Laura Goldfarb Cyrino, Dillan Amaral, Alexandre Yamada Fujimura Júnior, Bela J Parekh, Marcela Marino de Azeredo Bastos, Giovana de Souza Gaio, Maria Antônia Torres Arteche, Amanda Souza do Nascimento, Vitor Expedito Alves Ribeiro, Jaime Guedes, Marianna Almeida Hollaender
{"title":"Perioperative subconjunctival steroid injection in dropless cataract surgery: a systematic review and meta-analysis.","authors":"Laura Goldfarb Cyrino, Dillan Amaral, Alexandre Yamada Fujimura Júnior, Bela J Parekh, Marcela Marino de Azeredo Bastos, Giovana de Souza Gaio, Maria Antônia Torres Arteche, Amanda Souza do Nascimento, Vitor Expedito Alves Ribeiro, Jaime Guedes, Marianna Almeida Hollaender","doi":"10.5935/0004-2749.2024-0394","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0394","url":null,"abstract":"<p><p>The advantages and disadvantages of using perioperative subconjunctival steroid injections in dropless cataract surgery continue to be debated. A systematic review of PubMed, EMBASE, and the Cochrane Central database identified five studies-two randomized controlled trials and three non-randomized studies-encompassing 70,751 eyes. Among these, 12,319 eyes (17.4%) received subconjunctival steroid injections, while 58,432 eyes (82.6%) were managed with topical steroids. The Cochrane Collaboration's RoB 2 tool was applied for bias assessments in randomized controlled trials, and heterogeneity was assessed using the I² statistics. No statistically significant differences were found between the two groups regarding macular edema (p=0.249), visual acuity (p=0.73), or laser flare count (p=0.45). Both subconjunctival injections and topical steroids demonstrated comparable efficacy and safety in controlling postoperative inflammation after cataract surgery. Additional research is warranted to validate these conclusions.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240394"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of screen use on tear breakup time: associations with ophthalmological factors and break frequency in office workers.","authors":"Berire Şeyma Durmuş Ece, İremnur Altındaş","doi":"10.5935/0004-2749.2025-0083","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0083","url":null,"abstract":"<p><strong>Purpose: </strong>To examine how ophthalmological features, screen exposure duration, and break habits among office employees affect ocular surface parameters.</p><p><strong>Methods: </strong>This single-center cross-sectional study involved two assessments on the same day: one before and one after a visual display terminal task. During the initial assessment, information on screen use was gathered, and refractive error, anterior segment examination, tear breakup time, and Schirmer test measurements were conducted. Participants tracked their screen usage and break durations throughout the day. At the end of the workday, tear breakup time and Schirmer I tests were repeated. Baseline and follow-up results were compared, and regression analysis was performed to identify factors linked to tear breakup time reduction.</p><p><strong>Results: </strong>The study enrolled 60 female office employees. Their mean screen time was 269.26 ± 70.21 min, with an average break duration of 151.93 ± 46.24 min. Tear breakup time at the second assessment (6.38 ± 2.70) was significantly lower than at baseline (8.62 ± 2.73) (p<0.001), whereas Schirmer test scores showed no significant change (p>0.05). Tear breakup time reduction was noted in 54 participants (90.0%), with a significant association between tear breakup time decrease percentage and screen exposure (p=0.001, r=0.463). Regression analysis showed that uncorrected or undercorrected refractive error was an independent risk factor for a ≥30% tear breakup time reduction, while taking more frequent short breaks (<15 min) acted as a protective factor.</p><p><strong>Conclusions: </strong>Taking more frequent short breaks (<15 min) and correcting refractive errors help prevent intra-day tear breakup time decline during visual display terminal use. Structuring breaks to support tear film stability is advisable for occupations that require regular visual display terminal tasks.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250083"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Longitudinal evaluation of corneal stability and tear film changes in first-time soft-contact lens wearers.","authors":"Neşe Arslan, Şule Barman Kakil, Bahar Aydoğdu, Hande Hüsniye Telek","doi":"10.5935/0004-2749.2025-0118","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0118","url":null,"abstract":"<p><strong>Purpose: </strong>Using advanced imaging techniques, this study aimed to evaluate corneal stability, epithelial remodeling, and tear film changes over a one-year period in first-time soft-contact lens wearers.</p><p><strong>Methods: </strong>A retrospective study was conducted on 100 eyes of 50 first-time daily soft-contact lens users aged 21-65 years with no prior rigid gas-permeable lens wear. The Sirius Scheimpflug imaging system was used to assess corneal topography, epithelial thickness, and non-invasive tear break-up time at baseline, 3, 6, and 12 months. Corneal warpage was evaluated using symmetry indices and Baiocchi Calossi Versaci indices. We performed statistical analysis using repeated-measures analyses of variance with Greenhouse-Geisser correction.</p><p><strong>Results: </strong>The mean baseline central corneal thickness was 537.83 (±7.92) µm, with no significant thinning after one year. The average simulated keratometry values remained stable, indicating no progressive corneal steepening or flattening. There were no significant changes in warpage indices over time, suggesting corneal shape preservation. Higher-order aberrations (coma, trefoil, and spherical aberrations) and non-invasive tear break-up time remained unchanged throughout the study period.</p><p><strong>Conclusions: </strong>Modern silicone hydrogel soft-contact lenses do not induce significant corneal warpage, epithelial remodeling, or optical aberrations over a one-year period. We found that corneal morphology and tear film stability were preserved, supporting the safety of soft-contact lens use. These findings provide clinically relevant insights into the long-term impact of contact lens wear. They may facilitate improved lens fitting strategies and preope rative refractive surgery assessments.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250118"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Betânia Calzavara Lemos, Bruno Mendes de Faria, Mariana Botrel Cunha, Frederico de Miranda Cordeiro, Pedro Hélio Estevam Ribeiro Júnior, Ana Luiza Bassoli Scoralick, Fábio Bernardi Daga, Fabio Nishimura Kanadani, Tiago Santos Prata
{"title":"24-Month outcomes of gonioscopy-assisted transluminal trabeculotomy for congenital glaucoma.","authors":"Maria Betânia Calzavara Lemos, Bruno Mendes de Faria, Mariana Botrel Cunha, Frederico de Miranda Cordeiro, Pedro Hélio Estevam Ribeiro Júnior, Ana Luiza Bassoli Scoralick, Fábio Bernardi Daga, Fabio Nishimura Kanadani, Tiago Santos Prata","doi":"10.5935/0004-2749.2024-0309","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0309","url":null,"abstract":"<p><strong>Purpose: </strong>To report the surgical outcomes of patients with primary congenital glaucoma who underwent gonioscopy-assisted transluminal trabeculotomy.</p><p><strong>Methods: </strong>This retrospective, noncomparative, interventional study included consecutive patients with primary congenital glaucoma with uncontrolled intraocular pressure undergoing gonioscopy-assisted transluminal trabeculotomy between January 2017 and January 2020. The included participants were followed up for at least 24 months, and only one surgeon performed all the procedures. The number of glaucoma medications, pre- and postoperative intraocular pressure, treatment extension (in quadrants), surgical complications, and any associated events or interventions were documented.</p><p><strong>Results: </strong>This study included 13 eyes from 10 patients (mean age, 4.5 ± 3.2 years; range, 3 months to 10 years). After a 24-month follow-up, the mean intraocular pressure significantly decreased from 26.1 ± 3.7 to 11.8 ± 2.5 mmHg (p<0.001). The mean number of glaucoma medications was reduced from 3.3 ± 0.5 to 0.85 ± 1.0 (p<0.001). At the end of the follow-up interval, all eyes (13 out of 13) had an intraocular pressure between 7 and 15 mmHg. In 11 of 13 eyes (84.6%), gonioscopy-assisted transluminal trabeculotomy was performed in all quadrants (360º). The most frequent postoperative complication was transitory (self-limited) hyphema (7 out of 13 eyes [53.8%]). No sight-threatening adverse events occurred during the entire follow-up period.</p><p><strong>Conclusions: </strong>The 2-year follow-up results indicated gonioscopy-assisted transluminal trabeculotomy as an efficient and safe option for primary congenital glaucoma treatment with minimal postoperative complications.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240309"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rodrigo Pessoa Cavalcanti Lira, Ana Paula Teles Silveira, Gabriel Rocha Lira, Maria Isabel Lynch Gaete
{"title":"Dose adjustment of intravitreal medications and gases according to axial length and vitreous cavity volume.","authors":"Rodrigo Pessoa Cavalcanti Lira, Ana Paula Teles Silveira, Gabriel Rocha Lira, Maria Isabel Lynch Gaete","doi":"10.5935/0004-2749.2025-0077","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0077","url":null,"abstract":"<p><strong>Purpose: </strong>Standard intravitreal medication dosages are based on an assumed vitreous cavity volume of 4.0-4.5 mL. However, individual variations in vitreous cavity volume may influence both the efficacy and safety of these medications. This study proposes dosage adjustments for intravitreal medications and gases according to axial length and the corresponding vitreous cavity volume.</p><p><strong>Methods: </strong>This descriptive study employed reference guidelines that use axial length to estimate the Axial Length-based Volume of the Vitrectomized Space and the Vitreous Volume EXact table for determining dose adjustments across varying eye sizes. Small eyes (axial length 19-22 mm) have an average vitreous cavity volume of 3.5 mL at an axial length of 20.5 mm; standard-sized eyes (22-25 mm) have 4.8 mL at 23.5 mm; large eyes (25-28 mm) have 6.4 mL at 26.5 mm; and extra-large eyes (28-32 mm) have 8.4 mL at 29.5 mm. The medications considered included anti-infectives, anti-VEGFs, complement inhibitors, recombinant proteases, chemotherapy agents, corticosteroids, and medical gases.</p><p><strong>Results: </strong>Analysis of intravitreal drug concentrations relative to vitreous cavity volume demonstrated notable variability when a standard dose was administered. Small eyes received about 135% of the concentration intended for a standard-sized eye; large eyes received around 75%; and extra-large eyes received under 60%. The recommended dose adjustments are as follows: for small eyes, administer 70-80% of the standard dose; for large eyes, 130-140%; and for extra-large eyes, 170-180%.</p><p><strong>Conclusions: </strong>Tailoring intravitreal drug and gas dosages according to axial length and vitreous cavity volume may enhance intraocular drug distribution, potentially improving both safety and therapeutic outcomes.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250077"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trends in the management of anophthalmic sockets and external ocular prostheses among oculoplastic surgeons: a web-based study.","authors":"Alicia Galindo-Ferreiro, Elvira Martinez-Fernandez, Carolina Pereira Bigheti, Denise Cassia Moreira Zornoff, Hortensia Sanchez-Tocino, Silvana Artioli Schellini","doi":"10.5935/0004-2749.2025-0006","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0006","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the practices employed by oculoplastic surgeons in the assessment and management of anophthalmic sockets and external ocular prostheses.</p><p><strong>Methods: </strong>Oculoplastic surgeons from two countries, who specialized in the management of anophthalmic sockets, participated in a web-based survey. Data collected included demographics, types of surgery, implant use, external ocular prostheses management (including fabrication and cleaning), complications encountered, and follow-up times. The frequencies and distributions of the responses were statistically analyzed.</p><p><strong>Results: </strong>A total of 177 oculoplastic surgeons participated, 113 (63.8%) from Brazil, the remainder from Spain. Evisceration was the preferred surgical procedure of 149 (84.2%) surgeons. The most commonly reported indication for enucleation was a painful blind eye (n=103, 58.1%; both Brazil and Spain, p<0.001). Brazilian surgeons preferred polymethyl methacrylate implants (n=65, 57.5%), while Spanish surgeons favored porous polyethylene implants (n=53, 82.8%; p<0.001). Discharge was the most frequently observed clinical feature during socket evaluation (n=164, 92.6%; p<0.001). Brazilian surgeons recommended daily (n=53, 46.9%) or weekly (n=41, 36.2%) cleaning of exter nal ocular prostheses, while Spanish surgeons more commonly recommended monthly cleaning (n=31, 48.4%; p<0.001). The majority of Brazilian surgeons (n=83, 73.4%) advised patients to remove their external ocular prostheses at night. Only a small number of Spanish surgeons (n=3, 4.6%) suggested this practice (p<0.001). Overall, the follow-up recommendations varied, with 70 (39.5%) surgeons recommending follow-up based on indivi dual case needs, and 59 (33.3%) suggesting annual visits (p<0.001). The primary indications for external ocular prostheses replacement were edge damage (n=75, 42.3%) and loss of volume (n=68, 38.4%). The replacement intervals given typically ranged from 1 to 5 years (n=92, 51.9%; p<0.001).</p><p><strong>Conclusion: </strong>Oculoplastic surgeons in Brazil and Spain demonstrated similar practices in the management of anophthalmic sockets. However, notable differences were observed in the choice of implant materials, cleaning protocols, and recommendations regarding external ocular prostheses removal during sleep.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250006"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camila Mendes Costa Campelo, Fabricio Afonso Borges Silva, Paula Marques Marinho, Diego Casagrande, Allexya Affonso Antunes Marcos, Lincoln Lemes Freitas, Milton Seiyu Yogi, Rubens Belfort Junior
{"title":"Clinical outcomes of quad-loop intraocular lenses: trifocal, bifocal and toric types.","authors":"Camila Mendes Costa Campelo, Fabricio Afonso Borges Silva, Paula Marques Marinho, Diego Casagrande, Allexya Affonso Antunes Marcos, Lincoln Lemes Freitas, Milton Seiyu Yogi, Rubens Belfort Junior","doi":"10.5935/0004-2749.2025-0085","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0085","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess visual outcomes and patient satisfaction following cataract surgery involving the implantation of quad-loop intraocular lenses, including trifocal, bifocal, and toric variants.</p><p><strong>Methods: </strong>Information was obtained from both physical and electronic medical records of patients who underwent phacoemulsification cataract surgery with implantation of different intraocular lenses between January 1, 2022, and December 31, 2023. The study included individuals aged over 18 who received bilateral implantation of bifocal, trifocal, or monofocal toric intraocular lenses. Visual acuity was assessed at various postoperative time points using the logMAR scale. Quantitative variables were analyzed using mean and standard deviation.</p><p><strong>Results: </strong>A total of 92 eyes received premium intraocular lenses: 4 bifocal, 32 trifocal, 52 toric monofocal, and 4 trifocal toric lenses. The average preoperative corrected visual acuity was logMAR 0.478 ± 0.259. On the first postoperative day, the average uncorrected visual acuity was logMAR 0.301 ± 0.207. By day 30, 67.4% of eyes achieved uncorrected distance visual acuity of logMAR 0.2 or better. Patient satisfaction was high, with few reports of glare or halos.</p><p><strong>Conclusion: </strong>Quad-loop intraocular lenses-including trifocal, bifocal, and toric models-demonstrated effective improvement in visual acuity and high levels of patient satisfaction. These lenses represent a suitable option for enhancing visual outcomes after cataract surgery. Additional studies with larger cohorts are recommended to confirm these results.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20250085"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcus Vinicius Cardoso de Souza, Alexandre Sampaio Moura
{"title":"Factors associated with professionalism among ophthalmology medical residents.","authors":"Marcus Vinicius Cardoso de Souza, Alexandre Sampaio Moura","doi":"10.5935/0004-2749.2024-0381","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0381","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine factors related to the professionalism of ophthalmology residents.</p><p><strong>Methods: </strong>A cross-sectional study was carried out involving 48 ophthalmology residents in Brazil. Professionalism was assessed using the professionalism mini-evaluation exercise, completed by both preceptors and residents, and the Pennsylvania State College of Medicine Professionalism Questionnaire, completed by the residents. The association between the professionalism score assigned by the preceptor through the professionalism mini-evaluation exercise and various sociodemographic and educational variables was assessed. The correlation between the residents' self-assessment across both instruments and the preceptor's assessments was measured using Spearman's Rho.</p><p><strong>Results: </strong>All 48 residents were included, with equal representation across the 3 years of residency. The majority were female (58.3%) and between 25 and 29 years old (66.7%). The average professionalism score on the professionalism mini-evaluation exercise given by the preceptors was 3.0 (75%). A significant association was found between the year of training and the score in the doctor-patient relationship domain, with first-year residents showing lower scores (p=0.002). Male residents had higher scores in the \"Interprofessional\" domain (p=0.031). Graduates from private medical schools scored higher in both the \"doctor-patient relationship\" (p=0.015) and \"reflective skills\" (p=0.033) domains. Lower interest in professionalism was linked to lower scores in the \"Interprofessional relationships\" (p=0.033) and \"time management\" (p=0.003) domains. A strong correlation was observed between preceptor's professionalism mini-evaluation exercise scores and residents' self-assessed professionalism mini-evaluation exercise scores (r=0.917). However, the correlation between the self-assessed professionalism mini-evaluation exercise and the Pennsylvania questionnaire scores was weak (r=0.226).</p><p><strong>Conclusion: </strong>Professionalism scores among ophthalmology residents were associated with year of training, gender, type of undergraduate education, and level of interest in the topic.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240381"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outcomes and success predictors of micropulse transscleral cyclophotocoagulation in patients with refractory glaucoma.","authors":"Fábio Nishimura Kanadani, Júlia Maggi Vieira, Larissa Fouad Ibrahim, Senice Alvarenga Rodrigues Silva, Syril Dorairaj, Tiago Santos Prata","doi":"10.5935/0004-2749.2024-0340","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0340","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to report the surgical outcomes and success predictors of micropulse transscleral cyclophotocoagulation in eyes with refractory glaucoma.</p><p><strong>Methods: </strong>This was a noncomparative, interventional case series. Patients with refractory glaucomas, defined as eyes with prior incisional glaucoma surgery failure and uncontrolled intraocular pressure, who underwent micropulse transscleral cyclophotocoagulation between March 2017 and June 2021 were enrolled. A minimum follow-up period of 6 months was required. Preoperative and postoperative intraocular pressure, number of hypotensive medications, surgical complications, and any subsequent related events were recorded. Success criteria were as follows: 1) intraocular pressure reduction ≥20% and intraocular pressure ≤18 mmHg; 2) intraocular pressure reduction ≥30% and intraocular pressure ≤15 mmHg. The need for topical hypotensive medications was not considered a failure.</p><p><strong>Results: </strong>Seventy-nine (79) eyes (79 patients; mean age, 57.5 ± 20.6 years) were included. Overall, the median follow-up duration was 12.0 (interquartile interval, 6-24) months, and the mean intraocular pressure was reduced from 22.8 ± 6.8 mmHg to 15.5 ± 5.6 mmHg at the last follow-up visit (p<0.001). The mean number of medications was reduced from 2.8 ± 0.7 to 2.0 ± 1.0 (p<0.01). At 12 months postoperatively, the success rates for criteria 1 and 2 were 54.9% and 49.7%, respectively. Aside from one case of corneal ulcer, which fully resolved with clinical treatment, and two cases of persistent hypotony (with no visual acuity loss during follow-up), no other vision-threatening complications were observed during the postoperative period. The magnitude of intraocular pressure reduction at 1 month (adjusted to preoperative intraocular pressure; HR=1.01; p=0.002).</p><p><strong>Conclusion: </strong>Our findings suggest that micropulse transscleral cyclophotocoagulation is a relatively effective alternative for managing refractory glaucomas, with minor postoperative complications. In addition, the initial intraocular pressure reduction was a statistically significant predictor of 1-year success in patients undergoing micropulse transscleral cyclophotocoagulation.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240340"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Cecília Carvalho Torres, Gerson Gomes da Nóbrega Filho, Analívia Barros da Costa Oliveira, Ciro Arruda Câmara Virgolino, Camila V Ventura
{"title":"Chemical ocular trauma outbreak caused by cosmetic hair braiding and modeling ointments in Brazil.","authors":"Ana Cecília Carvalho Torres, Gerson Gomes da Nóbrega Filho, Analívia Barros da Costa Oliveira, Ciro Arruda Câmara Virgolino, Camila V Ventura","doi":"10.5935/0004-2749.2024-0321","DOIUrl":"https://doi.org/10.5935/0004-2749.2024-0321","url":null,"abstract":"<p><strong>Purpose: </strong>To report the ophthalmological signs, symptoms, and clinical management observed during an unprecedented outbreak of chemical ocular injuries related to cosmetic hair ointments in Brazil.</p><p><strong>Methods: </strong>This descriptive, cross-sectional study reviewed medical records of patients treated at the emergency center of Fundação Altino Ventura for chemical ocular trauma associated with cosmetic hair ointment use between February 2022 and February 2023. Records with incomplete medical information were excluded.</p><p><strong>Results: </strong>The study included 168 patients (95.2% [n=160] female), with a mean age of 30.8 ± 9.7 years. The most frequently reported symptoms at presentation were pain (167/168, 99.4%) and photophobia (92/168, 54.8%). Severe pain was reported by 137 patients (80%). Keratitis was present in 280 of 336 eyes (83.3%), conjunctival hyperemia in 256 eyes (76.4%), and corneal abrasions in 174 eyes (51.8%). A decrease in visual acuity (worse than 20/25) was documented in 18.5% (31/168) of cases. Lubricants, antibiotics, and re-epithelialization ointments were prescribed to 64.8% (109/168) of the patients. Topical corticosteroids and oral vitamin C were administered to 34% (57/168) and 1.2% (2/168) of patients, respectively. Followup visits were required in 19% (33/168) of cases.</p><p><strong>Conclusion: </strong>The outbreak of chemical ocular injuries linked to cosmetic ointments used for braiding and hair modeling in Brazil was marked by intense ocular pain, conjunctival hyperemia, keratitis, and corneal abrasions. Most patients were treated with lubricants, antibiotics, and re-epithelialization ointments, although approximately one-fifth required followup care, and one-third received additional treatment with either topical corticosteroids and/or oral vitamin C.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"88 6","pages":"e20240321"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}