo Borges Souza

Visual acuity, contrast sensitivity, reading speed, and wavefront analysis: pseudophakic eye with multifocal IOL (ReSTOR) versus fellow phakic eye in non-presbyopic patients.

PURPOSE To compare the visual performance in the pseudophakic eye and the phakic eye in four patients who underwent unilateral intraocular lens (IOL) implantation. METHODS Four patients presenting with unilateral cataract underwent ReSTOR (Alcon Laboratories, Ft Worth, Tex) IOL implantation in their nondominant eye, targeting emmetropia. RESULTS Uncorrected near visual acuity was >20/32 in all operated eyes and best spectacle-corrected distance visual acuity was 20/16 for two eyes, 20/25 for one eye, and 20/32 for one eye. Reading speed was similar between the eyes, but not for critical print size. Contrast sensitivity was lower in the pseudophakic eyes. Wavefront analysis showed no considerable difference in total high order aberrations, coma, and spherical aberration between eyes for all patients. CONCLUSIONS In young patients with unilateral cataract surgery, unilateral multifocal IOL implantation provides satisfactory visual acuity and may be considered an alternative treatment option in this patient population.

Postoperative wavefront analysis and contrast sensitivity of a multifocal apodized diffractive IOL (ReSTOR) and three monofocal IOLs.

PURPOSE To compare visual acuity, total and high order wavefront aberrations (coma, spherical aberration, and other terms of high order aberration), and contrast sensitivity in 105 eyes implanted with 4 different types of intraocular lenses (IOLs) (1 multifocal apodized diffractive IOL and 3 monofocal IOLs). METHODS A prospective study comparing four types of IOLs (Alcon ReSTOR [50 eyes], Alcon Acrysof MA30AC [20 eyes], Alcon Acrysof SA60AT [20 eyes], and Mediphacos Acqua IOL [15 eyes]) was carried out. All eyes were targeted for emmetropia. Complete ophthalmological examination, including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity (Pelli-Robson chart), and wavefront analysis, was performed 2 months postoperatively. RESULTS All eyes in all groups had BSCVA > or = 20/32 postoperatively. Mean total aberration root-mean-square (RMS) values were: 0.72 +/- 0.25 microm (ReSTOR), 0.94 +/- 0.26 microm (MA30), 0.84 +/- 0.23 microm (SA60), and 2.04 +/- 0.77 microm (Acqua). Mean higher order aberration values were: 0.35 +/- 0.15 microm (ReSTOR), 0.41+/- 0.12 microm (MA30), 0.43 +/- 0.13 microm (SA60), and 0.85 +/- 0.50 microm (Acqua). The Acqua IOL showed statistically significant more total and higher order aberrations when compared with the other IOLs (P < .05). The ReSTOR IOL showed statistically significant less induction of spherical aberration when compared to the monofocal IOLs (P < .05). Mean contrast sensitivity values were: 1.64 +/- 0.08 (ReSTOR), 1.72 +/- 0.08 (MA30), 1.70 +/- 0.07 (SA60), and 1.65 +/- 0.11 (Acqua). CONCLUSIONS Different types of IOLs resulted in measurably different postoperative higher order aberration patterns. The multifocal apodized diffractive IOL (ReSTOR) induced significantly less spherical aberration compared to the monofocal IOLs. Contrast sensitivity revealed better values with MA30 and SA60 IOLs when compared to ReSTOR. The integration of wavefront technology in evaluating pseudophakic patients represents a step towards better understanding and analyzing postoperative visual quality.

Avaliação da contaminação microbiana da membrana amniótica e líquido amniótico

PURPOSE: To verify and compare the possible microbiological contamination of amniotic fluid, and amniotic membranes at time zero and at different times after delivery. METHODS: Nine amniotic fluid samples were collected by intrauterine aspiration and nine amniotic membranes were collected after cesarean deliveries of patients with negative serology (HIV, syphilis, hepatitis B and C). Samples were collected at different times after delivery (zero, thirty, sixty minutes). The samples were inoculated in culture media for bacteria and fungi. RESULTS: Bacteria were retrieved from four amniotic fluid samples, as well as from all nine amniotic membranes. Coagulase-negative Staphylococcus was the most prevalent bacteria. At time zero, coagulase-negative Staphylococcus was revealed in all nine amniotic membranes, Staphylococcus aureus in two, Neisseria sp., Enterobacter and Streptococcus viridans in one. Thirty minutes after delivery, coagulase negative Staphylococcus grew in all nine amniotic membranes and Streptococcus viridans in one. Sixty minutes after delivery, coagulase-negative Staphylococcus was shown in eight, Staphylococcus aureus in two and Streptococcus viridans in one sample. Coagulase-negative Staphylococcus was found in three amniotic fluids and corresponding membranes. CONCLUSION: Amniotic membrane contamination was a problem in all samples, and the processing protocol used at the Federal University of Sao Paulo was efficient to decontaminate the AM. Care must be taken before the use of AM. Further studies are necessary to establish the accurate variation of AM contamination at different times after delivery.

Intravitreal Injection of Sulfamethoxazole and Trimethoprim Associated with Dexamethasone as an Alternative Therapy for Ocular Toxoplasmosis

ABSTRACT Purpose: To evaluate intravitreal injections of sulfamethoxazole/trimethoprim in association with dexamethasone for treating toxoplasmic retinochoroiditis. Methods: Thirteen patients with active, recurrent ocular focal toxoplasmic retinochoroiditis and visual acuity worse than 20/63 in the affected eye were included. Ocular toxoplasmosis was diagnosed according to the classic clinical findings. The primary end point was the change in the final best-corrected visual acuity (BCVA). Results: The intraocular inflammation decreased within 2 weeks after injection in all eyes and resolved in 8 (62%) eyes with only one injection after 30 days; the remaining eyes received two injections. In all eyes, the retinitis was inactive and no patient had decreased early treatment diabetic retinopathy study lines of BCVA at the final examination. Conclusion: The combination of intravitreal trimethoprim/sulfamethoxazole and dexamethasone might be an alternative treatment strategy in patients with toxoplasmic retinochoroiditis.

Optic Nerve: Comparison of Technologies

Each optic nerve imaging technology has its unique strengths and weaknesses.Each technology is in evolution to minimize it’s limitations.Frequency of imaging will be dictated by variables of the individual patient, such as stage of glaucoma or suspicion of progression.

Análise clínica, cirúrgica e laboratorial de pacientes com conjuntivocálase

OBJETIVO: Avaliacao clinica, cirurgica e laboratorial de pacientes com conjuntivocalase. METODOS: Foi realizado exame oftalmologico antes e apos tratamento cirurgico em dez pacientes com conjuntivocalase avaliando os seguintes dados: acuidade visual, biomicroscopia do segmento anterior, padrao de coloracao pela rosa bengala, teste de Schirmer e citologia de impressao. RESULTADOS: Apos a cirurgia todos os pacientes apresentaram melhora na sintomatologia e no padrao de rosa bengala. A citologia de impressao revelou metaplasia escamosa em oito pacientes. CONCLUSAO: A cirurgia pode ser eficaz na melhora da sintomatologia dos pacientes com conjuntivocalase. Metaplasia escamosa foi achado frequente nesses pacientes.