Marisa Braga Potério

An Improved Surgical Technique for Pterygium Excision With Intraoperative Application of Mitomycin-C

A surgical technique was designed to improve safety after pterygium excision with intraoperative application of mitomycin-C (MMC). A limbic incision was performed in 40 eyes. The body of the pterygium was dissected from the episclera to allow its excision. Care was taken to avoid excessive delamination and cauterization of tissues. A 0.02% MMC solution was then applied. Only at the end of the surgery was the head of the pterygium dissected from the cornea. The 8-0 absorbable sutures were used to place both edges of the conjunctiva together to completely cover the area of bare sclera. After a mean follow-up time of 12 months, a recurrence rate of 5% was observed. No complications of therapy were observed. This is a logical alternative to other surgical techniques. However, randomized studies with more patients and longer follow-up are necessary to determine the potential of this procedure in improving the safety of pterygium excision with intraoperative MMC.

The Feasibility of Introducing a Visual Screening Test for Children During Vaccination Campaigns

PURPOSE A visual screening test for children was prepared for the use of paramedics during vaccination campaigns. This test was used in a vaccination campaign in Taquaritinga, São Paulo, Brazil. METHODS The campaign was carried out by two paramedics trained by ophthalmologists. The first 130 children vaccinated whose families showed interest in participating in the visual screening program were chosen. The program consisted of demographic information and eight questions, a visual screening test for children >4 years, and an external eye examination. After studying the data collected, the paramedic decided if the child needed a more thorough ophthalmologic examination. RESULTS Of the 4505 children vaccinated, 130 children participated in the screening test. One (76.9%) hundred of the 130 children were reexamined by ophthalmologists. Of these, 38 (29.2%) were initially considered to have visual disorders. Ophthalmologic disorders were confirmed in 22 (57.9%) children; of these, 3 were already under ophthalmologic care. The paramedics correctly screened a total of 77 (77%) children. CONCLUSION Visual screening during vaccination campaigns is simple and rapid, and provides the opportunity to identify children with visual disorders during the critical stage of visual development without the need of ophthalmologists.

Influência da aplicação intraoperatória de mitomicina C tópica episcleral na proliferação e diferenciação de células epiteliais córneo-conjuntivais de coelhos

Objective: To evaluate the influence of a three-minute application of 0.02% mitomycin C (MMC) on proliferation and differentiation of rabbit corneal epithelial cells. Methods: Topical MMC or 0.9% saline solution was applied to the episclera of the temporal limbal area of both eyes, maintaining intact epithelial tissue in one eye, and after partial corneal deepithelialization in the contralateral eye. The animals were arranged in groups A (20 eyes), B (16 eyes) and C (14 eyes) and sacrificed respectively on the 4th, 15th and 45th postoperative days. In order to stimulate cell proliferation, group C was submitted to central corneal deepithelialization three days before sacrifice. Cell differentiation markers (AE1, AE3 and AE5) were used for differentiation analysis and 5-bromo-2-deoxyuridine (BrdU) for detection of corneal epithelial cells proliferation. Results: There was no statistical difference in differentiation cells when drugs or surgical techniques were analyzed. Cell proliferation when using MMC or SF was statis-tically significant at central and temporal areas when applied after partial corneal deepithelialization in all groups. Conclusion: These results suggest that the three-minute episcleral application of 0.02% MMC does not affect epithelial cell differentiation; however, when MMC application occurs after corneal deepithelialization, it may affect cell proliferation.

A double-masked evaluation of lignocaine-prilocaine cream used to alleviate the paio on peribulbar injection

Purpose: A randomized double-masked study was carried out on 64 patients, scheduled for cataract surgery, in order to assess the efficacy of a topical anesthetic, in alleviating the pain on peribulbar injection. Methods: The patients were divided into two groups. Group 1 36 patients were treated with the lignocaine-prilocaine cream. Group II 27 patients treated with a placebo cream with the sarne physical characteristics. Both groups remained with the cream 60 minutes before receiving the peribulbar injection. Pain was assessed objectively by the anesthesiologist, who observed the reaction of the patient when inserting the needle and the anesthesia. The pain was also analyzed subjectively by the patient with a international pain scale. Results: Significantly lower pain scores were recorded, both subjectively and objectively, in Group 1 patients. None ofthe patients experienced any si de effects during the study, due to the use of the cream. Conclusion: These results support the efficacy and relative safety of lignocaine-prilocaine cream used to alleviate the pain during peribulbar injection.