RESUMO
Los cuerpos extraños constituyen la segunda forma más común de traumatismos corneales. Pueden localizarse superficiales o intracorneales. Se realiza presentación de caso de paciente con cuerpos extraños intracorneales retenidos de 34 años de evolución secundario a trauma por onda expansiva, con el objetivo de mostrar los hallazgos clínicos y resultados por pruebas diagnósticas como la microscopía confocal corneal, frente de onda corneal por topografía y microscopía especular. La presencia de cuerpos extraños intracorneales en este paciente provocó respuestas en el tejido corneal en dependencia de su composición, nivel de profundidad; evidentes a pesar de tiempo de retención. La presencia de estos induce niveles altos de aberraciones corneales que dependen del grado de afectación(AU)
Foreign bodies are the second most common form of corneal trauma. They can be superficial or intracorneal. A case of a patient was presented, with retained intracorneal foreign bodies of 34 years of secondary evolution due to blast wave trauma. The objective is to show the clinical findings and results of diagnostic tests such as corneal confocal microscopy, corneal wavefront topography and specular microscopy. The presence of intracorneal foreign bodies in this patient provoked responses in the corneal tissue depending on its composition, depth level; evident in spite of retention time. The presence of intracorneal foreign bodies induces high levels of corneal aberrations depending on the degree of involvement(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Corpos Estranhos no Olho , Microscopia Confocal/métodos , Lesões da CórneaRESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Lesões da Córnea/complicações , Lesões da Córnea/diagnóstico , Lesões da Córnea/terapia , Qualidade de Vida , Acuidade Visual , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos LongitudinaisRESUMO
PURPOSE: To evaluate the performance of full-thickness (FT) versus partial-thickness (PT) sutures in a full-thickness corneal wound in an animal model. METHODS: This is a prospective, experimental, comparative, longitudinal study. A 6-mm linear, full-thickness corneal incision was performed on the right eye of eight domestic pigs. Eyes were randomly assigned for repair with interrupted PT (80-90% depth) sutures or FT 10-0 nylon sutures. Anterior segment OCT, corneal pachymetry and clinical photographs were obtained 1, 4 and 8 weeks postoperatively. Corneal thickness, depth of suture placement, perilesional edema, coaptation of wound edges and complications were noted. Histopathologic examination was performed at 8 weeks. RESULTS: 100% of the eyes with FT sutures developed a linear, less opaque scar. 100% of the eyes with PT developed a dense, opaque stromal scar (p = 0.02). Vascularization of the cornea was present in 75% of PT group and 25% in the FT group (p = 0.50). As the corneas healed, there was a marked trend toward thicker corneas in the PT group versus FT group with a median difference of - 63 µm at week 1 [median 788 µm vs. 725 µm, (p = 0.11)], - 38 µm at week 4, (724 µm vs. 686 µm, (p = 0.63)) and - 47 µm median difference at week 8 with (670 µm vs. 623 µm, (p = 0.06)). Histopathology showed disorganization of the collagen fibers and the formation of a retrocorneal fibrous membrane in the PT group. CONCLUSIONS: The FT group presented less corneal edema at week 8 with a more linear and less opaque scar. Histopathology showed a better-organized scar and endothelialization without the formation of a fibrous membrane.
Assuntos
Lesões da Córnea , Animais , Córnea/cirurgia , Estudos Longitudinais , Modelos Teóricos , Estudos Prospectivos , SuturasRESUMO
This is a prospective clinical assay that included six patients who were diagnosed with penetrating corneal injury, traumatic cataract, and posterior segment intraocular foreign body (IOFB). Following anterior segment repair and extraction of traumatic cataract by clear cornea phacoemulsification, a standard 25-gauge transconjunctival pars plana vitrectomy was performed to find and release the IOFB. With active suction using a 25-gauge silicone tipped cannula, the foreign body was retrieved and safely placed in the anterior chamber. After stabilization of the anterior chamber with viscoelastic injection, IOFB extraction through the main phaco incision was easily performed, followed by placement of an intraocular lens. Of the six patients, 66.6% showed a significant improvement of visual acuity. No complications associated directly with the surgical procedure occurred. Our surgical technique is a safe alternative for handling and removing a posterior IOFB. There was no need for a scleral incision.
RESUMO
OBJETIVOS: Identificar los principales factores de riesgo en pacientes con sospecha de úlcera corneal micótica en la provincia Pinar del Río. MÉTODOS: Se realizó una investigación observacional, analítica de tipo caso-control. La información fue obtenida a través de la revisión de historias clínicas de los pacientes que ingresaron en el Servicio de Oftalmología del Hospital Clinicoquirúrgico "Abel Santamaría Cuadrado" con impresión diagnóstica de úlcera corneal micótica en el periodo comprendido entre el 1 de enero de 2004 y el 30 de noviembre de 2007. Se emplearon como variables edad, sexo, ocupación, tipo de lugar de residencia, antecedente reciente de trauma corneal con materia vegetal, trauma corneal, uso de lentes de contacto, uso de esteroides tópicos, enfermedades sistémicas inmunosupresoras, cirugía ocular previa y enfermedades crónicas de la superficie ocular. Se emplearon medidas de frecuencia y asociación. RESULTADOS: Se determinó que la ocupación, el tipo de lugar de residencia y el antecedente de trauma corneal con materia vegetal constituyen posibles factores de riesgo de la úlcera corneal micótica en esa provincia. La frecuencia de la úlcera corneal micótica fue de un 27 por ciento con respecto al total de pacientes ingresados con diagnóstico de úlcera corneal. El sexo más afectado fue el masculino y el grupo etario el de 38 a 57 años. CONCLUSIONES: El antecedente de trauma corneal con materia vegetal, el lugar de residencia rural y las actividades laborales relacionadas con la manipulación directa de plantas constituyeron factores de riesgo de úlcera corneal micótica en los pacientes estudiados. La frecuencia de la úlcera corneal micótica en el estudio se correspondió con el patrón observado en países con clima cálido y húmedo, especialmente cerca del ecuador. La úlcera corneal micótica es más común en hombres en edades laboralmente activas.
OBJECTIVE: To identify the main risk factors in patients suspected of mycotic corneal ulcer in Pinar del Río province. METHODS: An observational and analytical case-control study was conducted. Data were collected from the medical histories of those patients with possible diagnosis of mycotic corneal ulcer, who had been admitted at the Ophthalmology Service of "Abel Santamaría Cuadrado" clinical and surgical hospital from January 1st, 2004 to November 30th, 2007. The variables such as age, sex, occupation, kind of residence place, recent history of corneal trauma caused by vegetable matter, corneal trauma, use of contact lenses, use of topical steroids, immunosuppressive systemic diseases, previous eye surgery and and ocular surface chronic illness were all used . The frequency and association measures were also used. RESULTS: It was determined that occupation, kind of residence place and recent history of corneal trauma with vegetable matter are possible risk factors of mycotic corneal ulcer in the province. The frequency of mycotic corneal ulcer was 27 percent of the total number of patients admitted and diagnosed with that disease. Males were the most affected and the 38-57 y age group as well. CONCLUSIONS: The recent history of corneal trauma caused by the vegetable material, rural place of residence and direct handling of plants at work were those risk factors in the studied patients. The frequency of mycotic corneal ulcer in this study matched that of the pattern seen in those countries with warm and humid climate, particularly near the Equator. Mycotic corneal ulcer is more common in men at working age.