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Facoemulsifica??o versus extra??o extracapsular no sistema público de saúde: análise de custos para o hospital, para o governo e para a sociedade
Kara-Junior, Newton;Santhiago, Marcony Rodrigues de;Espindola, Rodrigo Fran?a de;
Revista Brasileira de Oftalmologia , 2012, DOI: 10.1590/S0034-72802012000200009
Abstract: purpose: to compare the costs of cataract surgery for a public hospital, the government and the society between the techniques of phacoemulsification (phaco) and extracapsular cataract extraction (eecp). methods: a review based on several clinical studies between 2002 and 2010 at the ambulatorial surgical center of the university of s?o paulo. results: the estimated expenses associated with medical supplies used for surgery were r$ 468.92 and r$ 259.96 in the phaco and eecp groups respectivelly. the hospital expenditures in the postoperative follow-up was approximately r$ 16.40 (42%) lower in the phaco. regarding the estimated spending for social security, the eecp group cost an average, us$ 44.58 per patient more than the phaco group.
Efeito da facectomia no posicionamento palpebral superior: compara o entre as técnicas de facoemulsifica o e a extracapsular
Coelho Roberto Pinto,Paiva Raquel Nunes,Cruz Antonio Augusto Velasco e
Arquivos Brasileiros de Oftalmologia , 2003,
Abstract: OBJETIVO: Comparar o efeito de duas técnicas de facectomia (facoemulsifica o e extracapsular) no posicionamento da pálpebra superior. MéTODOS: Foi analisado o posicionamento palpebral de dois grupos de pacientes submetidos à cirurgia de catarata: facoemulsifica o e extracapsular. As imagens foram digitalizadas (antes e 30 dias após a cirurgia) e processadas com o programa NIH 1.62. O posicionamento palpebral foi medido em rela o a uma linha horizontal que unia os cantos medial e lateral da fenda palpebral, passando pelo centro da pupila. RESULTADOS: O posicionamento palpebral foi afetado de maneira diferente segundo a técnica utilizada. Na facoemulsifica o a diferen a média entre a posi o palpebral superior pós e pré-operatória foi de -0,54 mm. Na extracapsular esta diferen a aumentou para -1,41 mm. O teste t de Student (amostras pareadas) mostrou que as médias das diferen as entre os dois grupos s o significativamente diferentes (p=0,0068). CONCLUS O: A técnica de cirurgia de facoemulsifica o induziu menor varia o do posicionamento palpebral em rela o à cirurgia extracapsular no pós-operatório recente.
Conduta cirúrgica na subluxa o do cristalino  [cached]
Severo Nórton Souto,Kleinert Fabíola,Kwitko Sérgio
Arquivos Brasileiros de Oftalmologia , 2004,
Abstract: OBJETIVO: Apresentar 10 casos de subluxa o de cristalino, secundários a trauma ou a síndrome de Marfan, discutindo o tratamento e os resultados obtidos. MéTODOS: Foram estudados 10 olhos de 9 pacientes, 6 casos secundários a trauma contuso e 4 casos a síndrome de Marfan. A idade média foi de 48,9 ± 18,2 anos, com tempo de seguimento de 34,6 ± 11,6 meses (12 a 62 meses). Os pacientes foram submetidos à facectomia intracapsular (1 caso), extracapsular com capsulorrexe (1 caso), facoemulsifica o sem LIO (1 caso), e facoemulsifica o com implante de LIO (7 casos). Anéis expansores capsulares foram utilizados em 7 olhos. RESULTADOS: Houve melhora da acuidade visual em todos os casos durante o seguimento, exceto em um, em que houve descolamento de retina, 20 dias após o procedimento. CONCLUS O: A facectomia com implante de LIO em pacientes com cristalino subluxado é procedimento viável, principalmente com a facoemulsifica o e o uso do anel expansor capsular, podendo melhorar bastante a acuidade visual e a qualidade de vida desses pacientes.
Extracción extracapsular del cristalino transparente en pacientes con alta miopía Extracapsular extraction of the transparent crytalline lens in patients with high myopia
Sandra M. Borges Pérez,Katia Arias Salas,Edith Ballate Nodales,Caridad Monteagudo
Revista Cubana de Oftalmolog?-a , 2003,
Abstract: Se estudiaron 64 ojos de 32 pacientes de alta miopía con más de -15 dioptrías, a los que se les realizó cirugía extracapsular del cristalino transparente. Se efectuó estudio previo de la retina y se aplicó tratamiento profiláctico con crio-fotocoagulación a las lesiones degenerativas generadoras de desprendimiento de retina. Se utilizó la fórmula de Binkhorst como pronóstico refractivo preoperatorio que fue muy útil. Los resultados obtenidos en la mayoría de los pacientes fueron satisfactorios, pues refractivamente disminuyó la miopía. Se presentaron complicaciones transoperatorias y posoperatorias similares a las descritas por la literatura y todas fueron resueltas de manera adecuada. 64 eyes from 32 high myopia patients with more than -15 dioptres that underwent extracapsular surgery of the transparent crystalline lens were studied. A previous study of the retina was conducted and prophylactic treatment with cryo-photocoagulation was applied to the degenerative injuries generating retinal detachment. The use of Binkhorst's formula as a preoperative refractive prognosis proved to be very useful. The results obtained in most of the patients were satisfactory, since myopia was refractively reduced. There were transoperative and postoperative complications similar to those described in literature and all of them were adequately solved.
Impregna o inadvertida da cápsula posterior do cristalino com azul de tripano durante a facectomia extracapsular: relato de caso  [cached]
Marques Frederico Fran?a,Soccol Fábio Medaglia,Marques Daniela M. V.,Rehder José Ricardo C. L.
Arquivos Brasileiros de Oftalmologia , 2006,
Abstract: Relato de complica o relacionada ao uso do azul de tripano 0,1% ocorrida ao corar a cápsula anterior do cristalino em facectomia extracapsular com implante de lente intra-ocular. O corante foi injetado sob alta press o utilizando a técnica de bolha de ar ocasionando a migra o deste através da z nula e conseqüente perda do reflexo vermelho no peroperatório dificultando os passos subseqüentes à extra o da catarata e comprometendo temporariamente a acuidade visual no pós-operatório. Tendo como objetivo evitar esta complica o, os autores descrevem ainda, o uso da "Técnica de bolha de ar modificada" no qual o viscoelástico dispersivo é injetado no espa o iridolenticular 360degrees para compor uma barreira de prote o.
Extracción extracapsular del cristalino transparente en pacientes con alta miopía
Borges Pérez,Sandra M.; Arias Salas,Katia; Ballate Nodales,Edith; Monteagudo,Caridad;
Revista Cubana de Oftalmolog?-a , 2003,
Abstract: 64 eyes from 32 high myopia patients with more than -15 dioptres that underwent extracapsular surgery of the transparent crystalline lens were studied. a previous study of the retina was conducted and prophylactic treatment with cryo-photocoagulation was applied to the degenerative injuries generating retinal detachment. the use of binkhorst's formula as a preoperative refractive prognosis proved to be very useful. the results obtained in most of the patients were satisfactory, since myopia was refractively reduced. there were transoperative and postoperative complications similar to those described in literature and all of them were adequately solved.
Clinical Trial of Manual Small Incision Surgery and Standard Extracapsular Surgery
Parikshit Gogate
Community Eye Health Journal , 2003,
Abstract: Introduction. Manual small incision cataract surgery (MSICS) is used increasingly for cataract extraction and intraocular lens implantation. It is thought that the small wound heals faster than a conventional incision, leading to less astigmatism and a better uncorrected visual acuity. This is important as many patients do not wear or cannot afford spectacles after surgery, which means that their uncorrected visual acuity is what they rely on to carry out their every day functions. Often this is less than 6/18 on the Snellen s chart, which would fall below the WHO good outcome category for post-operative visual impairment. A post-operative vision of 6/18 or better without spectacles is a goal which appears to be within the reach of small incision techniques for cataract surgery. However, there are concerns that the method used to remove the nucleus in MSICS may be more traumatic to the corneal endothelium than conventional ECCE surgery.
Efeito da facectomia no posicionamento palpebral superior: compara??o entre as técnicas de facoemulsifica??o e a extracapsular
Coelho, Roberto Pinto;Paiva, Raquel Nunes;Cruz, Antonio Augusto Velasco e;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000500012
Abstract: purpose: to compare changes in the upper eyelid position after cataract surgery with phacoemulsification and extracapsular techniques. methods: the upper eyelid position was measured in two groups of patients before and 30 days after cataract surgery performed with phacoemulsification and extracapsular techniques. palpebral fissure images (before and after the cataract surgery) were digitized and then processed using the nih 1.62 software. eyelid position was measured relative to a horizontal line passing through the pupil center and connecting both canthi of the palpebral fissure. results: the palpebral position was differently affected according to the techniques. in phacoemulsification the mean difference between eyelids position before and after surgery was -0.54 mm. in the extracapsular technique this difference increased to -1.41 mm.the paired student t test showed that the difference between two means was significant (p=0.0068). conclusion: the phacoemulsification technique induces less variation in the upper eyelid position than the extracapsular technique in the recent postoperative period.
Estudo do endotélio corneano em cirurgias de cataratas duras: extra??o extracapsular planejada da catarata e facoemulsifica??o
Stumpf, Simone;Nosé, Walton;
Arquivos Brasileiros de Oftalmologia , 2006, DOI: 10.1590/S0004-27492006000400007
Abstract: purpose: to evaluate and compare the endothelial damage after planned extracapsular cataract extraction (ecce) and phacoemulsification of very hard cataracts. methods: in this prospective, randomized study, 41 patients with age-related and very hard cataract were divided into two groups: in group 1 (21 patients) an extracapsular cataract extraction was performed and in group 2 (20 patients), phacoemulsification. in both groups, intraocular lenses were implanted in the capsular bag. preoperatively and 1, 3 and 6 months postoperatively, a complete ophthalmological examination, endothelial specular microscopy, and ultrasonic pachymetry were done. endothelial cell loss, pleomorphism, polymegathism and corneal thickness were studied. results: both groups presented an endothelial cell loss in the postoperative time, as compared with the preoperative values, but there were no significant differences among the postoperative values (1, 3 and 6 months). six months after surgery, mean cell loss was 28.50% in group 1 and 34.77% in group 2. there were no differences among the indexes of pachymetry, polymegathism and pleomorphism between the two groups. conclusions: endothelial response was not statistically different between the two studied groups.
Resultados anatómicos y funcionales en la cirugía de catarata mediante la técnica de extracción extracapsular del cristalino versus facoemulsificación Anatomical and functional results in cataract's surgery by extracapsular extraction of crystalline lens versus phacoemulsification  [cached]
Ailén Garcés Fernández,Iván Hernández López,Odalys Carmona Pérez,Leansy Pe?a López
Revista Cubana de Oftalmolog?-a , 2011,
Abstract: OBJETIVOS: Evaluar resultados anatómicos y funcionales mediante las técnicas de extracción extracapsular del cristalino (tunelizada con viscoelástico) y facoemulsificación (facochop) e identificar las complicaciones transosoperatorias y posoperatorias más frecuentes. MéTODOS: Se realizó una investigación observacional descriptiva longitudinal en 386 ojos con catarata sometidos a cirugía en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre enero y diciembre de 2009. Se estudiaron en dos grupos, según técnica quirúrgica empleada. En 140 ojos se realizó extracción extracapsular del cristalino (tunelizada con viscoelástico) y en 246 ojos se efectuó facoemulsificación (facochop). Se analizaron el tipo de catarata, la agudeza visual sin corrección y mejor corregida, así como el cilindro queratométrico preoperatorio y el posoperatorio, las complicaciones transoperatorias y las posoperatorias. Se realizó seguimiento posoperatorio durante tres meses. RESULTADOS: Predominaron mujeres de 60 - 80 a os; la media de la agudeza visual sin corrección y mejor corregida posoperatoria fue similar en ambos grupos (0,6 y 0,8). La frecuencia de complicaciones transquirúrgicas y posoperatorias entre ambos grupos no difirió de modo significativo (10,7 vs. 8,5 %; 13,5 vs. 6,5 %). CONCLUSIONES: Ambas técnicas resultaron ser efectivas para lograr calidad visual en pacientes operados de catarata. OBJECTIVES: To assess the anatomical and functional results using the techniques of the crystalline extracapsular lens extraction (tunneled with viscoelasticity) and phacoemulsification (phacochop) and also to identify the more frequent complications trans- and postoperative. METHODS: A longitudinal, descriptive and observational research was conducted in 386 eyes with cataract operated on the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from January to December, 2009 and studied in two groups according the surgical technique used. In 140 eyes a crystalline lens extraction was carried out (tunneled with viscoelasticity) and in 246 eyes with phacoemulsification (phacochop). Authors analyzed the type of cataract, the visual acuity without correction and better corrected, as well as the preoperative and postoperative keratometry cylinder, the transoperative and postoperative complications. There was a postoperative follow-up for three months. RESULTS: There was predominance of women aged 60-80; the mean of visual acuity without correction and better postoperative corrected was similar in both groups (0.6 and 0.8). The frequency of trans-surgical and postoperative compl
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