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Degenera??es periféricas da retina do olho míope X LASIK
Nassaralla Jr., Jo?o J.;Nassaralla, Belquiz A.;
Arquivos Brasileiros de Oftalmologia , 2004, DOI: 10.1590/S0004-27492004000200031
Abstract: the purpose of this paper is to present the most frequent peripheral retinal degenerations in myopic eyes and discuss those degenerations which are a great risk for the retina and to point out the features associated with retinal detachment, its relation to lasik and the indication for prophylactic treatment.
Ten-year results of phototherapeutic keratectomy on recurrent corneal erosions
Nassaralla, Belquiz Rodrigues do Amaral;Nassaralla Junior, Jo?o Jorge;
Arquivos Brasileiros de Oftalmologia , 2012, DOI: 10.1590/S0004-27492012000100007
Abstract: purpose: to determine the ten-year visual results and outcomes of excimer laser phototherapeutic keratectomy (ptk) for recurrent corneal erosions. methods: twenty-six eyes of 23 patients with recurrent corneal erosions were treated by ptk from 1996 to 2000 at the goiania eye institute, brazil. all eyes had failed to respond to conventional therapy. data regarding preoperative and postoperative best-spectacle-corrected visual acuity (bscva), spherical equivalent (se), symptomatic relief, incidence of recurrence, and complications arising from the laser treatment were analyzed. the mean duration of symptoms prior to ptk was 18 months (range, 8 to 36 months). the corneal epithelium was debrided, and laser ablation was performed to a depth of 5 micron with an ablation zone of 7 to 9 mm, using the technolas 217c plano scan excimer laser. mean postoperative follow-up was 12 years (range, 10 to 14 years). results: at the last follow-up visit, 15 eyes (57.69%) were symptomsfree. five eyes (19.2%) had occasional mild symptoms of irritation and photophobia upon awakening. recurrence of painful corneal erosions occurred in six eyes (23.07%), which required a ptk retreatment. twenty-four eyes had a preserved or improved bcva, while 2 eyes showed deterioration of 1 line on snellen test. eleven eyes (42.3%) had no change in se, and the others (57.69%) had a change of less than +/-0.75 diopters (d). there were no major complications during the follow-up period. conclusion: ten-year data show that ptk is a safe, fast, effective and minimal invasive choice of treatment for recurrent corneal erosions in patients who do not respond to conventional treatments.
Três anos pós-LASIK em crian?as anisométropes de 8 a 15 anos de idade
Nassaralla, Belquiz R. Amaral;Nassaralla Jr, Jo?o J.;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000200006
Abstract: purpose: to determine the safety, efficacy, predictability and stability of laser in situ keratomileusis (lasik), three years after surgery, to correct high myopia or high myopic astigmatism in children with high anisometropia in whom conventional treatments had failed. methods: nine eyes of 9 patients, 3 boys and 6 girls with a mean age of 11.5 years (range, 8 to 15 years) underwent lasik using the chiron technolas 217 excimer laser. minimum follow-up was 36 months. results: three years after lasik, uncorrected visual acuity improved by at least five snellen lines in all eyes; five eyes (55.5%) were 20/50 or better without correction. six eyes (66.6%), were 20/50 or better with correction and five eyes (55.5%) improved at least 1 line in the best spectacle corrected visual acuity (bscva). due to amblyopia, no eye had uncorrected visual acuity of 20/20 or better. the mean spherical refraction equivalent decreased from -7.66 (± 3.75) d to -1.02 (± 1.26) d, and mean preoperative astigmatism decreased from -3.11 (± 2.09) d to -0.75 (± 0.25) d. highest anisometropia was 1.5 d. conclusion: three years after surgery, lasik seems to be a safe and effective option for the correction of high anisometropia in children from 8 to 15 years old, in whom conventional therapy had failed. the natural change in refraction related to maturation did not affect the use of appropriate spectacle correction.
Refractive changes after scleral buckling surgery
Nassaralla Junior, Jo?o Jorge;Nassaralla, Belquiz Rodriguez do Amaral;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000500006
Abstract: purpose: a prospective study was conducted to compare the refractive changes after three different types of scleral buckling surgery. methods: a total of 100 eyes of 100 patients were divided into three groups according to the type of performed buckling procedure: group 1, encircling scleral buckling (42 patients); group 2, encircling with vitrectomy (30 patients); group 3, encircling with additional segmental buckling (28 patients). refractive examinations were performed before and at 1, 3 and 6 months after surgery. results: changes in spherical equivalent and axial length were significant in all 3 groups. the amount of induced astigmatism was more significant in group 3. no statistically significant difference was found in the amount of surgically induced changes between groups 1 and 2, at any postoperative period. conclusions: all three types of scleral buckling surgery were found to produce refractive changes. a correlation exists between additional segments and extent of refractive changes.
Degenera es periféricas da retina do olho míope X LASIK
Nassaralla Jr. Jo?o J.,Nassaralla Belquiz A.
Arquivos Brasileiros de Oftalmologia , 2004,
Abstract: O objetivo deste artigo é apresentar as degenera es periféricas mais comuns na retina dos olhos míopes, discutindo aquelas que oferecem maiores riscos para o descolamento regmatogênico da retina, seu relacionamento com a cirurgia de LASIK e a indica o para o tratamento profilático.
Três anos pós-LASIK em crian as anisométropes de 8 a 15 anos de idade
Nassaralla Belquiz R. Amaral,Nassaralla Jr Jo?o J.
Arquivos Brasileiros de Oftalmologia , 2003,
Abstract:
Refractive changes after scleral buckling surgery
Nassaralla Junior Jo?o Jorge,Nassaralla Belquiz Rodriguez do Amaral
Arquivos Brasileiros de Oftalmologia , 2003,
Abstract: PURPOSE: A prospective study was conducted to compare the refractive changes after three different types of scleral buckling surgery. METHODS: A total of 100 eyes of 100 patients were divided into three groups according to the type of performed buckling procedure: Group 1, encircling scleral buckling (42 patients); Group 2, encircling with vitrectomy (30 patients); Group 3, encircling with additional segmental buckling (28 patients). Refractive examinations were performed before and at 1, 3 and 6 months after surgery. RESULTS: Changes in spherical equivalent and axial length were significant in all 3 groups. The amount of induced astigmatism was more significant in Group 3. No statistically significant difference was found in the amount of surgically induced changes between Groups 1 and 2, at any postoperative period. CONCLUSIONS: All three types of scleral buckling surgery were found to produce refractive changes. A correlation exists between additional segments and extent of refractive changes.
Retinal peripheral changes after LASIK
Nassaralla Junior, Jo?o Jorge;Santos, Regina Candido Ribeiro dos;Nassaralla, Belquiz Amaral;
Revista Brasileira de Oftalmologia , 2008, DOI: 10.1590/S0034-72802008000300005
Abstract: purpose: to better define the effect of laser in situ keratomileusis (lasik) on myopic eyes and the risk and incidence of retinal complications after surgery. methods: in a prospective study, 200 eyes of 100 patients, 49 male and 51 female, with a mean age of 29.7 years, had a complete posterior pole examination before and at 1 week, 1, 3 and 12 months after bilateral simultaneous lasik for the correction of myopia. mean spherical equivalent was 7.75d (range 1.00 to -17.25d). before lasik, preventive treatment was carried out on predisposing lesions to retinal complications, with laser photocoagulation. re: before surgery, the ophthalmic features were: 86 eyes (43%) presented no peripheral abnormalities; 49 eyes (24.5%) had lattice degeneration; 18 eyes (9%), white without pressure; 5 eyes (2.5%), white with pressure; 33 (16.5%), oral chorioretinal degenerations; 6 (3%), paving stone; 45 (22.5%,) posterior vitreous detachment; 20 (10%), retinal vitreous traction; and 12 (6%), round holes. comparing the incidence of ophthalmic features before and at one year after surgery, there was not a statistical significant difference (p>0.05). conclusion: although retinal pathologic conditions have been described as complications after lasik, our data did not reveal a cause-effect relationship between the refractive error corrective procedure and retinal complications. the retinal changes found after lasik in this series of patients, appear to reflect the predisposition of myopes. both patient and doctor should be aware that, even after the refractive error correction, the risk of complications related to the myopic eye would persist.
LASIK X PRK após cirurgia de descolamento de retina
Rodovalho, Adriano Jorge Mattoso;Rego, Marcelo Guimar?es Brand?o;Nassaralla Júnior, Jo?o J.;Nassaralla, Belquiz Rodrigues do Amaral;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000200017
Abstract: purpose: to compare the results of "laser in situ keratomileusis" (lasik) and "photorefractive keratectomy" (prk) to correct myopia and astigmatism in eyes previously submitted to retinal detachment (rd) surgery with scleral "buckle". methods: twenty-five eyes of 22 patients submitted to scleral buckling procedure with significant refraction changes after surgery were evaluated. fourteen eyes of 13 patients underwent lasik and 11 eyes of 9 patients underwent prk. minimum time between rd surgery and refractive surgery was 12 months. all patients were followed-up for at least 12 months. results: twelve months after surgery, mean spherical equivalent in the lasik group changed from -6.49d preoperatively to -0.17d and mean astigmatism decreased from -1.10d to -0.23d. spherical equivalent in the prk group decreased from -5.35d before surgery to +0,02d and average astigmatism changed from -1.38d to -0.54d. in both groups, uncorrected visual acuity (ucva) improved at least 4 lines in 11 eyes. conclusion: both lasik and prk were safe and effective to correct refractive error after rd surgery. our results showed no significant difference between procedures. further studies with more patients and long-term follow-up are required to better evaluate the effects of refractive surgery in patients submitted to scleral buckling procedure.
Sensibilidade corneana e secre??o lacrimal após LASIK
Rêgo, Marcelo Guimar?es Brand?o;Rodovalho, Adriano Jorge Mattoso;Rocha, André Adolfo Alves da;Nassaralla Júnior, Jo?o J.;Nassaralla, Belquiz R. Amaral;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000200013
Abstract: purpose: to analyze the changes in corneal sensitivity and tear secretion after "laser in situ keratomileusis" (lasik). methods: thirty-eight eyes from nineteen patients, 9 men and 10 women, were submitted to myopic lasik. the mean spherical equivalent before surgery was -3.79d (± 1.29). corneal sensitivity was measured with a cochet-bonnet esthesiometer in the central region of the cornea. tear secretion was evaluated by the schirmer test, basal secretion, breakup time test and symptoms. examinations were performed before and 7, 30, 90, 180, and 270 days after surgery, or until full recovery. results: median preoperative corneal sensitivity was 60 mm (range, 50 to 60 mm); median schirmer test was 21.5 mm (range, 10 to 30 mm); median basal secretion was 11.5 mm (range, 6 to 20 mm); median breakup time test was 16.0 seconds (range, 8 to 22 seconds). all patients recovered their preoperative corneal sensitivity and tear secretion values between 90 to 180 days after surgery. during 9 months of follow-up, 5 patients (10 eyes) did not present any dry eye symptom. conclusion: after lasik, the corneal sensitivity and tear secretion are decreased as long as for 6 months. during the postoperative period, 73.6% of the patients had dry eye symptoms. further studies are required to best evaluate the effects on the corneal physiology.
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