Cristiano Menezes Diniz

Ceratocone unilateral associado a constante massagem ocular devido à obstrução da via lacrimal: relato de caso

To describe a possible case of unilateral keratoconus in a patient with continual eye rubbing due to an ipsilateral nasolacrimal obstruction in a 17-year-old woman complaint of progressing low visual acuity in the left eye. Presented with constant epiphora in the left eye throughout her life as a result of ipsilateral nasolacrimal obstruction, which required frequent wiping of this eye. Based on ocular examination, the patient was diagnosed as having unilateral keratoconus in the left eye. As in other studies, keratoconus is thought to be associated with persistent eye rubbing. This patient represents a case of unilateral keratoconus, where there is a confirmed history of habitual eye rubbing due to ipsilateral nasolacrimal obstruction, thereby suggesting a possible causal relationship between eye rubbing and keratoconus.

Mitomicina C colírio como tratamento para granuloma piogênico em cavidade anoftámica

OBJETIVO: Avaliar a eficacia do uso topico de colirio de mitomicina C 0,02% (MMC 0,02%) no tratamento de pacientes com granuloma piogenico em cavidade anoftalmica. METODOS: Seis pacientes portadores de granuloma piogenico em cavidade anoftalmica foram submetidos ao tratamento com mitomicina C 0,02% instilada quatro vezes ao dia durante ciclos quinzenais e intervalo de 15 dias entre os ciclos. Os pacientes foram acompanhados semanalmente. RESULTADOS: Foram acompanhados seis pacientes dos quais um apresentou resolucao do granuloma piogenico ao final do primeiro ciclo de uso da MMC 0,02%. Em dois pacientes a MMC 0,02% foi eficaz na resolucao da lesao apos a segunda semana de tratamento (primeiro ciclo). Dois pacientes apresentaram resolucao completa do granuloma piogenico na quinta semana de uso da MMC 0,02% (inicio do segundo ciclo). Este farmaco foi ineficaz em apenas um paciente que persistiu com a lesao apos dois ciclos de tratamento. Nao foram observadas complicacoes decorrentes do uso de MMC 0,02% em nenhum dos pacientes. CONCLUSAO: A MMC 0,02% topica mostrou-se eficaz no tratamento de granuloma piogenico em cavidade anoftalmica, entretanto, diante de casuistica pequena, torna-se necessario estudo mais amplo, comparando a eficacia da MMC 0,02% com drogas ja utilizadas no tratamento desta lesao, tais como os esteroides e antimetabolicos.

Tarsorrhaphy: applications in a Cornea Service

PURPOSE To evaluate the main indications for tarsorrhaphy in a Corneal Service, as well as success rate and possible complications. METHODS All patients who underwent tarsorrhaphy from January 1st, 2002 to December 30th, 2002, in São Geraldo Eye Hospital - Federal University of Minas Gerais were evaluated retrospectively. Reviewed data included patients sex and age, indication for tarsorrhaphy, duration of signs and symptoms before tarsorrhaphy, time for epithelial healing after tarsorrhaphy, type of tarsorrhaphy, complications, follow-up time. RESULTS Eighteen patients underwent tarsorrhaphy. The indications for a tarsorrhaphy were exposure keratopathy (27.8%), persistent epithelial defect associated with penetrating keratoplasty (38.8%), neurotrophic ulcer (11.1%), dry eye syndrome (5.6%), Stevens-Johnson syndrome (11.1%), and chemical burn (5.6%). The epithelial defect resolved completely in 15 patients (83.3%). Mean duration of signs and symptoms before tarsorrhaphy was 98.7+/-48.6 days, and time to heal after tarsorrhaphy was 53.2+/-22.8 days. Of the 18 procedures, two (11.1%) were temporary and 16 (88.9%) permanent. Complications after tarsorrhaphy were premature opening of the tarsorrhaphy, trichiasis and pyogenic granuloma. CONCLUSION Tarsorrhaphy is a simple procedure, being also very safe and effective in the management of nonhealing epithelial defects, with a success rate of 83.3% and with minor complications.

Técnica para preparação e conservação de olhos de porco para cirurgia experimental

PURPOSES: To evaluate Dextran 40 10% efficacy to maintain pig eye corneal transparency in order to indicate the best method (0.9% physiological saline, Dextran 40 10% and the mixture of both at equal parts) of conservation to maintain the transparency. METHODS: Twenty pig eyes, all of them prepared with Dextran injection in the anterior chamber and soaked in this solution for 20 minutes. Four groups, each group with five eyes and kept at 6oC in the following solutions: Group 1 (0.9% physiological saline), Group 2 (Dextran 40 10% + 0.9% physiological saline at equal parts), Group 3 (Dextran 40 10%), Group 4 (humid chamber - control group). The eyes were observed after 12, 24, 48, 56, 72 hours and then classified according to their transparency. RESULTS: Corneal transparency occurred in 100% of the eyes with Dextran solution. 0.9% physiological saline and Dextran at equal parts achieved a longer period of transparency. CONCLUSIONS: Dextran 40 10% is an efficient solution to promote corneal transparency in post mortem pig eyes. The mixture of equal parts 0.9% physiological saline and Dextran can be used to keep feasible the prepared eyes for a period as long as 72 hours.

Nucleofragmentação horizontal: uma nova técnica para a cirurgia de catarata

PURPOSE: To study in vitro the efficacy of a pair of instruments designed to capture and split human nuclei obtained from extracapsular surgeries. METHODS: The sample is a compound of 47 cataract nuclei. They were classified as mature (4+) and immature (1 to 3+), and the visual acuity ranged from 20/60 to light perception. The instruments were used to split the nuclei. A methylcellulose over a gel base was made for this purpose. RESULTS: The average age was 67,38 years. Most patients (66%), had a visual acuity less than 20/400. 42,6% of the cataracts were mature. The capturing and splitting was easily done in over 90% of the nuclei. CONCLUSIONS: The designed instruments are effective to capture and split cataract nuclei.