Nilo Holzchuh

Popular beliefs regarding the treatment of senile cataract

OBJECTIVE To identify popular beliefs regarding the treatment of senile cataract in patients enrolled in the community health programs on eye rehabilitation. METHODS A cross-sectional survey was carried out using an interview questionnaire that was applied to 776 subjects drawn from a non-probabilistic sample in five cities of the state of São Paulo. The sample was made up of 47.2% males and 52.8% females, aged 50 to 96 years (average age 71.6 years). RESULTS Of the total of subjects studied, 41.9% had never attended school, and 78.5% were no longer in the employment market. Most (85.1%) credited the sight restoration to cataract surgery. Among those unconvinced, 47.4% asserted that sight restoration depended only on Gods will. A greater proportion of women than men (p 0.0000) believed in the association of cataract and menopause, maternity, and menstrual periods and they admitted using herbal and rose teas for treating cataract. CONCLUSIONS Misbeliefs related to the causes and treatment of senile cataract were identified, most probably of sociocultural basis, indicating the need of education on the subject.

Two-Year Outcome of Partial Lacrimal Punctal Occlusion in the Management of Dry Eye Related to Sjögren Syndrome

Purpose: To analyze the influence of thermal partial punctal occlusion on the ocular surface of dry eye related to Sjögren syndrome. Material and Methods: Thirty-seven eyes of 19 patients (3 male and 16 female; 49.11 ± 14.33 years old) with keratoconjunctivitis sicca were enrolled in this study. Superior and inferior partial occlusion were performed in both eyes under topical anesthesia using thermal cautery with a sterile tip to obtain lacrimal punctum smaller than 0.5 mm. Schirmer I, break-up-time, diameter of lacrimal puncta, corneal fluorescein, and rose Bengal staining scores were analyzed before and after 24 weeks and after 24 months of the procedure. All measurements were performed under controlled climate. Results: The average lacrimal punctum diameter before the procedure was 0.65 ± 0.134 mm. All lacrimal puncta were successfully reduced to less than 0.5 mm after 4 weeks of the procedure. The average Schirmer I test values improved statistically after 24 weeks and maintained stable after 24 months. Average break-up-time, rose Bengal, and fluorescein staining score values improved statistically after 24 weeks and improved even more after 24 months. Average Schirmer I test, break-up-time, rose Bengal, and fluorescein staining scores showed significant improvement (p < 0.0001) after 24 months of partial thermal punctal occlusion. Conclusion: Our study showed that reducing the punctum diameter to 0.5 mm can improve vital staining scores, break-up-time, and Schirmer I test in dry eye related to Sjögren syndrome.

Politetrafluoroetileno e esclera humana no tratamento cirúrgico de perfuração escleral em coelhos

Objetivo: Foi realizado estudo experimental para avaliar o comportamento do politetrafluoroetileno (Gore-Tex®) em relacao a esclera humana, em perfuracoes esclerais produzidas em olhos de coelhos. Metodos: Vinte e dois olhos de coelhos foram submetidos a perfuracao escleral seguida da colocacao e sutura do enxerto de Gore-Tex® no olho esquerdo e esclera humana no olho direito. A evolucao pos-operatoria foi avaliada diariamente durante um mes e, analisada a intensidade da hiperemia ocular, presenca de infeccao, secrecao ocular, rejeicao e tonicidade do olho a digito-pressao. Resultados: Nao foi observada presenca de secrecao, casos de infeccao ou rejeicao. As seccoes histopatologicas mostraram presenca de processo inflamatorio nao granulomatoso tipo fibrose nos olhos com Gore-Tex®, com boa adesao e epitelizacao. Conclusao: O Gore-Tex® mostrou ser material plausivel quando utilizado nos defeitos e perfuracoes esclerais com algumas vantagens como facil obtencao, manuseio e durabilidade.

Influência do uso tópico de mitomicina C no processo de diferenciação do epitélio corneano de coelhos

PURPOSE: To evaluate the effects of mitomycin C eye drops (0.2 mg/ml) on the corneal epithelium of rabbits. The changes in clinical examination, histopathologic and immunohistochemical analysis were investigated. METHODS: Mitomycin C and distilled water (controls) were instilled 4 times daily for 14 consecutive days in the eyes with intact ocular surface. The ocular surface was evaluated by slit-lamp examination, during the days of the drug instillation. The animals were sacrificed on the 15th, 50th and 100th day of the experiment. The histopathologic analysis of the corneal epithelium was complemented by immunohistochemical studies using monoclonal antibodies to cytokeratins (AE1 and AE5). RESULTS: During the use of mitomycin C eye drops mild conjunctival hiperemia was detected. It disappeared 7 days after the drug was discontinued. There was no other clinical sign by slit-lamp examination. No histopathologic alterations in the corneal epithelium were detected, epithelium continuity was observed as well as maturation and presence of atypical cells. The use of 0.02% mitomycin C not influence the differentiation pattern of the corneal epithelial cell. CONCLUSION: The results of this investigation, in conditions of the study, showed that 0.02% mitomycin C, instilled 4 times daily for 14 consecutive days, showed a low toxic potential regarding the intact ocular surface.

Toxicidade da mitomicina C no epitélio corneano de coelhos

OBJECTIVE: To evaluate the effects of mitomycin C eye drops (0.2 mg/ml) on the corneal epithelium of rabbits. METHODS: Mitomycin C and distilled water (controls) were instilled 4 times daily for 14 consecutive days in the eyes with intact ocular surface. The animals were sacrificed in the 15th, 50th and 100th day of the experiment. The histopathologic analysis of the corneal epithelium was complemented by morphometry. Epithelium area, number of nuclei, nucleus-cytoplasm relation, epithelial cell and cytoplasm area were studied. RESULTS: The morphometric analysis was performed by point counting under light microscopy. It showed variations characterized by alteration of the epithelium area, nucleus area and cytoplasm area, epithelial cell hypertrophy, alteration of the nucleus-cytoplasm relationship and decrease of the number of nuclei. CONCLUSION: The results of this investigation, in the study conditions, showed that 0.02% mitomycin C, instilled 4 times daily for 14 consecutive days, has low toxic potential in the intact ocular surface.