Mauro Waiswol

Amblyopia after unilateral infantile cataract extraction after six weeks of age

PURPOSE To determine interocular grating acuity difference in children treated for unilateral infantile cataract. METHODS A group of 27 children previously treated for unilateral infantile cataract, had their monocular visual acuity measured by sweep visual evoked potentials. Interocular grating acuity difference was calculated as the absolute subtraction of monocular acuity scores. Lens status, opacity severity and eye alignment were considered for analysis. RESULTS Mean interocular grating acuity difference obtained from unilateral cataract patients was 0.58 +/- 0.20 logMAR. This result was significantly larger than 0.10 logMAR used as normative data. Children with severe opacities had a more pronounced amblyopia than the moderate ones. No significant correlation between amblyopia and strabismus or aphakia was found. CONCLUSIONS Interocular acuity difference in this group of unilateral congenital cataract was more pronounced than previous reports, mainly because of delay in diagnosis, surgery and optical correction.

Anoftalmia associada à catarata congênita: relato de caso

The authors report a case of anophthalmia, congenital cataract and systemic malformations. Male patient, 6 months old, left anophthalmia and congenital posterior polar cataract in the right eye. The patient was treated with manual aspiration of the crystalline lens, with no intraocular lens implantation with primary posterior capsulorhexis and anterior vitrectomy through a small incision. The association of anophthalmia and congenital cataract is rare. The early diagnosis and management in these cases is very important for the best visual rehabilitation.

Técnica de "mini-nuc" de Blumenthal: resultados de 454 casos

Purpose: In this retrospective study the results of surgical management of cataract by the Mini-Nuc Blumenthal technique were analyzed. Methods: ECCE with Mini-Nuc Blumenthal technique was carried out always by the same surgeon (M.W.) on 454 eyes of 284 patients (148 women and 136 men) during a period of six years (from February 1994 to March 2000). Results: Low rates (4.8%) of transoperative complications were recorded; posterior capsule rupture occurred in 3.7% of the cases. Visual acuity equal to or higher than 20/40 was observed in 89.1% of the cases. Conclusion: The technique was efficient for cataract surgery with the advantage of dispensing with sophisticated instrumentation and involving low costs.

Congenital fibrovascular pupillary membrane

These eyes are usually treated with a membranectomy and pupilloplasty with or without a lensectomy. After fulfilling the anterior chamber with the viscoelastic, the pupil was mechanically distended and subsequently the fibrovascular membrane was resected (sphincterectomy was not required). For patients who require only membranectomy, it is important to be careful as not to cause traumatic cataract, by accidently touching the anterior capsule of the crystalline. In the postoperative period, the left eye was treated with prednisolone acetate 1% and cyclopentolate chloridrate 1% eyedrops. Crystalline lenses remained clear on both eyes. Posterior to that, glasses were prescribed and occlusion antisupressive therapy in partial time, of contralateral eye.

Variação da acuidade visual em pacientes jovens com ectopia lentis submetidos à cirurgia

PURPOSE To assess the results as to visual acuity of two different surgical procedures for ectopia lentis. METHODS Fifty-one eyes of 28 patients (16 males and 12 females, mean age 16.00 +/- 8.5) with simple (19 cases) or Marfan syndrome-associated (9 cases) ectopia lentis with different levels of subluxation underwent lens extraction with implantation of intraocular lenses (IOL) with scleral fixation (21 cases) or by lens extraction with implantation of the intraocular lenses in the capsular bag expanded by endocapsular ring (RING) (30 cases). Result analysis emphasized pre- and postoperative visual acuity during a six-month follow-up. RESULTS Both techniques showed significant increase of postoperative visual acuity with and without correction, but it was better among the cases operated on by scleral fixation of the intraocular lenses. More than the used technique, the preoperative subluxation grades were crucial as to the results. CONCLUSION The two surgical techniques for correction of simple or Marfan syndrome-associated ectopia lentis are safe and effective, resulting in significant recovery of visual acuity, although surgical results are completely dependent on the preoperative lens subluxation grades.

Variações nas dimensões do cristalino humano de acordo com a idade

Purpose: To determine an eventual relationship between human lens thickness and age. Methods: Lens thickness and diameter were assessed by pachymetry and stereoscopic microscopy in 108 eyes donated for corneal graft. Results: Mean lens thickness was 3.73 mm with standard deviation of 0.73 mm and mean diameter was 8,96 mm with standard deviation of 0.41 mm. Sixty-three lenses (58.3%) were from female subjects and forty-five (41.7%) were from male subjects. There was no significant difference of lens diameter and thickness between genders. Age and lens thickness presented a significant direct correlation with a 54.86 mm mean increase between ages ten and ninety. This correlation was not observed in relation to the lens diameter. Conclusion: With age, lens thickness presented a significant increase among all studied age groups.