Complicações da blefaroplastia superior

The blepharoplasty has been performed with great frequency due to the appreciation of aesthetic surgery. The complications related to this procedure are rare. This case report aims to emphasize complications that can occur. T.J.S.P., 45 years old, female, white, resident of Botucatu City, presented dermatocalase bilaterally. We opted to perform upper blepharoplasty bilateral, by removing skin and fat of the upper eyelid. In the postoperative period was observed left eyelid ptosis. We decided to reinsert the levator muscle of the left upper eyelid. One month after the ptosis correction, retraction was observed in both upper eyelid. The patient was then submitted to surgery for the correction of eyelid retraction by disinsertion of the muscle of Muller. Two months after this last surgery, the patient presented right eyelid ptosis and worsening of eyelid retraction to the left. New surgery for correction of the eyelid retraction was made, using free graft sclera for elongation of the left eyelid levator muscle, with good results.The authors presented a patient who underwent a blepharoplasty and developed ptosis in the post-operative period, followed by eyelid retraction. These two possibilities may occur as a complication of blepharoplasty and the surgeon must be careful to handle in an appropriate way, in order to get the result that the patient expects to have.

Aspectos imunogeneticos na pesquisa da etiologia da catarata senil

The immunogenetic study of senile cataract showed that the association with the HLA antigens and Ia antigens suggests an influence of the antigenicity for cataractogenesis, but not a peculiar specificity. However, the investigation of the immunoglobulins in lens suggest that the lens pathology may be produced by antibodies reacting with the lens capsule and consequently interfering with the lens epithelial metabolism, and contributes to the complex mechanism of cataract formation.

Obstrução nasolacrimal congênita - Diagnóstico e tratamento

Patients with congenital nasolacrimal obstruction (CNLO) were evaluated at the Lacrimal Apparatus Service of Botucatu Faculty of Medicine - UNESP from 1990 to 1993. 45 children were seen at this period with CNLO. The diagnosis was confirmed by dacryocystography (DCG). Obstruction was unilateral in 77,7% of the patients; 68,1% at Arlt Sinus and 43,6% had lacrimal sac grade 1. Probing was made in children older than 6 months, under general anaesthesia, after DCG was performed. Cure was greater in children age 6 to 12 months with obstruction at Hasner's Valve and without dilation of lacrimal sac.

FATORES RELACIONADOS COM A OCORRENCIA E EVOLUCAO DAS ENDOFTALMITES

We retrospectively analysed 33 endophthalmitis patients treated at the Faculdade de Medicina de Botucatu. We observed that 81,8% of these patients were males and older than 60 years. Trauma was the main cause of endophthalmitis (42,4%). Endophthalmitis severity can be assessed by the fact there was no improvement on the final visual acuity.

Avaliacao do efeito do diclofenaco de sodio topico sobre a midriase e sintomas oculares apos dilatacao pupilar

The aim of this study was evaluate the effectiveness of the sodium diclophenac on the mydriasis induced by drugs and on the tearing, blepharospasm and photophobia in normal individuals that received mydriatic or cycloplegic eyedrops. We observed that there was not increase of the pupil diameter with the use of the diclophenac (f = 0,52). The photophobia symptom was mainly present in the patients with dark iris and that received the cycloplegic drops (p < 0,01). The authors concluded that there is not benefit in the use of the sodium dyclophenac eyedrops for the mydriasis increase or the decrease of the ocular symptoms in routine ophthalmologic examination.

Efetividade do Argirol e do Povidine no pre-operatorio da catarata

Purpose: The purpose of this study was to evaluate the effectiveness of the Silver Vitelinate and Povidine as antiseptics used before the cataract surgery. Place: Faculdade de Medicina de Botucatu - UNESP. Method: Cultures were taken from the conjuntiva of 30 patients after the use of Silver Vitelinate (15 patients) and Povidine (15 patients) immediately before the cataract surgery. Result: Positive culture was observed in 8 patients that received Silver Vitelinate and 8 that received Povidine. Conclusion: The both antiseptics have the same effectiveness in reducing the microorganisms of the conjunctiva in the cataract preoperative preparation.

Efeito de drogas utilizadas no tratamento de hipertensão arterial sistêmica sobre a pressão intra-ocular: Estudo experimental no cão

Purpose: To study the effects of two drugs (captopril and propranolol) used in the treatment of systemic hypertension, on the intraocular pressure (IOP) of anesthetized dogs. Methods: 24 dogs, divided into 3 groups of 8 each. In the first group, 1.5 mg/kg IV of captopril (an angiotensin converting enzyme inhibitor) was administered. In the second group, 1.5 mg/kg IV of propranolol (a beta-blocker) was administered. The third group was the control. IOP and blood pressure (BP) were measured by manometry. The perfusion pressure was calculated by the difference between BP and IOP (BP-IOP). The parameters were studied at 6 moments (0, 10, 30, 60, 90 and 120 minutes). Results: There was significant reduction of IOP (p<0.05) with captopril and propranolol, without difference between the drugs. With captopril the BP and PP decreased markedly at 10 and 30 minutes. With propranolol there was no reduction of BP or PP. Conclusions: Captopril and propranolol reduced IOP. However, the marked reduction of BP, and consequently of PP caused by captopril may be undesirable for irrigation of the optic nerve.

Trauma dos canalículos lacrimais

Purpose: To evaluate the canalicular trauma causes and the characteristics of the patients in our region. Local: Faculdade de Medicina de Botucatu - UNESP - Botucatu, São Paulo. Method: A retrospective observational study was conducted in a 7 years period evaluating 25 canalicular trauma carriers according gender, occupation, cause and lesion localization, associated structures affected, time to surgical procedure, surgery performed and results with the treatment. Results and conclusion: 68,0% of the patients were male and there is no age prevalence. The car accidents was the most important cause of canalicular trauma. The inferior canaliculus were the most frequently affected. The majority of the patients showed another structure lesioned (eye, eyelid or orbit) and most of patients presented good results with treatment.

Liberação de mitomicina C - Influência de diferentes materiais

Purpose: To evaluate the quantity of Mitomycin C discharged from different materials with the same size, potentially used in the application of this medicine accessible in the surgery center of an Universitarian Hospital. Material and Method: It was studied 20 fragments with 5 to 5mm, from each 5 materials: Lyostypt, Weck sponge, absorbable cloth which is used to clean, cotton plate and of cotton swab concerning the saturation capacity and the quantity of mitomicyn discharged. In the first stage, it was studied the saturation capacity from each material. In the second stage, it was applied 0,1 ml solution of Mitomicyn C (0,5 mg/ml) and it was measured the biggest discharge halo in the filter paper and the discharged quantity (the difference between the weight before and after the medicine discharge). Results: The absorveble capacity from each material varied from 0,144 ml (absorbable cloth) to 0,216 ml Weck sponge. The discharge of Mitomicyn C was varied too, the biggest was the cotton plate and absorbable cloth. The Weck sponge and the cotton (of cotton swab) discharges the same quantity. Conclusion: The different materials discharged different quantities of Mitomicyn C. This can explain the different results of the trabeculectomy with Mitomicyn C. The surveys must inform not only the material used to apply the mitomycin C but the volume used too. Because the same values of mitomycin C liberation, cotton may substitute Weck sponje in trabeculectomy.

Cinedacryocystography in the diagnosis of lacrimal obstruction in children

Purpose: To analyze the cinedacryocystography in children with congenital nasolacrimal obstruction suspicion. Methods: The cinedacryocystographic examination was done in 143 children (58% of girls and 42% of boys) younger than 5 years old, suspected of congenital nasolacrimal obstruction. The exams were done under general anesthesia and the children were probed immediately when obstruction was detected. Results: Epiphora, discharge or both were the most common complaints. Nevertheless 11% children had undergone unsuccessfully probing once, no one had any radiologic evaluation previously. The cinedacryocystographic exam showed nasolacrimal duct obstruction in 65,73%. Permeable lacrimal vies were presented in 34,3% of the children with epiphora. The obstruction was mainly at the Arlt's sinus. Using the cinedacryocystography, it was possible to observe the lacrimal sac enlargement and alterations in the contiguous structures such as hypertrophic turbinates (91,1%), sinusitis (44,6%) and septum deviation (24,1%). Conclusion: Cinedacryocystographic evaluation provides important information about lacrimal system obstruction in children, therefore, it is useful in all children with suspected congenital lacrimal obstruction.

Estudo quantitativo da lágrima pelo teste de fenol vermelho na população brasileira

Purpose: To detect normal values of red phenol thread test in the Brazilian population and compare it between different races, age and sex. Methods: 280 white individuals (560 eyes) and 280 non-white individuals (560 eyes) were analyzed regarding sex and age, and analyzed using the Phenol Red test. Individuals with ocular diseases, contact lens or ocular drug users were excluded from this study. Results: Of the 1,120 evaluated eyes, the mean ± standard deviation result was 19,77±7,90 mm. Conclusion: The mean result found in this study was an intermediate value compared to the previously studied populations (Japanese and American).

Obstrução nasolacrimal congênita - Diagnóstico e tratamento

This article assembled the congenital lacrimal obstruction according embryology, clinical presentation, propedeutic exams and other differential anomalies.

Lesões epiteliais malignas da conjuntiva e recidiva tumoral - Estudo retrospectivo

Purpose: To evaluate the conjunctival epithelial malign lesions carriers and the recurrence rate using exeresis and radiotherapy. Methods: A retrospective study was conducted observing 52 conjunctival epithelial malign lesions carriers treated from 1989 by 2003. The subjects were assessed to evaluation according: age, gender, time of start, classification of the lesion and recurrence rate. The lesion were surgically removed and radiotherapy was indicated when the exeresis was incomplete. Results: The majority of the patients were male, with 61 year old median age, white. The conjunctival squamous carcinoma was presented in 86,5% of the patients. The recidive rate was 11,5%, happened between 1 to 60 month postoperative. Conclusion: according our results the conjunctival epithelial malign lesions were more often observed in older, males and whites. The majority of the patient had conjunctival squamous carcinoma (86,5%). The recidive rate after exeresis and radiotherapy in patients with incomplete exéresis was 11,5%.

Efeito cicloplégico na refração automatizada

Purpose: To show the importance of the cicloplegic method in the refraction evaluation comparing the automated refraction (subjective and objective) and the subjective static refraction. Method: One-hundred patients (200 eyes) between 5 and 40 years were prospectivelly evaluated according the static and dynamic automated refraction and the subjective static refraction, using an automated refractor Nidek ARK - 900. The data were submitted to statical evaluation. Results: The concordance indices were better after cycloplegia mainly in relation of the spheric degree and cílindric axes. Conclusion: Cycloplegia is very important to have accurace in the automated refraction in patients before 40 year-old.