RESUMEN

ABSTRACT This review is intended to describe the therapeutic approaches for corneal blindness, detailing the steps and elements involved in corneal wound healing. It also presents the limitations of the actual surgical and pharmacological strategies used to restore and maintain corneal transparency in terms of long-term survival and geographic coverage. In addition, we critically review the perspectives of anabolic agents, including vitamin A, hormones, growth factors, and novel promitotic and anti-inflammatory modulators, to assist corneal wound healing. We discuss the studies involving nanotechnology, gene therapy, and tissue reengineering as potential future strategies to work solely or in combination with corneal surgery to prevent or revert corneal blindness.(AU)

RESUMO O presente trabalho traz uma revisão das abordagens terapêuticas para a cegueira da córnea. O estudo detalha as etapas e os elementos envolvidos na cicatrização da córnea. Ele mostra as limitações das estratégias cirúrgicas e farmacológicas usadas para restaurar e manter a transparência da córnea em termos de sobrevida a longo prazo e alcance geográfico. As perspectivas dos agentes anabólicos, incluindo vitamina A, hormônios, fatores de crescimento e novos moduladores pró-mitóticos e anti-inflamatórios para auxiliar a cicatrização da ferida na córnea, são revisadas criticamente. Aqui, apresentamos estudos envolvendo nanotecnologia, terapia gênica e reengenharia de tecidos como possíveis estratégias futuras para atuar de maneira isolada ou combinada com a cirurgia da córnea para prevenir ou reverter a cegueira corneana.(AU)

Asunto(s)

RESUMEN

RESUMEN Introducción: En el Hospital General Docente "Dr. Agostinho Neto" se desconocen las características de los pacientes atendidos por herida corneal. Objetivo: Caracterizar la herida corneal en pacientes ingresados en el servicio de Oftalmología del citado hospital en el período de enero de 2014 a julio de 2019. Método: Se realizó un estudio descriptivo, retrospectivo y longitudinal del total de pacientes con este diagnóstico (n=35). Se estudiaron las variables: sexo, edad, procedencia, actividad que realizaba, tipo de herida, complicaciones; tipo de tratamiento y modificaciones de la agudeza visual de acuerdo al tratamiento que aplicó. Resultados: El 80,0 % de los pacientes fueron hombres, tenían entre 19 y 40 años de edad (57,0 %), procedían de áreas rurales (66,0 %) y se dedicaban a actividades laborales (60,0 %). El 91,0 % presentó una herida corneal penetrante. La catarata traumática fue la complicación más frecuente (40,0 %). El 97,0 % de los pacientes recibió tratamiento quirúrgico y sutura de la herida. Antes y después del tratamiento, el 54,0 % y el 40,0 %, respectivamente, de los pacientes presentaron agudeza visual visión cuenta dedos a percepción luminosa. Conclusiones: La herida corneal no es un problema de salud, pero sí interfiere negativamente en la calidad de vida de los perjudicados al afectar la agudeza visual.

ABSTRACT Introduction: Characteristics of the patients treated for corneal wound remain unknown at the Hospital General Docente "Dr. Agostinho Neto". Objective: To characterize the corneal wound in patients admitted to the ophthalmology service of the aforementioned hospital in the period from January 2014 to July 2019. Method: A descriptive, retrospective and longitudinal study of all patients with this diagnosis (n = 35) was carried out. The variables studied were: gender, age, origin, activity carried out at the time of injury, type of wound, complications, type of treatment and modifications of visual acuity, according to the treatment applied. Results: 80.0% of the patients were men, 57.0% were between 19 and 40 years old, 66.0% came from rural areas and 60.0% were engaged in work activities. 91.0% presented a penetrating corneal wound. Traumatic cataract was the most frequent complication (40.0%). 97.0% of the patients received surgical treatment and wound suture. Before and after treatment, 54.0% and 40.0% of the patients, respectively, presented visual acuity, counting finger vision and light perception. Conclusions: Corneal wounds are not a health problem, but it does negatively interfere with the quality of life of those affected by affecting visual acuity.

RESUMO Introdução: No Hospital General Docente "Dr. Agostinho Neto", não se conhecem as características dos pacientes tratados por ferida corneana. Objetivo: Caracterizar a ferida corneana em pacientes internados no serviço de Oftalmologia do referido hospital no período de janeiro de 2014 a julho de 2019. Método: Foi realizado um estudo descritivo, retrospectivo e longitudinal de todos os pacientes com esse diagnóstico (n=35). As variáveis estudadas foram: sexo, idade, procedência, atividade realizada, tipo de ferida, complicações; tipo de tratamento e modificações da acuidade visual de acordo com o tratamento aplicado. Resultados: 80,0% dos pacientes eram homens, tinham entre 19 e 40 anos (57,0%), procediam da zona rural (66,0%) e exerciam atividades laborais (60,0%). 91,0% apresentavam ferida penetrante na córnea. Catarata traumática foi a complicação mais frequente (40,0%). 97,0% dos pacientes receberam tratamento cirúrgico e sutura da ferida. Antes e após o tratamento, 54,0% e 40,0%, respectivamente, dos pacientes apresentavam acuidade visual, visão de contagem de dedos e percepção luminosa. Conclusões: A ferida corneana não é um problema de saúde, mas interfere negativamente a qualidade de vida das pessoas feridas, afetando a acuidade visual.

Asunto(s)

RESUMEN

Eye burns due to the accidental application of pharmacological or nonpharmacological substances packaged in plastic dropper bottles have been described for more than three decades and continue to occur. These burns can cause potentially serious corneal injuries. We report the case of a patient who mistakenly applied salicylic acid to the right eye after confusing it with an eye lubricant, which caused him a severe corneal burn. Fortunately, after aggressive medical and surgical management (including oxygen therapy and amniotic membrane grafting), the visual results were good. We suggest conducting educational campaigns and taking legislative measures in our country to avoid packaging corrosive substances in this type of dropper bottle to reduce the risk of accidental burns.

Las quemaduras oculares por aplicación accidental de sustancias farmacológicas o no farmacológicas envasadas en frascos goteros plásticos, se han descrito desde hace más de tres décadas y siguen ocurriendo. Estas quemaduras pueden causar lesiones potencialmente graves de la córnea. Se presenta el caso de un paciente que se aplicó ácido salicílico en el ojo derecho al confundir el envase con el de un lubricante ocular, lo que le causó una grave quemadura corneal. Afortunadamente, tras un manejo médico y quirúrgico agresivo (incluida oxigenoterapia e injerto de membrana amniótica) los resultados visuales fueron buenos. Se sugiere hacer campañas educativas y adoptar normas en el país para evitar el envase de sustancias corrosivas en este tipo de frascos goteros, con el fin de disminuir el riesgo de quemaduras accidentales.

Asunto(s)

RESUMEN

INTRODUCCIÓN: En lo que a traumatismos se refiere, el ojo es el tercer órgano más afectado después de manos y pies [1]. El trauma ocular constituye una de las principales causas de pérdida de la visión unilateral y determina consecuencias graves en el ámbito psico-social del individuo; siendo la causa más común de ceguera unilateral en la edad pediátrica, principalmente en países en vías de desarrollo [2]. La epidemiología de las lesiones oculares depende de varios factores; como el estilo de vida, el estado socioeconómico y las actividades deportivas y recreativas [2]. Según la Organización Mun-dial de la Salud (OMS), la incidencia anual mundial de traumatismo ocular es de alrededor de 55 millones [1]. Alrededor del 38-52% de todos los casos de urgencias oftálmicas son traumas ocu-lares y el 0.9-1.8% de ellos deben ser ingresados debido a un traumatismo grave [2]. Las lesiones varían desde una pequeña abrasión epitelial de la córnea hasta penetración y ruptura del globo [3]. El desgarro de la córnea, el desgarro de la esclerótica y el daño de la lente son las morbilidades observadas con mayor frecuencia del traumatismo ocular, seguidas de laceración del párpado, prolapso uveal, anomalías de la cámara anterior, desprendimiento de retina y avulsión del nervio óptico [1]. Las lesiones oculares, incluso las de menor importancia, pueden generar importantes cargas económicas por la necesidad de cuidados especiales, la costosa hospitalización, tratamiento y rehabilitación visual [2]. Este artículo presenta un caso clínico de trauma ocular, con pronóstico desfavorable según OTS. Epidemiológicamente entre el 30-40% de las cegueras monoculares son producidas por traumas oculares [2]. Al existir un trauma ocular con herida penetrante, se debe intervenir de forma oportuna en las primeras 24 horas para prevenir complicaciones y mejorar el pronóstico [4].(au)

BACKGROUND: The eye is the third most common organ affected by trauma after hands and feet [1]. Eye trauma is one of the main causes of unilateral vision loss and imposes major social and psychological impact on patients; in fact it is the most common cause of unilateral blindness in pediatric age groups, especially in developing countries [2]. The epidemiology of eye injuries depends on several factors, such as lifestyle, socioeconomic sta-tus, and sports and recreational activities.[2] According to the World Health Organization (WHO), the global annual incidence of eye trauma is around 55 million [1]. About 38-52% of all cases in ophthal-mic emergency rooms are ocular traumas and 0.9-1.8% of them needs to be admitted due to severe trauma [2]. Corneal tear, scleral tear and lens damage are the most frequently observed morbidities of ocular trauma, followed by lid laceration, uveal prolapse, anterior chamber abnormality, retinal detachment and optic nerve avulsion. [1]. Eye injuries, even the minor ones, can result in significant economic burdens due to special care and family costs, the expensive hospital admission, treatment and visual rehabilitation. [2] We present a case report of ocular trauma, with poor prognosis according to OTS. Epidemiologically between 30-40% cases of monocular blindness are caused by eye trauma [2]. In cases of ocular trauma with penetrating injuries, patients should be treated in the first 24 hours to prevent complications and improve the prognosis [4].(au)

Asunto(s)

RESUMEN

A perfuração ocular é considerada uma emergência na oftalmologia veterinária. Ela ocorre quando camadas mais profundas da córnea são lesionadas, levando ao extravasamento dos componentes oculares. O tratamento é cirúrgico e dentre as técnicas existentes, os enxertos conjuntivais pediculados são considerados como procedimentos de eleição. O presente trabalho tem o objetivo de relatar um caso de perfuração corneana na qual realizou-se a técnica de enxerto conjuntival pediculado para recuperação da integridade do globo ocular de um paciente canino. Durante o pós-cirúrgico ocorreu a deiscência de sutura, sendo necessária a realização de uma nova cirurgia, alcançando assim a cicatrização da lesão e a preservação do bulbo ocular acometido.(AU)

Eye perforation is considered an emergency in veterinary ophthalmology. It occurs when deeper layers of the cornea are injured, leading to leakage of eye components. The treatment is surgical and among the existing techniques, pediculated conjunctival grafts are considered as procedures of choice. This paper aims to report a case of corneal perforation in which the pediculated conjunctival graft technique was performed to recover the integrity of the eyeball of a canine patient. During the postoperative period there was suture dehiscence and a new surgery was necessary, thus achieving wound healing and preservation of the affected ocular bulb.(AU)

Asunto(s)

RESUMEN

Se realizó un estudio clínico, prospectivo, intervencionista y comparativo, de 41 pacientes (31 ojos) con diagnóstico de queratitis punteada superficial -seleccionados por muestreo aleatorio simple-, atendidos en el Hospital Infantil Docente Sur Dr Antonio María Béguez César de Santiago de Cuba, desde noviembre del 2016 hasta mayo del 2017, con vistas a demostrar la eficacia del tratamiento tópico con colirio de plaquetas plasmáticas en ellos, para lo cual se conformaron 2 grupos: el A, que recibió tratamiento tópico convencional, y el B con la misma terapia más colirio de plasma rico en plaquetas. Los pacientes tuvieron seguimiento clínico a las dos y cuatro semanas de aplicado el tratamiento. En la mayoría de los pacientes del grupo B el tiempo de cicatrización corneal fue de 7 días y el de curación de 2 semanas; de manera que se demostró la eficacia de este colirio autólogo en la cicatrización corneal, sin riesgo de reacción inmunológica y de bajo costo económico.

A clinical, prospective, interventionist and comparative study of 41 patients (31 eyes) with diagnosis of superficial punctate queratitis -selected by simple random sampling-, assisted in Dr Antonio María Béguez Caesar Southern Teaching Pediatric Hospital in Santiago de Cuba was carried out from November, 2016 to May, 2017, with the objective of demonstrating the effectiveness of the topical treatment of plasmatic platelets in them with eyewash, for which 2 groups were formed: group A with conventional topical treatment, and group B with the same therapy plus eyewash with rich platelets plasm. The patients had clinical follow- up at two and four weeks of having applied the treatment. In most of the patients of group B the time of corneal scaring was of 7 days and that of cure of 2 weeks; so that the effectiveness of this autologous eyewash was demonstrated in the corneal scaring, without risk of immunological reaction and with low economic cost.

Asunto(s)

RESUMEN

PURPOSE: To evaluate the efficacy of mannitol solution as a decontamination agent on the chemical burn of the human corneas. METHODS: Eight donor corneas from an eye bank were exposed to 25µl of 2.5% hydrofluoric acid (HF) solution on a filter paper for 20s. Three eyes were rinsed with 1000ml of mannitol 20% for 15min immediately after removal of the filter paper, 3 other were rinsed with sodium chloride (NaCl) 0.9% (1000ml for 15min) and two eyes were not rinsed. Microstructural changes were monitored in the time domain by optical coherence tomography (OCT) imaging for 75min. RESULTS: NaCl reduced the penetration depth to approximately half the thickness of the cornea at 15min; scattering within the anterior cornea was higher than that for the unrinsed eye. With mannitol, no increased scattering was observed in the posterior part of the corneal stroma within a time period of 1h after rinsing. OCT images revealed low-scattering intensity within the anterior stroma at the end of the rinsing period. CONCLUSION: In eye bank human corneas, mannitol proved to be an efficient agent to decontaminate HF burn.

Asunto(s)

RESUMEN

En la cicatrización de las quemaduras oculares son necesarios los factores de crecimiento endógeno, presentes en el colirio de suero autólogo. Este tratamiento tópico es una terapia efectiva, asequible y segura para estimular la curación de defectos epiteliales, en aquellos casos donde la afectación por el caustico no comprometa la viabilidad celular necesaria para su recuperación, lo que implicaría forzosamente la realización de otras medidas quirúrgicas de soporte o de reconstrucción de la superficie ocular. Se han descrito algunas complicaciones, como el depósito de inmunoglobulinas en la córnea y la presencia de infiltrados periféricos. El tratamiento con suero autólogo es muy bien tolerado y no se han descrito efectos adversos cuando su uso es prolongado (AU)

For the cicatrization of ocular burns endogenous growth factors, present in the autologous serum eye drops, are necessary. This topical treatment is an effective, affordable and safe therapy to stimulate the healing of epithelial defects, in those cases where the damage caused by the caustic does not affect the cell viability needed for its recovery. With no other option, this would entail the running of other surgical measures to support or reconstruct the ocular surface. Some complications have been described, such as the immunoglobulins deposit in the cornea and the presence of peripheral infiltrates. Treatment with autologous serum is very well tolerated and no adverse reactions have been reported when its use is prolonged (AU)

Asunto(s)