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OBJECTIVE: To evaluate the standards of practice of Brazilian cataract surgeons in relation to the protective measures adopted to mitigate the risks of transmission of COVID-19 during cataract surgery, in asymptomatic patients. METHODS: A descriptive, cross-sectional, quantitative paradigm study, developed from a self-administered electronic questionnaire sent to ophthalmologists and residents/specialists in ophthalmology in Brazil, who performed cataract surgeries in 2019 and 2020, connected through social media and mail listing from local societies. RESULTS: Of the 303 participating surgeons, 159 (n=52.2%) performed elective cataract surgeries between March 20th, 2020 to June 1st, 2020. Among the measures adopted by ophthalmologists with the purpose of preventing viral transmission, the patient's temperature was measured by 84.3% (n=134), and the verification of respiratory symptoms and contact/exposure to cases of COVID-19 by 87.4% (n=139). Most did not submit their patients to laboratory tests to detect COVID-19 (145; 91.2%). In surgery, 44.7% (n=71) used an N95 mask, and 69.2% (n=110) kept their patients with a mask. No stage of phacoemulsification was modified in 144 (90.6%) participants, 13 (8.2%) added methylcellulose under the main incision, and two (1.3%), modified another surgical stage. CONCLUSION: The COVID-19 pandemic significantly interrupted part of cataract surgeries in Brazil from March to June 2020 and measures to prevent viral spread are being heterogeneously adopted by surgeons. Understanding these measures could be the first step to improve strategies to return to pre-pandemic levels.
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COVID-19 , Catarata , Catarata/epidemiologia , Estudos Transversais , Humanos , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
ABSTRACT Objective To evaluate the standards of practice of Brazilian cataract surgeons in relation to the protective measures adopted to mitigate the risks of transmission of COVID-19 during cataract surgery, in asymptomatic patients. Methods A descriptive, cross-sectional, quantitative paradigm study, developed from a self-administered electronic questionnaire sent to ophthalmologists and residents/specialists in ophthalmology in Brazil, who performed cataract surgeries in 2019 and 2020, connected through social media and mail listing from local societies. Results Of the 303 participating surgeons, 159 (n=52.2%) performed elective cataract surgeries between March 20th, 2020 to June 1st, 2020. Among the measures adopted by ophthalmologists with the purpose of preventing viral transmission, the patient's temperature was measured by 84.3% (n=134), and the verification of respiratory symptoms and contact/exposure to cases of COVID-19 by 87.4% (n=139). Most did not submit their patients to laboratory tests to detect COVID-19 (145; 91.2%). In surgery, 44.7% (n=71) used an N95 mask, and 69.2% (n=110) kept their patients with a mask. No stage of phacoemulsification was modified in 144 (90.6%) participants, 13 (8.2%) added methylcellulose under the main incision, and two (1.3%), modified another surgical stage. Conclusion The COVID-19 pandemic significantly interrupted part of cataract surgeries in Brazil from March to June 2020 and measures to prevent viral spread are being heterogeneously adopted by surgeons. Understanding these measures could be the first step to improve strategies to return to pre-pandemic levels.
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OBJECTIVE: To compare the efficacy and tolerability of a fixed combination of 0.3% gatifloxacin and 1% prednisolone(ZypredH) versus the individual components used separately (Zymar® and Predfort® ) for infection prophylaxis and inflammation control after cataract surgery with intraocular lens implantation [corrected]. METHODS: A prospective, randomized, double-blind, parallel-group study of 108 patients who underwent phacoemulsification and intraocular lens implantation was conducted. After random assignment, 47 eyes received the fixed combination of topical 0.3% gatifloxacin/1% prednisolone drops, and 61 eyes received the same doses of the individual components as separate solutions four times a day for 15 days. Baseline and postoperative assessments were made on postoperative days 1, 7, 15, and 20. RESULTS: All objective (best corrected visual acuity, sign of active ocular inflammation, central and incisional corneal edema, the number of cells per high-power field in the anterior chamber, and intraocular pressure) and subjective (eye pain, photophobia, burning sensation, itching, and foreign body sensation) criteria of efficacy were similar in both groups, with no significant differences. Group I included 47 eyes that received the fixed combination of gatifloxacin/prednisolone acetate eye drops and a placebo eye drop solution. Group II included 61 eyes that were treated with 0.3% gatifloxacin and 1% prednisolone acetate eye drops separately. The intraocular pressure was slightly higher in Group II (p<0.05). CONCLUSION: Treatment with the fixed-dose combination of gatifloxacin/prednisolone eye drops was as effective as the non-fixed combination in preventing infection and controlling inflammation after phacoemulsification and intraocular lens implantation.
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Antibacterianos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Endoftalmite/prevenção & controle , Fluoroquinolonas/administração & dosagem , Facoemulsificação/métodos , Prednisolona/análogos & derivados , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Gatifloxacina , Humanos , Pressão Intraocular , Implante de Lente Intraocular/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Prednisolona/administração & dosagem , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Acuidade VisualRESUMO
OBJECTIVE: To compare the efficacy and tolerability of a fixed combination of 0.3% gatifloxacin and 1% prednisolone (Zypred®) versus the individual components used separately (Zypred® and Predfort®) for infection prophylaxis and inflammation control after cataract surgery with intraocular lens implantation. METHODS: A prospective, randomized, double-blind, parallel-group study of 108 patients who underwent phacoemulsification and intraocular lens implantation was conducted. After random assignment, 47 eyes received the fixed combination of topical 0.3% gatifloxacin/1% prednisolone drops, and 61 eyes received the same doses of the individual components as separate solutions four times a day for 15 days. Baseline and postoperative assessments were made on postoperative days 1, 7, 15, and 20. RESULTS: All objective (best corrected visual acuity, sign of active ocular inflammation, central and incisional corneal edema, the number of cells per high-power field in the anterior chamber, and intraocular pressure) and subjective (eye pain, photophobia, burning sensation, itching, and foreign body sensation) criteria of efficacy were similar in both groups, with no significant differences. Group I included 47 eyes that received the fixed combination of gatifloxacin/prednisolone acetate eye drops and a placebo eye drop solution. Group II included 61 eyes that were treated with 0.3% gatifloxacin and 1% prednisolone acetate eye drops separately. The intraocular pressure was slightly higher in Group II (p<0.05). CONCLUSION: Treatment with the fixed-dose combination of gatifloxacin/prednisolone eye drops was as effective as the non-fixed combination in preventing infection and controlling inflammation after phacoemulsification and intraocular lens implantation. .
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antibacterianos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Endoftalmite/prevenção & controle , Fluoroquinolonas/administração & dosagem , Facoemulsificação/métodos , Prednisolona/análogos & derivados , Método Duplo-Cego , Combinação de Medicamentos , Pressão Intraocular , Implante de Lente Intraocular/métodos , Estudos Prospectivos , Complicações Pós-Operatórias/prevenção & controle , Prednisolona/administração & dosagem , Fatores de Tempo , Resultado do Tratamento , Acuidade VisualRESUMO
Accurate alignment of a toric intraocular lens (IOL) is a requisite to achieving the intended reduction in astigmatism at the time of cataract surgery. However, it requires a reasonably clear view of the limbal vascular anatomy, which is sometimes altered by chemosis from a subconjunctival anesthetic injection or a hemorrhage. We describe a technique that can quickly restore vascular anatomy and facilitate toric IOL alignment.
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Astigmatismo/cirurgia , Implante de Lente Intraocular/métodos , Lentes Intraoculares , Astigmatismo/complicações , Catarata/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJETIVO: Determinar o efeito de gatifloxacina 0,3 por cento tópica, nas culturas de humor aquoso humano, instilada quatro vezes ao dia por três dias antes de facoemulsificação comparada a uma gota gatifloxacina 0,3 por cento tópica instilada imediatamente antes da cirurgia. MÉTODOS: Trinta e sete pacientes com catarata sem outras afecções oculares foram distribuídos aleatoriamente nos Grupos A e B antes da facoemulsificação. Os pacientes do Grupo A receberam uma gota de gatifloxacina 0,3 por cento imediatamente antes da cirurgia e o Grupo B recebeu gatifloxacina 0,3 por cento quatro vezes ao dia três dias antes do procedimento. Após a facoemulsificação, o humor aquoso foi aspirado e semeado em meios de ágar-sangue, ágar-chocolate, Saboraud e TSB. Foi realizado esfregaço para bacterioscopia. RESULTADOS: O Grupo B apresentou 40 por cento das lâminas bacterioscópicas com cocos gram +. O Grupo B apresentou 17,6 por cento de cocos gram + na bacterioscopia, estes resultados não foram estatisticamente significativos (p=0,098). Cinco casos (25 por cento) do Grupo A apresentaram culturas positivas para Staphylococos epidermidis, resultado significativamente maior do que o Grupo B, que não apresentou nenhuma cultura positiva para bactérias ou fungos. CONCLUSÃO: Neste estudo, a gatifloxacina 0,3 por cento instilada três dias antes da facoemulsificação diminuiu significativamente o número de culturas do humor aquoso positivas quando comparada à instilação imediata de uma gota.
Purpose: To determine the effect on human aqueous humor cultures of topical gatifloxacin 0.3 percent applied four times a day three days before phacoemulsification compared to topical gatifloxaxin 0.3 percent applied and same-day surgery. METHODS: Thirty-seven patients with cataract without other ocular diseases were randomly assigned to Groups A and B before phacoemulsification. Group A received topical gatifloxacin 0.3 percent same-day surgery and Group B received gatifloxacin 0.3 percent four times a day three days before phacoemulsification. After the procedure the aqueous humor was aspirated for cultures on agar-blood, agar-chocolate, saboraud and TSB and smeared for bacterioscopy. RESULTS: Group A presented 40 percent of the bacterioscopies with cocci gram +, Group B presented 17.6 percent of the bacterioscopies with cocci gram +. These results are not statistically significant (p=0,098). Five cases (25 percent) from Group A presented positive cultures for S. epidermidis, which was significantly higher than Group B, which did not present positive cultures for any bacteria or fungus (p=0,027). CONCLUSION: Gatifloxacin 0.3 percent applied three days before phacoemulsification significantly lowered the rate of positive aqueous humor cultures when compared to immediate application of this antibiotic before surgery in this study.
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Humanos , Antibacterianos/administração & dosagem , Bactérias/isolamento & purificação , Humor Aquoso/citologia , Facoemulsificação , Estudos de Casos e ControlesRESUMO
OBJETIVO: O objetivo desse estudo é comparar acuidade visual, sensibilidade ao contraste, velocidade de leitura e a qualidade de vida pós-operatória de pacientes pseudofácicos unilaterais ou bilaterais com lentes intraoculares multifocais ReZoom. MÉTODOS: Estudo comparativo, prospectivo, não aleatório incluindo 38 olhos de 24 pacientes, separados em um grupo com implante bilateral (14 pacientes) e outro com implante unilateral (10 pacientes). O exame oftalmológico completo incluiu acuidade visual não corrigida pré-operatória para perto, intermediário e para longe, acuidade visual com melhor correção, topografia corneal, sensibilidade ao contraste, velocidade de leitura e escala de satisfação realizado 60 dias após a cirurgia. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis, Mann-Whitney e Qui-quadrado. RESULTADOS: Os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação foram semelhante entre os grupos. CONCLUSÃO: Não houve diferença estatística entre os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação entre os grupos.
PURPOSE: The aim of this study is to compare visual acuity, contrast sensitivity, reading speed and quality of life of postoperative pseudophakic patients with unilateral or bilateral ReZoom multifocal intraocular lenses. METHODS: Comparative, prospective, not randomized study including 38 eyes of 24 patients were divided into a group with bilateral implantation (14 patients) and another with unilateral implantation (10 patients). The ophthalmological examination included visual acuity preoperative close, intermediate and far away, best corrected visual acuity, corneal topography, contrast sensitivity, reading speed and level of satisfaction achieved 60 days after surgery. Statistical analysis was performed using the Kruskal-Wallis, Mann-Whitney and Chi-square test. RESULTS: The results comparing visual function, contrast sensitivity, reading speed and scale of satisfaction were similar between groups. CONCLUSION: There was no statistical difference between the results comparing visual function, contrast sensitivity, reading speed and level of satisfaction between the groups.
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Purpose: Compare the OPD-scan results and the contrast sensitivity in patients who had implantation of the AcrySof SN60D3 multifocal IOL, the AcrySof SA60AT spheric monofocal IOL and the AcrySof SN60AT aspheric monofocal IOL. Methods: Thirty-two eyes received the multifocal IOL, 32 eyes received the spheric monofocal IOL and 32 eyes received the aspheric monofocal IOL. They were closely paired in age, sex, pre-operative wavefront analysis and contrast sensitivity. All patients was tested with the OPD-scan aberrometer, ETDRS chart at 100 percent and 9% contrasts and contrast sensitivity. Results: Statistically significant differences were detected more total aberration in SN60AT group (KW = 9.42; p=0.009) when compared to SN60D3 group (p=0.016) and SN60WF group (p=0.0047). The SN60AT group (KW = 16.20; p=0.0003) showed with high spherical aberration values compared to the SN60WF (p=0.00046) and SN60D3 (p=0.0014) group. No significant differences were found between groups in far-distance VA measured using ETDRS at 100% and 9% contrast. The SN60D3 group compared to SN60AT group (p=0.016) had low contrast sensitivity (log units) with statistical difference in 6.0 cpd (KW = 7.84; p=0.0199), but no statistical difference between SN60WF and SN60AT group (p=0.91) and SN60WF and SN60D3 group (p=0.051). The SN60D3 group had low contrast sensitivity performed under mesopic conditions (KW = 10.79; p=0,0045) in 6cpd spatial frequency compared to the SN60AT group (p=0.011) and to the SN60WF group (p=0.007) with statistical significant differences. Conclusion: In all analyzed parameters of OPD-scan aberrometry the aspheric and the multifocal IOLs provided less total and spherical aberrations than spheric IOLs. All IOLs provided an excellent high and low contrasts vision, the multifocal IOL was as good as the spheric and aspheric monofocal IOLs.
Objetivo: Comparar a sensibilidade ao contraste e análise de "wavefront" com OPD-scan em pacientes submetidos a cirurgia de facoemulsificação com implantes de lentes intraoculares AcrySof SN60D3 multifocal, AcrySof SN60WF monofocal asférica e AcrySof SA60AT monofocal esférica. Métodos: Trinta e dois olhos com a lente intraocular multifocal, 32 olhos com a lente intraocular monofocal asférica e 32 olhos com a lente intraocular monofocal esférica. A avaliação oftalmológica foi realizada no primeiro, terceiro, sétimo, e nonagésimo dia pós-operatório. Todos os exames foram padronizados, realizada por um único examinador sob condições controladas de luminosidade fotópicas estabelecidas em 85 cd/m², medida por meio de tabelas de ETDRS, sensibilidade ao contraste e análise de aberrometria com OPD-Scan. Resultados: As médias de aberração total foi superior no grupo SN60AT (KW = 9.42; p=0.009) quando comparada com o grupo SN60D3 (p=0.016) e o grupo SN60WF (p=0.0047). O grupo SN60AT (KW = 16.20; p=0.0003) apresentou superioridade nas medias de aberração esférica comparada com o grupo SN60WF (p=0.00046) e o grupo SN60D3 (p=0.0014). Nenhuma diferença significante foi encontrada na acuidade visual para longe com e sem correção óptica com a tabela de ETDRS a 100% e 9% de contraste. O grupo SN60D3 comparada a SN60AT (p=0.016) apresentou baixa sensibilidade ao contraste em condições fotópicas com diferença estatística a 6.0 cpg (KW = 7.84; p=0.0199), mas sem diferença estatística entre os grupos SN60WF e SN60AT (p=0.91) e entre os grupos SN60WF e SN60D3 (p=0.051). O grupo SN60D3 apresentou baixa sensibilidade ao contraste em condições mesópicas (KW = 10.79; p=0,0045) a 6cpg quando comparada com o grupos SN60AT (p=0.011) e SN60WF (p=0.007). Conclusão: As lentes intraoculares multifocais e asféricas apresentaram menos aberração esférica quando comparadas à lente intraocular esférica, além da prevista multifocalidade sem correção para ...