RESUMO

Up to 25% of pediatric cataract cases are inherited. There is sparse information in the literature regarding the cost of whole-exome sequencing (WES) for suspected hereditary pediatric cataracts. Molecular diagnosis of suspected hereditary pediatric cataracts is important for comprehensive genetic counseling. We performed a partial economic evaluation with a mixed costing analysis, using reimbursement data and microcosting approach with a bottom-up technique to estimate the cost of using WES for genetic diagnosis of suspected hereditary pediatric cataracts from the perspective of the Brazilian governmental health care system. One hundred and ten participants from twenty-nine families in Rio de Janeiro (RJ) were included. Costs of consumables, staff and equipment were calculated. Two scenarios were created: (1) The reference scenario included patients from RJ with suspected hereditary pediatric cataracts plus two family members. (2) The alternative scenario considered other genetic diseases, resulting in 5,280 exams per month. Sensitivity analysis was also performed. In the reference scenario, the total cost per exam was 700.09 United States dollars (USD), and in the alternative scenario, the total cost was 559.23 USD. The cost of WES alone was 527.85 USD in the reference scenario and 386.98 USD in the alternative scenario. Sensitivity analysis revealed that the largest costs were associated with consumables in both scenarios. Economic evaluations can help inform policy decisions, especially in middle-income countries such as Brazil.

RESUMO

ABSTRACT Purpose: Visual impairment and blindness caused by cataracts are major public health problems. Several factors are associated with an increased risk of age-related cataracts, such as age, smoking, alcohol consumption, and ultraviolet radiation. This meta-analysis aimed to assess the association between body mass index and age-related cataracts. Methods: Studies on weight and age-related cataracts published from January 2011 to July 2020 were reviewed by searching PubMed, Medline, and Web of Science databases. The random-effects and fixed-effects models were used for the meta-analysis, and the results were reported as odd ratios. Results: A total of nine studies were included in the meta-analysis. No correlation was found between underweight and nuclear cataracts (OR=1.31, 95% CI [-0.50 to 3.12], p=0.156). The results of the random-effects model showed that overweight was significantly associated with age-related cataracts and reduced the risk of age-related cataracts (OR=0.91, 95% CI [0.80-1.02], p<0.0001; I2=62.3%, p<0.0001). Significant correlations were found between overweight and cortical, nuclear, and posterior subcapsular cataracts (OR=0.95, 95% CI [0.66-1.24], p<0.0001; OR=0.92, 95% CI (0.76-1.08), p<0.0001; OR=0.87, 95% CI [0.38-1.02], p<0.0001). Significant correlations were found between obesity and cortical, nuclear, and posterior subcapsular cataracts (OR=1.00, 95% CI [0.82-1.17], p<0.0001; OR=1.07, 95% CI [0.92-1.22], p<0.0001; OR=1.14, 95% CI [0.91-1.37], p<0.0001). Conclusion: This finding suggested a significant correlation between body mass index and age-related cataracts, with overweight and obesity reducing or increasing the risk of age-related cataracts, respectively.

RESUMO Objetivo: A deficiência visual e a cegueira causadas pela catarata são um grande problema de saúde pública. Há vários fatores associados a um risco maior de catarata relacionada à idade na população mundial, tais como idade, tabagismo, consumo de álcool e radiação ultravioleta. Esta meta-análise foi realizada para avaliar a associação entre o índice de massa corporal e a catarata relacionada à idade. Métodos: Foi revisada a literatura sobre catarata relacionada a peso e idade publicada de janeiro de 2011 a julho de 2020, através de buscas nos bancos de dados PubMed, Medline e Web of Science. Na meta-análise, foram utilizados modelos de efeito aleatórios e de efeitos fixos e os resultados foram apresentados como razões de chances (OR). Resultados: Um total de 9 estudos foi incluído na meta-análise. Não houve correlação entre ausência de sobrepeso e cataratas nucleares (OR=1,31, IC 95%: -0,50-3,12, p=0,156). Os resultados do modelo de efeitos aleatórios mostraram que o excesso de peso estava significativamente associado a uma redução do risco de catarata relacionada à idade (OR=0,91, IC 95%: 0,80-1,02, p<0,0001, I2=62,3%, p<0,0001). Houve correlações significativas entre o excesso de peso e cataratas corticais (OR=0,95, IC 95%: 0,66-1,24, p<0,0001), nucleares (OR=0,92, IC 95%: 0,76-1,08, p<0,0001) e subcapsulares posteriores (OR=0,87, IC 95%: 0,38-1,02, p<0,0001) relacionadas à idade. Houve correlações significativas entre obesidade e cataratas corticais (OR=1,00, IC 95%: 0,82-1,17, p<0,0001), nucleares (OR=1,07, IC 95%: 0,92-1,22, p<0,0001) e subcapsulares posteriores (OR=1,14, IC 95%: 0,91-1,37, p<0,0001) relacionadas à idade. Conclusão: Estes achados sugeriram uma correlação significativa entre o índice de massa corporal e a catarata relacionada à idade, com o excesso de peso e a obesidade reduzindo e aumentando o risco de catarata relacionada à idade, respectivamente.

RESUMO

Purpose: To determine the energy expenditure in phacoemulsification surgery expressed as cumulative dissipated energy (CDE) among the divide and conquer, ultrachopper-assisted divide and conquer, and phaco-chop techniques for dense cataract removal. Patients and Methods: The clinical data were obtained from the medical charts of dense cataracts patients undergoing routine phacoemulsification employing any of three phaco-fragmentation techniques, including divide and conquer using the Kelman 0.9 mm tip, the ultrachopper tip, and the phaco-chop technique using the Kelman 0.9 mm tip. Cumulated dissipated energy (CDE), longitudinal ultrasound time (UST), and endothelial cell loss were compared among groups at the one-month postoperative. Results: Surgeries from 90 eyes were analyzed, among whom the conventional divide-and-conquer technique group included 30 patients, 32 in the ultrachopper group, and 28 in the phaco-chop technique group. The average CDE in the conventional divide and conquer group was 44.52 ± 23.00, the ultrachopper technique was 43.27 ± 23.18, and 20.11 ± 11.06 in the phaco-chop group. Phaco-fragmentation chop demonstrated significantly lower CDE than the other techniques (p= <0.0001). The phaco-chop technique showed statistically significantly lower CDE when compared to the other two groups (p=<0.0001) with 93.96 ± 39.71 seconds. There were no statistically significant differences in postoperative endothelial cell density between groups (p=0.4916). Conclusion: The use of the phaco-chop technique in hard cataract phacoemulsification represents a lower energy expenditure than divide and conquer and ultrachopper techniques; nevertheless, no differences regarding endothelial density loss were evidenced.

RESUMO

Hereditary hyperferritinemia-cataract syndrome (HHCS) is a rare, frequently misdiagnosed, autosomal dominant disease caused by mutations in the FTL gene. It causes bilateral pediatric cataract and hyperferritinemia without iron overload. The objective of this case series, describing three Brazilian families, is to increase awareness of HHCS, as well as to discuss possible phenotypic interactions with concurrent mutations in HFE, the gene associated with autosomal recessive inheritance hereditary hemochromatosis. Whole-exome sequencing was performed in eight individuals with HHCS from three different families, as well as one unaffected member from each family for trio analysis-a total of eleven individuals. Ophthalmological and clinical genetic evaluations were conducted. The likely pathogenic variant c.-157G>A in FTL was found in all affected individuals. They presented slowly progressing bilateral cataract symptoms before the age of 14, with a phenotype of varied bilateral diffuse opacities. Hyperferritinemia was present in all affected members, varying from 971 ng/mL to 4899 ng/mL. There were two affected individuals with one concurrent pathogenic variant in HFE (c.187C>G, p.H63D), who were also the ones with the highest values of serum ferritin in our cohort. Few publications describe individuals with pathogenic mutations in both FTL and HFE genes, and further studies are needed to assess possible phenotypic interactions causing higher values of hyperferritinemia.

Assuntos

RESUMO

MicroRNAs (miRNAs) are highly conserved, small non-coding RNA molecules (∼21 nucleotides) that regulate numerous biological processes, including developmental timing, hematopoiesis, organogenesis, apoptosis, cell differentiation, and proliferation either by mRNA degradation or translation repression. Since eye physiology requires a perfect orchestration of complex regulatory networks, an altered expression of key regulatory molecules such as miRNAs potentially leads to numerous eye disorders. In recent years, comprehensive progress has been made in demonstrating the precise roles of miRNAs, emphasizing their potential use in diagnostic and therapeutic purposes of chronic human diseases. Thus, this review explicitly illustrates the regulatory roles of miRNAs in four common eye disorders, such as cataract, glaucoma, macular degeneration, and uveitis, and their application in disease management.

RESUMO

Previous studies propose that genetic mutations and post-translational modifications in protein crystallins promote protein aggregation and are considered significant risk factors for cataract formation. The ßB2-crystallin (HßB2C) forms a high proportion of proteins in the human eye lens. Different congenital mutations and post-translational deamidations in ßB2-crystallin have been reported and linked to cataract formation. In this work, we employed extensive all-atom molecular dynamics simulations to evaluate the conformational stability of deamidated and mutated HßB2C. Our results show critical changes in the protein surface and its native contacts due to a modification in the conformational equilibrium of these proteins. The double deamidated (Q70E/Q162E) and single deamidated (Q70E) impact the well compact conformation of the HßB2C. These post-translational modifications allow the exposure of the protein hydrophobic interface, which lead to the exposure of electronegative residues. On the other hand, our mutational studies showed that the S143F mutation modifies the hydrogen-bond network of an antiparallel ß-sheet, unfolding the C-terminal domain. Interestingly, the chain termination mutation (Q155X) does not unfold the N-terminal domain. However, the resultant conformation is more compact and avoids the exposure of the hydrophobic interface. Our results provide valuable information about the first steps of HßB2C unfolding in the presence of deamidated amino acids that have been reported to appear during aging. The findings reported in this work are essential for the general knowledge of the initial steps in the cataract formation mechanism, which may be helpful for the further development of molecules with pharmacological potential against cataract disease.

Assuntos

RESUMO

Cataracts are defined as the clouding of the lens due to the formation of insoluble protein aggregates. Metal ions exposure has been recognized as a risk factor in the cataract formation process. The γ and ß crystallins are members of a larger family and share several structural features. Several studies have shown that copper and zinc ions induce the formation of γ-crystallins aggregates. However, the interaction of metal ions with ß-crystallins, some of the most abundant crystallins in the lens, has not been explored until now. Here, we evaluate the effect of Cu(II) and Zn(II) ions on the aggregation of HßA1, as a representative of the acidic form, and HßB2, as a representative of the basic ß-crystallins. We used several biophysical techniques and computational methods to show that Cu(II) and Zn(II) induce aggregation following different pathways. Both metal ions destabilize the proteins and impact protein folding. Copper induced a small conformational change in HßA1, leading to high-molecular-weight light-scattering aggregates, while zinc is more aggressive towards HßB2 and induces a larger conformational change. Our work provides information on the mechanisms of metal-induced aggregation of ß-crystallins.

Assuntos

RESUMO

Crystallin aggregation in the eye lens is one of the leading causes of cataract formation. The increase in the human γD-crystallin (HγDC) aggregation propensity has been associated with the oligomerization of its partially folded and fully unfolded structure. A recent study demonstrated that the binding of flavonoid morin (MOR) to HγDC inhibits the fibrillation of this protein. In this work, we carry out an exhaustive search for the possible binding site of MOR on HγDC by combining an ensemble docking approach with the Wrap 'N' Shake protocol. In agreement with previous results, we found a potential MOR-binding site in the cleft formed between the N-terminal and C-terminal domains of HγDC. MOR preference for the cleft residues was observed even with the interface-opened intermediate conformers of HγDC. In addition, metadynamics simulations were carried out to corroborate the stabilizing activity of MOR on HγDC structure and to identify the structural regions implicated during the unfolding inhibition. Overall, this study provides relevant insights into the identification of new HγDC aggregation inhibitors.

Assuntos

RESUMO

A previous work has reported a methodology to quantify intraocular scattering using a high sensitivity double-pass instrument with a robust index, the frequency scatter index. The purpose of our study was to evaluate an adaptation of the frequency scatter index for use in clinical double-pass systems. A prospective observational study was carried out in a group of patients with nuclear cataracts (n = 52) and in a control group (n = 11) using conventional double-pass systems. The frequency scatter index and the objective scatter index were used to assess the scattering. The Spearman coefficient was calculated to assess the correlation between both indexes, obtained from the double-pass images. Simultaneous measurements were performed with a double-pass and with a Hartmann-Shack wavefront sensor in the control group. The root-mean-square wavefront error and the full width at half maximum of the double-pass image were used to quantify the residual aberrations introduced by the variations in pupil size and retinal eccentricity. Measurement in eyes with different grades of cataracts shows a strong correlation (ρ = 0.929, p < .0001) between the frequency scatter index and the objective scatter index. A certain degree of correlation was observed between the objective scatter index and the root-mean-square and between the objective scatter index and the full width at half maximum, both for measurements with a different pupillary diameter and with a different retinal eccentricity (p < .05). No relationship was observed between the frequency scatter index and the root-mean-square or between the frequency scatter index and the full width at half maximum (p > .05). We have introduced and evaluated an adaptation of a methodology proposed recently for the measurement of intraocular scattering using the double-pass technique with a robust index, which is less affected by ocular aberrations. The frequency scatter index can be applied to conventional double-pass instruments available in clinical environments.

Assuntos

RESUMO

PURPOSE: To assess the axial length (AL) measurement failure rate using partial-coherence interferometry (PCI) and swept-source optical coherence tomography (SS-OCT) in dense cataracts. As a secondary outcome, the SS-OCT biometry was compared to immersion ultrasound. METHODS: This is a prospective cross-sectional and comparative study. Seventy eyes from 70 patients with dense cataracts were enrolled in this study. Dense cataract was defined according to the Lens Opacities Classification System III (LOCS III) scores equal to or more than NO4, NC4, C4, and P3. The failure rate of AL measurement was evaluated using PCI and SS-OCT. Anterior chamber depth (ACD), lens thickness (LT), and AL measurements obtained by SS-OCT were compared with IUS. RESULTS: AL measurement failure rate with PCI was 68.57% and 21.43% with SS-OCT (P = 0.007). AL measurement was achieved in 69.23% of NO4, 66.6% of P3, and 15.3% of mixed cataracts using PCI, while SS-OCT was achieved in 100% of NO4, NO5, P3, and P5 and 76.9% of mixed cataracts. Cortical cataracts alone did not influence AL measurement. Biometric data of ACD, LT, and AL were statistically different comparing US and SS-OCT with a good correlation of AL. CONCLUSION: SS-OCT significantly improves the rate of successful AL measurements when compared to PCI in dense cataracts. The LOCS III clinical cut-off for the use of SS-OCT ocular biometry may well be up to P4 and NO5.

Assuntos

RESUMO

PURPOSE: To evaluate corneal endothelial health after cataract surgery without viscoelastic substance (VS). METHODS: A prospective, non-randomized, case-series study was developed, and phacoemulsification cataract surgery without VS was performed on 1324 eyes between September 2015 and September 2018. As main outcomes, mean endothelial cell density (ECD) and mean central corneal thickness (CCT) were assessed before surgery and then 6 and 12 months after surgery. Data are summarized as mean, standard deviation (SD), and 95% confidence intervals (CI). RESULTS: A total of 1324 eyes were operated, and 31 were excluded by intraoperative complications. The mean ECD baseline was 2506 cells/mm2 (SD = 215, CI = 2494-2518); 6 months after surgery, it was 2328 cells/mm2 (SD = 213, CI = 2316-2340); and 1 year after surgery, it was 2265 cells/mm2 (SD = 214, CI = 2253-2277). In terms of percentage differences, the mean ECD decrease was 9.4% after 1 year. The mean preoperative CCT was 531.6 µm (SD = 34.8, CI = 529.7-533.5); 6 months after surgery, it was 537.7 µm (SD = 38.2, CI = 535.6-539.8); and 1 year after surgery, it was 537.9 µm (SD = 37.9, CI = 535.8-540.0). The mean CCT increased 1.2% 1 year after surgery. CONCLUSIONS: Phacoemulsification cataract surgery can be completely performed without VS, with very low intraoperative complications. The postoperative ECD and CCT changes occurred primarily during the first 6 months, and the changes decreased during the second semester.

RESUMO

Glaucoma, cataracts, and cognitive decline are most common in older ages. Although cross-sectional studies showed that these disorders are associated, follow-up studies are lacking. To investigate this issue, baseline and follow-up data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were employed. We evaluated participants ≥ 55 years-old at follow-up without diagnosis of dementia, stroke, and other eye conditions except for glaucoma and cataracts. Cognition was evaluated using delayed word recall, verbal fluency, and trail making (version B) tests. Regression models were employed to investigate associations between glaucoma and cognition, adjusted by several confounders. Out of 3,867 participants, 379 and 118 presented cataracts and glaucoma, respectively. Only glaucoma was apredictor of lower verbal fluency (B = -0.23, 95% CI -035 to -012, p< 0.001). Other associations were not significant (ps>0.57). Our results suggest that glaucoma may be related to declining cognition.

Assuntos

RESUMO

Cataract formation is a slow accumulative process due to protein aggregates promoted by different factors over time. Zinc and copper ions have been reported to induce the formation of aggregates opaque to light in the human gamma D crystallin (HγD) in a concentration and temperature dependent manner. In order to gain insight into the mechanism of metal-induced aggregation of HγD under conditions that mimic more closely the slow, accumulative process of the disease, we have studied the non-equilibrium process with the minimal metal dose that triggers HγD aggregation. Using a wide variety of biophysics techniques such as turbidimetry, dynamic light scattering, fluorescence, nuclear magnetic resonance and computational methods, we obtained information on the molecular mechanisms for the formation of aggregates. Zn(II) ions bind to different regions at the protein, probably with similar affinities. This binding induces a small conformational rearrangement within and between domains and aggregates via the formation of metal bridges without any detectable unfolded intermediates. In contrast, Cu(II)-induced aggregation includes a lag time, in which the N-terminal domain partially unfolds while the C-terminal domain and parts of the N-terminal domain remain in a native-like conformation. This partially unfolded intermediate is prone to form the high-molecular weight aggregates. Our results clearly show that different external factors can promote protein aggregation following different pathways.

RESUMO

El número y la complejidad de los procedimientos de diagnóstico e intervencionismo cardiovascular han incrementado de manera significativa, hecho que genera mayor exposición a dosis bajas de radiación ionizante debido a la radiación dispersa por el paciente. El cristalino es una de las estructuras más sensibles a la radiación y las cataratas son la enfermedad ocular más estudiada y frecuente en el personal de la salud ocupacionalmente expuesto a dosis bajas de radiación. La formación de cataratas es un proceso multifactorial y la exposición a la radiación ionizante se ha asociado a opacidades subcapsulares posteriores, que es la forma más común de lesión, seguida por las cataratas corticales. Existen varios estudios que han evaluado los efectos de la exposición ocupacional por radiación ionizante en el cristalino en cardiólogos intervencionistas, comparándolos con controles no expuestos. Concluyen que hay mayor prevalencia de opacidades subcapsulares posteriores en el personal expuesto a radiación ionizante, especialmente en los cardiólogos intervencionistas (por trabajar muy cerca del generador de rayos X), las cuales están relacionadas con la duración de la práctica del intervencionismo cardíaco y disminuyen con el uso regular de los lentes plomados. Lo llamativo de muchos estudios es el bajo uso por parte de los cardiólogos intervencionistas de los elementos de protección radiológica, especialmente gafas y mampara plomada, las cuales han demostrado efectividad en la reducción de la radiación ionizante recibida por el personal de la sala de cateterismo cardiaco.

As the number and complexity of diagnostic and cardiovascular intervention procedures has increased significantly, this has led to a greater exposure to low doses of ionising radiation due to the radiation dispersal by the patient. The crystalline lens is one of the structures most sensitive to radiation, and cataracts are the most studied eye disease, and are common in health staff occupationally exposed to low radiation doses. The formation of cataracts is a process involving many factors, and exposure to ionising radiation has been associated with posterior sub-capsular opacities, the most common form of the injury, followed by cortical cataracts. There are several studies that have evaluated the effects of occupational exposure due to ionising radiation in the crystalline lens in interventionist cardiologists, and comparing them with non-exposed controls. They conclude that there is a higher prevalence of posterior sub-capsular opacities in personnel exposed to ionising radiation, especially in interventionist cardiologists (due to working very near the X-ray generator). These are associated with the duration of the practice of cardiac interventions, and decrease with the regular use of leaded glasses. The low use of radiation protection wear by interventionist cardiologists is highlighted in many studies, especially glasses and a leaded screen, which have shown to be effective in the reduction in the ionising radiation by the staff in the cardiac catheterisation room.

Assuntos

RESUMO

RESUMEN Objetivo: Evaluar el costo en la cirugía de catarata por facoemulsificación bilateral simultánea vs. facoemulsificación bilateral secuencial, con implante de lente intraocular. Métodos: Se realizó un estudio analítico de evaluación económica en 762 pacientes mayores de 50 años, intervenidos de catarata con la cirugía de facoemulsificación bilateral simultánea (grupo I), y 762 pacientes operados de catarata con la cirugía de facoemulsificación bilateral secuencial (grupo II), en el Instituto Cubano de Oftalmología Ramón Pando Ferrer, del año 2014 al 2019. Se evaluaron los costos en recursos humanos, materiales e indirectos, así como los costos totales de ambos grupos después de la intervención quirúrgica, partiendo de la demostración científica de que ambos procedimientos son igualmente eficaces. Resultados: Predominó la edad de 61 a 80 años y el sexo femenino (75 por ciento) en ambos grupos. Los costos unitarios relacionados con los recursos humanos disminuyeron en 1,69 pesos para el grupo I, mientras que los costos totales y unitarios en relación con los recursos materiales fueron similares en ambos grupos. Los costos unitarios indirectos disminuyeron en 3,63 pesos en el grupo I. Finalmente, el costo unitario total para el grupo de cirugía bilateral simultánea resultó 6,19 pesos menor que el de cirugía bilateral secuencial. Conclusiones: La cirugía de catarata por facoemulsificación bilateral simultánea tiene menores costos que la facoemulsificación bilateral secuencial(AU)

ABSTRACT Objective: Evaluate the cost of simultaneous bilateral phacoemulsification cataract surgery vs. sequential bilateral phacoemulsification with intraocular lens implantation. Methods: An analytic economic evaluation was conducted of 762 patients aged over 50 years undergoing simultaneous bilateral phacoemulsification cataract surgery and 762 patients undergoing sequential bilateral phacoemulsification cataract surgery at Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period 2014-2019. Evaluation was performed of costs incurred on human resources and materials, indirect costs, and total costs for the two groups after surgery, starting from the scientific certainty that both procedures are equally effective. Results: The 61-80 years age group and female sex (75 percent) prevailed in both groups. Human resources unit costs decreased 1.69 CUP in group I, whereas material resources total and unit costs were similar in both groups. Indirect unit costs decreased 3.63 CUP in group I. Total unit cost was 6.19 CUP lower in the simultaneous bilateral surgery group than in the sequential bilateral surgery group. Conclusions: Simultaneous bilateral phacoemulsification cataract surgery is more cost-effective than sequential bilateral phacoemulsification(AU)

Assuntos

RESUMO

It is well known that posterior capsule opacification (PCO), one of the most common late postoperative complications of cataract surgery, is mainly caused by proliferation and differentiation of remaining lens epithelial cells (LECs) on the posterior lens capsule. Many authors suggest that alterations induced by the pathophysiology of cataracts, its metabolism and the use of 0.1% trypan blue (TB) must cause some degree of cellular damage on these cells, wicht would help to prevent and/or reduce the incidence of PCO after cataract surgery in humans. Therefore, the aim of this study was to evaluate the expression of cell death markers on LECs of older dogs with diabetic and hypermature cataracts, after capsulorhexis, both using 0.1% TB. Twenty samples collected from 13 dogs of different breeds, with ages varying from 8 to 12 years-old, with diabetic and hypermature cataracts, which had been subjected to phacoemulsification surgery (Phaco) using 0.1% TB for staining were studied. Animals were classified as dogs with diabetic (DC) and hypermature cataracts (HC), and expression of molecular markers for apoptosis and autophagy (caspase-3 and beclin-1) on LECs were obtained by immunofluorescence technique. The expression of caspase-3 and beclin-1 was observed in every studied sample and did not differ between groups. In conclusion, our findings suggest that apoptosis and autophagy processes occur to LECs in older dogs presenting diabetic and hypermature cataracts after Phaco utilizing 0.1% TB. Our results may be helpful to future studies of PCO in post-phacoemulsification surgery patients.(AU)

A opacificação da cápsula posterior da lente do globo ocular é a complicação mais observada após a remoção da lente. Essa patologia é causada principalmente pela proliferação e diferenciação das células do epitélio anterior da lente em sua cápsula posterior. Muitos autores sugerem que alterações induzidas pelo metabolismo e/ou patofisiologia da catarata e o uso do corante de azul de tripan a 0,1% devam causar algum dano a essas células, o que supostamente ajudaria a prevenir e reduzir a incidência de tal complicação em humanos. Este trabalho avaliou a expressão de marcadores de morte celular no epitélio anterior da lente de cães idosos com catarata diabética e hipermadura, após capsulorrexe realizada com o emprego do azul de tripan a 0,1%. Foram estudadas vinte amostras colhidas de treze cães de diferentes raças, com idades variando de oito a doze anos, que apresentavam catarata diabética ou hipermadura e que foram submetidos à facoemulsificação utilizando corante de azul de tripan a 0,1%. Foram designados dois grupos: com catarata diabética (DC) e com catarata hipermadura (HC). A expressão molecular dos marcadores de morte celular por apoptose a autofagia (caspase-3 e beclina-1) no epitélio anterior da lente foi avaliada pela técnica de imunofluorescência. Observou-se que a expressão de caspase-3 e beclina-1 ocorreu em todas as amostras e não foi diferente entre os grupos. Os achados deste estudo sugerem que o processo de morte celular por apoptose e autofagia ocorre no epitélio anterior da lente de cães idosos com catarata diabética e hipermadura submetidos à facoemulsificação com o corante de azul de tripan a 0,1%. Este resultado pode ser útil para estudos futuros da opacidade da cápsula posterior da lente em cães submetidos à facoemulsificação.(AU)

Assuntos

RESUMO

It is well known that posterior capsule opacification (PCO), one of the most common late postoperative complications of cataract surgery, is mainly caused by proliferation and differentiation of remaining lens epithelial cells (LECs) on the posterior lens capsule. Many authors suggest that alterations induced by the pathophysiology of cataracts, its metabolism and the use of 0.1% trypan blue (TB) must cause some degree of cellular damage on these cells, wicht would help to prevent and/or reduce the incidence of PCO after cataract surgery in humans. Therefore, the aim of this study was to evaluate the expression of cell death markers on LECs of older dogs with diabetic and hypermature cataracts, after capsulorhexis, both using 0.1% TB. Twenty samples collected from 13 dogs of different breeds, with ages varying from 8 to 12 years-old, with diabetic and hypermature cataracts, which had been subjected to phacoemulsification surgery (Phaco) using 0.1% TB for staining were studied. Animals were classified as dogs with diabetic (DC) and hypermature cataracts (HC), and expression of molecular markers for apoptosis and autophagy (caspase-3 and beclin-1) on LECs were obtained by immunofluorescence technique. The expression of caspase-3 and beclin-1 was observed in every studied sample and did not differ between groups. In conclusion, our findings suggest that apoptosis and autophagy processes occur to LECs in older dogs presenting diabetic and hypermature cataracts after Phaco utilizing 0.1% TB. Our results may be helpful to future studies of PCO in post-phacoemulsification surgery patients.(AU)

A opacificação da cápsula posterior da lente do globo ocular é a complicação mais observada após a remoção da lente. Essa patologia é causada principalmente pela proliferação e diferenciação das células do epitélio anterior da lente em sua cápsula posterior. Muitos autores sugerem que alterações induzidas pelo metabolismo e/ou patofisiologia da catarata e o uso do corante de azul de tripan a 0,1% devam causar algum dano a essas células, o que supostamente ajudaria a prevenir e reduzir a incidência de tal complicação em humanos. Este trabalho avaliou a expressão de marcadores de morte celular no epitélio anterior da lente de cães idosos com catarata diabética e hipermadura, após capsulorrexe realizada com o emprego do azul de tripan a 0,1%. Foram estudadas vinte amostras colhidas de treze cães de diferentes raças, com idades variando de oito a doze anos, que apresentavam catarata diabética ou hipermadura e que foram submetidos à facoemulsificação utilizando corante de azul de tripan a 0,1%. Foram designados dois grupos: com catarata diabética (DC) e com catarata hipermadura (HC). A expressão molecular dos marcadores de morte celular por apoptose a autofagia (caspase-3 e beclina-1) no epitélio anterior da lente foi avaliada pela técnica de imunofluorescência. Observou-se que a expressão de caspase-3 e beclina-1 ocorreu em todas as amostras e não foi diferente entre os grupos. Os achados deste estudo sugerem que o processo de morte celular por apoptose e autofagia ocorre no epitélio anterior da lente de cães idosos com catarata diabética e hipermadura submetidos à facoemulsificação com o corante de azul de tripan a 0,1%. Este resultado pode ser útil para estudos futuros da opacidade da cápsula posterior da lente em cães submetidos à facoemulsificação.(AU)

Assuntos

RESUMO

El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.

Ocular trauma is a significant problem worldwide. The obj ective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.

Assuntos

RESUMO

Ocular trauma is a signifcant problem worldwide. The objective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.

El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.

Assuntos

RESUMO

The Argentinean Flag Sign is a complication that occurs during capsulorhexis construction, in which the capsulorhexis extends to the periphery due to lens intumescence. Phaco capsulotomy is a technique in which the phacoemulsification tip is used to simultaneously create the initial tear in the anterior capsule and remove a portion of the intumescent lens, thereby debulking and relieving pressure from the lens and capsule, and preventing the Argentinean Flag Sign. A detailed description of the phaco capsulotomy technique is provided, including applications and potential complications.