Arquivos brasileiros de oftalmologia最新文献

{"title":"Comparative retrospective analysis of trabeculectomy with mitomycin C, with and without adjunctive Ologen collagen matrix: Efficacy and safety outcomes.","authors":"Ana Flavia Belfort, Heloisa Andrade Maestrini, Heloisa Helena Abil Russ Giacometti, Aline Domingos Pinto Ruppert, Emilio Rintaro Suzuki Junior, Herika Danielle de Miranda Santos, Alberto Basile Neto, Clarice Freire Dayrell de Souza, Marcos Balbino, Marcelo Jordão Lopes da Silva, Lunna Pires Moreira, Regina Cele Silveira Seixas","doi":"10.5935/0004-2749.2025-0216","DOIUrl":"10.5935/0004-2749.2025-0216","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy and safety of trabeculectomy with mitomycin C, performed with versus without adjunctive Ologen collagen matrix in a multicenter real-world setting.</p><p><strong>Methods: </strong>This multicenter retrospective comparative study included 277 patients (365 eyes) who underwent trabeculectomy with mitomycin C, with or without Ologen, between 2017 and 2022 across five Brazilian centers. Extracted data comprised demographic characteristics, glaucoma subtype, intraocular pressure, number of glaucoma medications, postoperative interventions, complications, and additional surgical procedures. Surgical success was defined using two criteria: (1) intraocular pressure ≤21mmHg with ≥20% reduction from baseline and (2) final intraocular pressure between 6 and 21mmHg. Outcomes were categorized as complete (without medications) or qualified (with medications).</p><p><strong>Results: </strong>Both groups achieved substantial reductions in intraocular pressure and medication burden at 12 months, with high rates of complete and qualified success under both definitions. The Ologen group required fewer suture lysis procedures (49.0% vs. 60.8%; p=0.025), suggesting a modulatory effect on early postoperative fibrosis. Rates of other postoperative interventions, complications, and additional glaucoma surgeries were comparable between groups. Kaplan-Meier analysis demonstrated no significant difference in cumulative success over time.</p><p><strong>Conclusion: </strong>Trabeculectomy with mitomycin C is effective and safe regardless of adjunctive Ologen use. Although Ologen did not confer superior long-term efficacy, its association with reduced suture lysis suggests a potential role in modulating early wound healing.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250216"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683167","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":"Historical underfunding of cataract surgery in Brazil: Impact of a state-level financial incentive on the Public Health System and implications for private health insurance.","authors":"Felipe Augusto Casseb Dos Santos, João Victor Tenório Lossio de Macedo, Daniel Haruo Ishigai, Bernardo Kaplan Moscovici, Ricardo Menon Nosé","doi":"10.5935/0004-2749.2026-0090","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-0090","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20260090"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683137","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":"Evaluation of early retinal microvasculature changes after cardiopulmonary bypass.","authors":"Mehmet Özbaş, Bengi Demirayak","doi":"10.5935/0004-2749.2025-0344","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0344","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate early postoperative changes in retinal microvasculature in patients undergoing cardiopulmonary bypass surgery by comparing preoperative and postoperative measurements of superficial capillary plexus and, deep capillary plexus vessel density, foveal avascular zone area using optical coherence tomography angiography (OCT-A).</p><p><strong>Methods: </strong>This prospective longitudinal study included 38 patients, undergoing cardiopulmonary bypass surgery. Each patient served as their own control optical coherence tomography angiography imaging was performed at four time points: 3 days preoperatively and at postoperative week 1, week 2, and month 1. Vessel densities in the superficial capillary plexus and deep capillary plexuses and the foveal avascular zone area were measured and analyzed. Depending on data distribution repeated measures analysis of variance or the Friedman test was used for statistical analysis.</p><p><strong>Results: </strong>Data from all 38 patients were included in the analysis. A significant increase in overall superficial capillary plexus vessel density was observed following cardiopulmonary bypass surgery (p=0.008). In contrast, deep capillary plexus vessel density did not differ significantly between the preoperative and postoperative assessments. The foveal avascular zone area showed a significant increase at postoperative week 2 compared with baseline (p=0.016).</p><p><strong>Conclusion: </strong>Cardiopulmonary bypass surgery may induce early retinal microvascular alterations, particularly in the superficial capillary plexus and foveal avascular zone. Optical coherence tomography angiography is a noninvasive and reproducible imaging modality that enables precise assessment of subtle retinal vascular changes after major cardiovascular surgery. These findings may contribute to postoperative monitoring and risk assessment in patients undergoing cardiopulmonary bypass.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250344"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683230","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":"Prognostic testing in Brazilian patients with uveal melanoma using 15-gene expression profile and preferentially expressed antigen in melanoma.","authors":"Carolina C Valente, Gustavo R Gameiro, Beatriz K T Oguido, Rodrigo Jorge, J William Harbour, Zelia M Correa","doi":"10.5935/0004-2749.2025-0356","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0356","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the results of the 15-gene expression profile/preferentially expressed antigen in melanoma (15-GEPP) prognostic classifier and associated survival outcomes in a series of Brazilian patients with posterior uveal melanoma.</p><p><strong>Methods: </strong>Patients born and raised in Brazil who were diagnosed with posterior uveal melanoma and underwent fine-needle aspiration biopsy for 15-GEPP prognostic testing using the DecisionDx-Uveal melanoma and DecisionDx-PRAME assays between September 2020 and 2023 were included. All patients were diagnosed and treated by the senior author.</p><p><strong>Results: </strong>Of 236 patients diagnosed with posterior uveal melanoma during the study period, 11 (4.6%) met the inclusion criteria, including six males and five females. Based on 15-GEPP results, seven patients (63.6%) were classified as Class 1 and 4 (36.4%) as Class 2. Preferentially expressed antigen in melanoma (PRAME) expression was negative in six patients (54.6%) and positive in five patients (45.4%). During a mean follow-up of 36.4 ± 17.6 months, five patients developed metastasis: two with Class 2/PRAME-positive tumors, one with Class 2/PRAME-negative tumors, one with Class 1/PRAME-positive tumors, and one with Class 1/PRAME-negative tumors. Three of these patients died. The mean survival after the diagnosis of metastasis was 21.2 months (median: 17.0 months).</p><p><strong>Conclusions: </strong>The proportions of Class 1 versus Class 2 tumors and PRAME-negative versus PRAME-positive tumors as well as the prognostic performance of these biomarkers appear similar in Brazilian patients with posterior uveal melanoma compared with large published cohorts from North America. Further studies with larger Brazilian cohorts are needed to validate these findings.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250356"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683165","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":"Change in pupil diameter after phacoemulsification with intraocular lens implantation.","authors":"Hugo Diehl de Souza, José de Mello Rosatelli Neto, Sofia Cabral Saqueti, Maria Antônia Vicente Camargo, Raíssa Gomes Nunes, Renan Nola Schmoeller, Jefferson Luiz Brum Marques","doi":"10.5935/0004-2749.2026-0010","DOIUrl":"10.5935/0004-2749.2026-0010","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate changes in scotopic pupil diameter before and after cataract surgery performed by phacoemulsification with intraocular lens implantation.</p><p><strong>Methods: </strong>This prospective longitudinal observational study included patients who underwent cataract surgery. Scotopic pupil diameter was measured preoperatively and 30-40 days postoperatively using an automated keratometer after a standardized dark-adaptation period under controlled ambient illumination. Each eye was considered an independent unit of observation. Because some participants contributed both eyes, intraindividual correlation was accounted for using a linear mixed-effects model with random patient intercepts. Time of assessment (preoperative versus postoperative), age, sex, and eye laterality were included as fixed effects.</p><p><strong>Results: </strong>A total of 354 eyes from 251 patients were analyzed. The mean patient age was 69.3±7.2 yr. Mean scotopic pupil diameter decreased from 5.3±0.9mm preoperatively to 4.8±0.8mm postoperatively, representing a mean reduction of 0.5mm (9.4%). In the linear mixed-effects model, cataract surgery was associated with a significant reduction in pupil diameter, with an adjusted mean difference of 0.45mm (95% confidence interval [95% CI], 0.39-0.51; p<0.001). Age (p=0.061), sex (p=0.920), and eye laterality (p=0.152) were not significantly associated with the magnitude of pupil diameter change.</p><p><strong>Conclusion: </strong>Phacoemulsification with intraocular lens implantation was associated with a significant reduction in scotopic pupil diameter, independent of age, sex, and eye laterality. This finding should be considered during preoperative planning, particularly when selecting intraocular lenses whose optical performance depends on postoperative pupil size.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20260010"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683139","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":"Correlation between tear crystallization and corneal esthesiometry in patients with Sjögren's syndrome.","authors":"Karolyna Andrade de Carvalho, Lucas Paolera, Bernardo Kaplan Moscovici, Luiz Antônio Brito, Luiz Felipe Ramos Bueno, Sergio Felberg","doi":"10.5935/0004-2749.2024-0409","DOIUrl":"10.5935/0004-2749.2024-0409","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to look into the relationship between tear film osmolarity, tear crystallization, and corneal esthesiometry findings in Sjögren's syndrome patients.</p><p><strong>Methods: </strong>This cross-sectional observational study included 43 eyes from patients with a confirmed diagnosis of Sjögren's syndrome. Tear osmolarity was measured with an iPen osmometer, tear crystallization was graded using Roland's classification, and corneal sensitivity was evaluated with a Cochet-Bonnet aesthesiometer. Ocular symptoms were assessed using the Ocular Surface Disease Index questionnaire. Patients who had undergone keratoplasty or worn contact lenses within 4 hours of testing were excluded.</p><p><strong>Results: </strong>The cohort's mean tear osmolarity was 292.5±15.0 mOsm/L (median: 293 mOsm/L, IQR: 17.5). There was no significant difference between patients with primary Sjögren's syndrome (mean: 289.4 mOsm/L) and those with secondary Sjögren's syndrome (mean: 294.5 mOsm/L; p=0.413). Tear crystallization patterns were more severe in patients with primary Sjögren's syndrome (mean: 3.25, median: 3.5, IQR: 1.25) than in those with secondary Sjögren's syndrome (mean: 3.19, median: 3.0, IQR: 1.0), though the difference was not statistically significant (p=0.87). Corneal sensitivity was reduced by 3.5±1.7 mm (median: 4.0 mm, IQR: 2.13). Tear crystallization has a significant negative correlation with corneal sensitivity (r=-0.313, p=0.041), suggesting that poorer tear quality leads to decreased corneal sensitivity.</p><p><strong>Conclusion: </strong>Tear crystallization patterns and corneal sensitivity were found to be significantly correlated in Sjögren's syndrome patients. The findings also indicate that systemic medication use may affect tear film quality.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20240409"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683235","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":"Viral infectious characteristics of cornea donors from the Londrina eye bank: a retrospective study and the impact of the COVID-19 pandemic.","authors":"Isadora C José, Ana Paula M T Oguido, Sergio M Borghi, Silvio César S G Filho, Claudia R Morgado, Rodolfo C Feijó, Beatriz I Dos Santos, Beatriz Karine Taba Oguido, Pedro Henrique R Cerqueira, Antônio Marcelo B Casella","doi":"10.5935/0004-2749.2025-0034","DOIUrl":"10.5935/0004-2749.2025-0034","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of the COVID-19 pandemic and characterize the serological profile of discarded corneal donations in the coverage area of the Banco de Olhos de Londrina, through reverse transcription-polymerase chain reaction testing for COVID-19 and serological screening of cornea donors excluded because of positive test results.</p><p><strong>Methods: </strong>This observational retrospective study included 776 cornea donors who's serological and reverse transcription-polymerase chain reaction test results were processed at the Hospital of Universidade Estadual de Londrina between May 2020 and 2022. The number of corneal donations and tissue utilization rates throughout the years of operation of the Banco de Olhos de Londrina were also analyzed.</p><p><strong>Results: </strong>The mean donor age was 53.14 years; 332 donors (43%) were female, and 444 (57%) were male. Positive results were identified in 15.76% of donors for hepatitis B core antibody antibodies, 0.65% for hepatitis B surface antigen, 1.03% for hepatitis C antibodies, and 0.52% for human immunodeficiency virus and human T-lymphotropic vírus. Positive reverse transcription-polymerase chain reaction results for SARS-CoV-2 were observed in 2.7% of cases. Older adults were 2.6 times more likely to test positive for SARS-CoV-2 (95% CI, 1.06-6.34) and 3.0 times more likely to test positive for hepatitis B core antibody (95% CI, 1.95-4.41) than younger individuals. A 75.2% reduction in corneal donations was observed in 2020 compared with 2019, accompanied by a 5% increase in tissue utilization, possibly associated with the effectiveness of donor screening during the pandemic.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic had a profound impact on the number of corneal transplants worldwide, in Brazil, and at the Banco de Olhos de Londrina because of the substantial decline in donations during this period. Hepatitis B was the leading cause of corneal tissue discard due to positive serology in both this study and previous reports, highlighting the importance of prevention programs and improved vaccination coverage. Strict legislation, comprehensive serological screening, and appropriate processing of donated tissue remain essential to eliminate potential sources of infection and ensure transplantation safety.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250034"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683213","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":"Unusual intraoperative separation of the trabecular meshwork during gonioscopy-assisted transluminal trabeculotomy.","authors":"Mireia Cucurull-Martí, Paula García-Valentín, Jaime Rigo-Quera","doi":"10.5935/0004-2749.2026-0116","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-0116","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20260116"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683183","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":"Corneal tomography in children and adolescents with systemic allergy.","authors":"Kishankumar Mahida, Snehal Rajendra Jagtap","doi":"10.5935/0004-2749.2026-0022","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-0022","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20260022"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683178","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":"Clinical presentation and management outcomes of congenital dacryocystocele: a retrospective study.","authors":"Gülistan Oyur, Muhammed Mustafa Mazlum, Fatma Savur","doi":"10.5935/0004-2749.2025-0373","DOIUrl":"https://doi.org/10.5935/0004-2749.2025-0373","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the clinical factors associated with dacryocystitis and the need for surgical intervention in infants with congenital dacryocystocele.</p><p><strong>Methods: </strong>This retrospective study included 26 infants diagnosed with congenital dacryocystocele and divided them into two groups: complicated-congenital dacryocystocele (with dacryocystitis or preseptal cellulitis) and uncomplicated-congenital dacryocystocele (without infection). Demographic and perinatal characteristics such as age at diagnosis, gender, birth weight, gestational age, delivery method, and laterality were compared between the groups. For an uncomplicated-congenital dacryocystocele, treatment included conservative management and intravenous antibiotics, followed by probing with intraoperative nasal endoscopy and endonasal marsupialization for a complicated-congenital dacryocystocele.</p><p><strong>Results: </strong>Of the 26 infants, 14 (53.8%) had complicated-congenital dacryocystocele, while 12 (46.2%) had uncomplicated-congenital dacryocystocele. There were no significant differences between the groups in terms of demographic or perinatal characteristics (p>0.05). Surgical intervention was necessary for all complicated-congenital dacryocystocele cases (100%) and two uncomplicated-congenital dacryocystocele cases (16.7%; p<0.001). During a 6-month median follow-up period, all patients demonstrated complete clinical recovery with no intraoperative complications.</p><p><strong>Conclusion: </strong>In conclusion, approximately half of infants with congenital dacryocystocele developed infection-related complications. While perinatal factors were similar across groups, infectious presentation was linked to the need for surgical intervention. These findings suggest that early detection, prompt conservative management, and close follow-up can help reduce the risk of dacryocystitis and the need for surgery.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 4","pages":"e20250373"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683198","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}