RESUMEN
PURPOSE: To evaluate surgical outcomes (recurrence rate, aesthetics and symptoms) of pterygium surgery with two different amniotic membrane preservation approaches - lyophilized (LAM) and cryopreserved (CAM). METHODS: Primary pterygium patients were randomized to either LAM or CAM surgery. Demographic data, ocular surface disease index (OSDI), aesthetic grading (1 to 4), recurrences and complications were recorded over a 6-month follow-up period. RESULTS: Twenty-nine patients were recruited. Recurrence at month 6 was detected in 11 cases (37.9%) and was more prevalent with CAM grafts, without reaching statistical significance (P=0.196). Aesthetic outcome grading showed no differences between LAM and CAM at month 6 (P=0.124). Aesthetic results were mostly unsatisfactory (grade 3 and 4) without statistical differences between groups (P=0.514). Baseline OSDI was similar in both groups (P=0.888), and it significantly decreased by the last follow-up visit (P<0.001) for both the LAM and CAM groups. This decrease did not significantly differ between amniotic membrane preservation approach surgery groups (P=0.714). CONCLUSION: LAM might be considered a legitimate alternative to CAM, showing no inferiority in outcomes, since clinical and aesthetic outcomes were similar for both groups.
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Pterigion , Humanos , Pterigion/cirugía , Amnios/trasplante , Estudios de Seguimiento , Recurrencia , Conjuntiva/trasplante , Resultado del Tratamiento , Trasplante AutólogoRESUMEN
Purpose: To evaluate safety and efficacy of customized central corneal regularization (CCR), together with simultaneous accelerated corneal collagen cross-linking (A-CXL) - CCR-CXL protocol, to treat keratoconus-related corneal ectasia. Design: Retrospective, comparative observational case series. Methods: Patients that had undergone combined CCR-CXL protocol. Main inclusion criteria were keratoconus visual acuity deterioration and contact lens intolerance. All patients underwent complete ophthalmological evaluation, corrected distance visual acuity (CDVA) and Scheimpflug-corneal tomography. Central corneal regularization was performed by ablation using flying spot laser. Subsequently, the stroma was saturated with 0.17% riboflavin-5-phosphate added every 2 minutes, followed by A-CXL 9 mW/cm2 for 10 minutes. CDVA, medium keratometry value (Kmed), and total corneal morphological irregularity index (CMI) of patients were analyzed before surgery and after 1, 3 and 12 months. A P value of .05 or less was considered statistically significant. Results: 46 eyes of 39 keratoconus patients were treated. At 1 month, the mean CDVA (LogMar) increased from 0.19 ± 0.02 to 0.12 ± 0.02 (P < .05), and the difference remained stable at month 12. Kmax decrease was statistically significant from 57.02 ± 5.65 to 50.21 ± 4.48 (P < .05). CMI decreased significantly from 47.8 ± 2.84 to 30.1 ± 2.4 (P < .01). Conclusions: CCR-CXL protocol is safe and effective in arresting keratectasia progression and increasing corneal optic regularity in keratoconus. These findings showed a significant improvement in CDVA, keratometry values and corneal optical aberrations after being treated with the CCR-CXL protocol.
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Queratocono , Fotoquimioterapia , Colágeno , Sustancia Propia/cirugía , Topografía de la Córnea , Reactivos de Enlaces Cruzados/uso terapéutico , Humanos , Queratocono/complicaciones , Queratocono/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Estudios Retrospectivos , Riboflavina/uso terapéutico , Rayos UltravioletaRESUMEN
PURPOSE: To describe the effectiveness and safety of nicergoline in patients with epithelial corneal defect or corneal ulcer due to neurotrophic keratitis (NK). METHODS: A prospective case series review was performed in 14 patients with NK who started treatment with nicergoline as an off-label prescription from January to November 2020. Patients with a epithelial defect or corneal ulcer due to NK were treated with oral nicergoline. RESULTS/SERIAL CASES: Complete corneal healing was observed in 10 (71.4%) of the 14 patients after 25.6 ± 26.60 days (range 7-90) with nicergoline. In three (21.5%) patients wound healing was not achieved, and one patient (7.1%) was lost to follow-up. The mean time between diagnosis and the starting of nicergoline was 10.92 ± 8.85 days (0-28). No adverse effects of nicergoline were observed. CONCLUSION: Nicergoline as an adjunctive treatment for NK showed a potential use in the healing of epithelial defect in real-life clinical practice.
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Úlcera de la Córnea , Nicergolina , Humanos , Úlcera de la Córnea/diagnóstico , Úlcera de la Córnea/tratamiento farmacológicoAsunto(s)
Queratomileusis por Láser In Situ , Miopía , Córnea , Sustancia Propia , Humanos , Láseres de Excímeros , Miopía/cirugíaRESUMEN
INTRODUCCIÓN: El uso de medicamentos citostáticos como la mitomicina C y el 5-fluorouracilo es bien conocido en cirugía filtrante de glaucoma y en el manejo de sus complicaciones, no obstante, existe una falta de información en cuanto a las medidas preventivas a tomar por parte del profesional que maneja este tipo de sustancias. OBJETIVO: Concienciar al profesional sobre los riesgos asociados con el uso de medicamentos citostáticos sin la adecuada prevención. RESULTADOS: Revisión de la bibliografía y legislación disponible sobre medidas preventivas en el manejo de citostáticos en el ámbito médico y oftalmológico. CONCLUSIONES: La prevención y concienciación del profesional cualificado que maneja estas sustancias es la medida más importante para prevenir los posibles riesgos derivados. Es necesaria la coordinación con los equipos de Salud Laboral del Hospital y los profesionales y personal implicados en las distintas fases del proceso, desde la preparación en Farmacia Hospitalaria hasta su eliminación
INTRODUCTION: The use of cytostatic drugs such as Mitomycin C and 5-Fluorouracil is well-known in glaucoma filtering surgery, as well as the management of its complications. However, there is a lack of information regarding the preventive measures to be taken by the professional that handles these types of substances. OBJECTIVE: Raise awareness among professionals of the risks associated with the use of cytostatic drugs without adequate prevention measures. RESULTS: Review of the available literature and legislation on preventive measures in the management of cytostatic drugs in the medical and ophthalmological field. CONCLUSIONS: The prevention and awareness of the risks of the qualified professionals that handle these substances is the most important measure to prevent the possible risks. Coordination is necessary with the Occupational Health teams of the Hospital, as well as the professionals and staff involved in the different phases of the process, from the preparation in Hospital Pharmacy to its elimination
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Humanos , Citostáticos/efectos adversos , Cirugía Filtrante , Glaucoma/cirugía , Exposición Profesional/prevención & control , Personal de Salud , Exposición Profesional/legislación & jurisprudencia , Conocimientos, Actitudes y Práctica en SaludRESUMEN
INTRODUCTION: The use of cytostatic drugs such as Mitomycin C and 5-Fluorouracil is well-known in glaucoma filtering surgery, as well as the management of its complications. However, there is a lack of information regarding the preventive measures to be taken by the professional that handles these types of substances. OBJECTIVE: Raise awareness among professionals of the risks associated with the use of cytostatic drugs without adequate prevention measures. RESULTS: Review of the available literature and legislation on preventive measures in the management of cytostatic drugs in the medical and ophthalmological field. CONCLUSIONS: The prevention and awareness of the risks of the qualified professionals that handle these substances is the most important measure to prevent the possible risks. Coordination is necessary with the Occupational Health teams of the Hospital, as well as the professionals and staff involved in the different phases of the process, from the preparation in Hospital Pharmacy to its elimination.
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Citostáticos/efectos adversos , Cirugía Filtrante , Glaucoma/cirugía , Sustancias Peligrosas/efectos adversos , Enfermedades Profesionales/inducido químicamente , Salud Laboral , Gestión de Riesgos/métodos , Anomalías Inducidas por Medicamentos/etiología , Anomalías Inducidas por Medicamentos/prevención & control , Accidentes de Trabajo/prevención & control , Conjuntivitis/inducido químicamente , Conjuntivitis/prevención & control , Citostáticos/uso terapéutico , Dermatitis Profesional/etiología , Dermatitis Profesional/prevención & control , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/prevención & control , Embalaje de Medicamentos , Contaminación de Equipos , Guías como Asunto , Residuos Peligrosos , Cefalea/inducido químicamente , Cefalea/prevención & control , Humanos , Neoplasias/inducido químicamente , Neoplasias/prevención & control , Enfermedades Profesionales/prevención & control , Exposición Profesional , Salud Laboral/legislación & jurisprudencia , Equipo de Protección Personal , Personal de Hospital , Administración de ResiduosRESUMEN
BACKGROUND AND PURPOSE: The purpose of this study is to compare two alternative methods of collecting and transporting media for the diagnosis of corneal ulcers, as not all clinical settings have conventional culture materials and transport media available. METHODS: In this open-label, prospective, comparative, and randomized study, patients with clinical suspicion of infectious keratitis with high risk of loss of vision had corneal specimens collected using two methods and transport media: Eswab scraping with Amies transport medium and 23-gauge needle scraping in BACTEC Peds broth. The order of each collection method was randomized. The samples were processed by standard methods, comparing the positivity frequencies for both by parametric and nonparametric tests, according to normality criteria. RESULTS: Corneal infiltrates from 40 eyes of 40 patients were analyzed. Culture positivity rate was 50% for Eswab and 35% for 23-gauge needle (P=0.258). The overall growth rate of the two methods combined was not higher than with the swab alone. The results obtained with a swab were not influenced by the collection sequence (P=0.112); however, the positivity rate was significantly higher when the sample taken with the needle was performed first (P=0.046). CONCLUSIONS: The single sample Eswab method of collection and transportation for the diagnosis of high risk corneal ulcers is a valid alternative and can be used in cases in which, for various reasons, there is no access to the full set of traditional culture materials.