Arquivos Brasileiros De Oftalmologia[JOURNAL]
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200 papers
Myopia control strategies: a survey of Brazilian ophthalmologists.
Moraes RFCM, Gracitelli CPB, Nakanami CR … +1 more , Rossetto JD
Arq Bras Oftalmol · 2026 · PMID 41779495 · Publisher ↗
PURPOSE: This study aimed to identify the strategies adopted by Brazilian ophthalmologists to control myopia in clinical practice. METHODS: This was a prospective cross-sectional study. Data were collected using an onlin...
PURPOSE: This study aimed to identify the strategies adopted by Brazilian ophthalmologists to control myopia in clinical practice. METHODS: This was a prospective cross-sectional study. Data were collected using an online questionnaire. RESULTS: Responses from 148 participants were collected between March and May 2024. The majority of respondents were general ophthalmologists (51%) and pediatric ophthalmologists (43%). They came from all regions of Brazil, but more than half (52%) were from the Southeast region. Most participants (30%) had over 20 years of clinical practice experience. A significant proportion (89.2%) treated progressive myopia. The most requested complementary exams were optical biometry (83.78%) and corneal topography or tomography (69.59%). Behavioral measures were considered the most effective myopia treatment strategies by 41.2% of the respondents, followed by optical (33.8%) and pharmacological interventions (25%). Most recommended spending more time outdoors (94.59%) and reducing screen time (93.92%). Spectacle lenses for myopia (83.11%) and 0.025% atropine eye drops (54.73%) were the most prescribed treatments after the recommendation of environmental and behavioral changes. CONCLUSION: This study presents a novel analysis of the clinical strategies for myopia control among Brazilian ophthalmologists. Understanding current clinical practices and identifying possible improvements are essential steps toward developing evidence-based guidelines and professional education aimed at improving patient care.
Beyond pressure control: Periorbital impact of prostaglandins vs. laser trabeculoplasty.
Leivas L, Procianoy F, Almeida RC … +6 more , Pakter MM, Fabris MV, Lindenmayer RL, Lavinsky F, Lavinsky D, Pakter HM
Arq Bras Oftalmol · 2026 · PMID 41779494 · Publisher ↗
PURPOSE: To assess the one-year impact of prostaglandin analog (travoprost) on periorbital appearance and lower eyelid horizontal tension, compared with the contralateral eye treated with Pascal selective laser trabeculo...
PURPOSE: To assess the one-year impact of prostaglandin analog (travoprost) on periorbital appearance and lower eyelid horizontal tension, compared with the contralateral eye treated with Pascal selective laser trabeculoplasty. METHODS: This nested case-control study was derived from a non-inferiority randomized clinical trial comparing Pascal selective laser trabeculoplasty efficacy with travoprost in fellow eyes over 12 months. One eye received daily travoprost, while the contralateral eye underwent Pascal selective laser trabeculoplasty. Lower eyelid horizontal tension was measured using a validated digital imaging method, and prostaglandin-associated periorbitopathy signs were graded by masked observers. Statistical analyses included generalized estimating equations and the Mann-Whitney U test for nonparametric data, with p<0.05 considered significant. RESULTS: Ten patients met the inclusion criteria for this subanalysis. Travoprost-treated eyes had significantly lower mean lower eyelid distension compared with Pascal selective laser trabeculoplasty-treated eyes (4.32 mm vs. 5.02 mm; mean difference: 0.70 mm; p<0.001). Prostaglandin--associated periorbitopathy scores were significantly higher in the travoprost group, reflecting more pronounced changes in ptosis, periorbital hyperpigmentation, and eyelid retraction. CONCLUSIONS: Chronic use of prostaglandin analogs is associated with notable periorbital changes and increased lower eyelid tension, potentially affecting aesthetics and ocular function. Pascal selective laser trabeculoplasty may offer a safer profile for preserving periorbital anatomy while maintaining effective intraocular pressure control. Laser trabeculoplasty should be considered as an initial treatment when appropriate to minimize cosmetic and functional changes from chronic topical therapy.
Performance of generative large language models in answering questions from the Brazilian Retina and Vitreous Society certification exam.
Faneli AC, Oliveira RDC, Nakayama LF … +3 more , Torres RA, Muccioli C, Regatieri CVS
Arq Bras Oftalmol · 2026 · PMID 41779493 · Publisher ↗
PURPOSE: Natural language models and chatbots, particularly OpenAI's Generative Pre-Trained Transformer architecture, have transformed human interaction with digital interfaces. The latest versions, including ChatGPT-4o,...
PURPOSE: Natural language models and chatbots, particularly OpenAI's Generative Pre-Trained Transformer architecture, have transformed human interaction with digital interfaces. The latest versions, including ChatGPT-4o, offer enhanced functionalities compared to their predecessors. This study evaluates the accuracy of ChatGPT-4, ChatGPT-4o, and Claude 3.5 Sonnet in answering questions from the Brazilian Retina and Vitreous Society certification exam. METHODS: We compiled 200 multiple-choice questions from the Brazilian Retina and Vitreous Society 2018 and 2019 exams. Questions were categorized into three domains: Anatomy and Physiology of the Retina, Retinal Pathology, and Diagnosis and Treatment. Using a standardized prompt developed according to prompt design guidelines, we tested ChatGPT-4, ChatGPT-4o, and Claude 3.5 Sonnet, recording their first responses as final. Three retina specialists performed a qualitative analysis of the answers. Accuracy was determined by comparing responses to the official correct answers. Statistical analysis was conducted using chi-square tests and Cohen's Kappa. RESULTS: Claude 3.5 Sonnet achieved the highest overall accuracy (72.5%), followed by ChatGPT-4o (66.0%) and ChatGPT-4 (55.5%). Claude 3.5 Sonnet and ChatGPT-4o significantly outperformed ChatGPT-4 (p<0.01 and p=0.03, respectively), while no significant difference was observed between Claude 3.5 Sonnet and ChatGPT-4o (p=0.16). Model responses agreed 74.5% of the time, with a Cohen's κ of 0.47. Retinal Pathology was the best-performing domain for all models, whereas Anatomy and Physiology of the Retina and Diagnosis and Treatment were the weakest domains for Claude 3.5 Sonnet and ChatGPT-4, respectively. CONCLUSIONS: This study is the first to assess Claude 3.5 Sonnet, ChatGPT-4, and ChatGPT-4o in retina specialist certification exams. Claude 3.5 Sonnet and ChatGPT-4o significantly outperformed ChatGPT-4, highlighting their potential as effective tools for studying retina specialist board exams. These findings suggest that the enhanced functionalities of Claude 3.5 Sonnet and ChatGPT-4o offer substantial improvements in medical education contexts.
Kahook Dual-Blade goniotomy combined with phacoemulsification in primary open-angle glaucoma patients: long-term results.
Correia ALO, Holanda BS, Costa VP … +1 more , Vasconcelos JPC
Arq Bras Oftalmol · 2026 · PMID 41637374 · Publisher ↗
PURPOSE: Glaucoma is a chronic and progressive disease that requires long-term treatment and continuous monitoring. The Kahook Dual Blade, a device used to perform goniotomy in adults, is designed to improve intraocular...
PURPOSE: Glaucoma is a chronic and progressive disease that requires long-term treatment and continuous monitoring. The Kahook Dual Blade, a device used to perform goniotomy in adults, is designed to improve intraocular pressure control in patients with glaucoma. This study aimed to evaluate the long-term efficacy and safety of kahook dual blade goniotomy in glaucoma patients undergoing cataract surgery over a 36-month follow-up. METHODS: This was a retrospective case series including 56 eyes from 56 patients with mild-to-moderate primary open-angle glaucoma who underwent phacoemulsification combined with kahook dual blade goniotomy. Mean intraocular pressure values, number of preoperative and postoperative hypotensive eye drops, procedure survival, and complications were evaluated over 36 months. Surgical success was defined as either a reduction in intraocular pressure of ≥20% with intraocular pressure between 6 and 18 mmHg without additional medication or a reduction of ≥1 eye drop with intraocular pressure between 6 and 18 mmHg. RESULTS: The mean preoperative intraocular pressure decreased from 15.96 ± 2,83) mmHg to 13.14 ± 2,11) mmHg at 36 months, representing a 14.9% reduction (p<0.001). The mean number of eye drops decreased from 1.91 ± 0,75) to 1.34 ± 0,92), a 29.8% reduction (p<0.001). The overall success rate was 69.6% at 36 months. CONCLUSION: Kahook dual blade goniotomy combined with cataract surgery significantly reduced intraocular pressure and the number of hypotensive eye drops required in patients with mild-to-moderate primary open-angle glaucoma, with a favorable success rate maintained at 36 months.
Surgical procedures in glaucoma: A preferred practice pattern report by the Latin American Glaucoma Society.
Justiniano MJ, Mura JJ, Giampani Junior J … +2 more , Silva MJL, Fong GB
Arq Bras Oftalmol · 2026 · PMID 41637373 · Publisher ↗
PURPOSE: To evaluate the preferred surgical practice patterns for glaucoma among members of the Latin American Glaucoma Society. METHODS: A cross-sectional study was conducted using an electronic survey distributed in Ju...
PURPOSE: To evaluate the preferred surgical practice patterns for glaucoma among members of the Latin American Glaucoma Society. METHODS: A cross-sectional study was conducted using an electronic survey distributed in July 2023 via email to members of the Latin American Glaucoma Society. The questionnaire comprised four sections addressing the specialists' profiles, preferred surgical procedures for open--angle glaucoma, and choices in 10 different clinical scenarios, including congenital glaucoma. RESULTS: Of the 63 members, 49 physicians (77.7%) responded - 13 women and 36 men - from nine Latin American countries. Thirty-one respondents (63.26%) had more than 20 yr of professional experience. For the surgical management of open-angle glaucoma, trabeculectomy was the most preferred procedure (48 physicians), followed closely by glaucoma drainage devices (47 physicians) and minimally invasive glaucoma surgery (29 physicians). Across the 10 clinical scenarios, glaucoma drainage devices were selected most frequently (203 preferences), followed by trabeculectomy (118), ciliary body laser procedures (107), and minimally invasive glaucoma surgery (40). However, minimally invasive glaucoma surgery was the preferred option for primary open-angle glaucoma with mild-to-moderate cataracts. CONCLUSION: Among specialists of the Latin American Glaucoma Society, trabeculectomy and glaucoma drainage devices remain the most commonly performed surgical procedures. Minimally invasive glaucoma surgery is primarily used in combination with cataract surgery, while ciliary body laser procedures are generally reserved for cases of previous glaucoma drainage device failure or as an initial option for newly diagnosed glaucoma cases.
Management of glaucoma during pregnancy and lactation: clinical considerations and therapeutic strategies.
F Netto C, Gracitelli CPB, Russ H … +3 more , Cruz DFBM, Lima NVDA, Maestrini HA
Arq Bras Oftalmol · 2026 · PMID 41637372 · Publisher ↗
Glaucoma is a progressive optic neuropathy that can cause irreversible blindness, though it rarely affects women of reproductive age. Its management during pregnancy and lactation is particularly challenging because of t...
Glaucoma is a progressive optic neuropathy that can cause irreversible blindness, though it rarely affects women of reproductive age. Its management during pregnancy and lactation is particularly challenging because of the potential impact of intraocular pressure fluctuations on disease progression and the risks of treatment to both the mother and fetus. Physiological changes in pregnancy, such as decreased intraocular pressure and hormonal alterations, may influence disease activity but do not guarantee disease stability. Preconception counseling plays a key role in mitigating risks and tailoring treatment strategies. Many glaucoma medications carry teratogenic risks, with brimonidine being the only US Food and Drug Administration Category B drug. Surgical interventions - including laser trabeculoplasty and minimally invasive glaucoma surgeries - offer alternative options but require careful timing and consideration of fetal safety. Multidisciplinary collaboration is essential to optimize maternal and neonatal outcomes. This review summarizes evidence-based approaches for glaucoma management during pregnancy and lactation, highlighting clinical considerations, therapeutic strategies, and patient-centered care.
Impact of mydriasis on image gradability and automated diabetic retinopathy screening with a handheld camera. A real-world setting evaluation.
Costa IDA, Restrepo D, Ribeiro LZ … +4 more , Aragaki AK, Malerbi FK, Regatieri CS, Nakayama LF
Arq Bras Oftalmol · 2026 · PMID 41637371 · Publisher ↗
PURPOSE: Diabetic retinopathy screening in lowand middle-income countries is limited by restricted access to specialized care. Portable retinal cameras offer a practical alternative; however, image quality - affected by...
PURPOSE: Diabetic retinopathy screening in lowand middle-income countries is limited by restricted access to specialized care. Portable retinal cameras offer a practical alternative; however, image quality - affected by mydriasis - directly influences the performance of artificial intelligence models. This study evaluated the effect of mydriasis on image gradability and AI-based diabetic retinopathy detection in real-world, resource-limited settings. METHODS: The proportions of gradable images were compared between mydriatic and non-mydriatic groups. Generalized estimating equations were used to identify factors associated with image gradability, including age, sex, race, diabetes duration, and systemic hypertension. A ResNet-200d model was trained on the mobile Brazilian Ophthalmological dataset and externally validated on both mydriatic and non-mydriatic images. Model performance was evaluated using accuracy, F1 score, area under the curve, and confusion matrix metrics. Sensitivity differences were assessed using the McNemar test, and area under the curves were compared using DeLong's test. The Youden index was used to determine optimal classification thresholds. Agreement between maculaand disc-centered images was analyzed using Cohen's κ. RESULTS: The mydriatic group demonstrated a higher proportion of gradable images compared with the non-mydriatic group (82.1% vs. 55.6%; p<0.001). In non-mydriatic images, lower gradability was associated with systemic hypertension, older age, male sex, and longer diabetes duration. The AI model achieved better performance in mydriatic images (accuracy, 85.15%; area under the curve, 0.94) than in non-mydriatic images (accuracy, 79.68%; area under the curve, 0.93). The McNemar test showed a significant difference in sensitivity (p=0.0001), whereas DeLong's test revealed no significant difference in area under the curve (p=0.4666). The Youden index indicated that optimal classification thresholds differed based on mydriasis status. Agreement between image fields was moderate to substantial and improved with mydriasis. CONCLUSION: Mydriasis significantly improves image gradability and enhances AI performance in diabetic retinopathy screening. Nonetheless, in lowand middle-income countries where pharmacologic dilation may be impractical, optimizing model calibration and thresholding for non-mydriatic images is essential to ensure effective AI implementation in real-world clinical environments.
Custom slow-coagulation transscleral cyclophotocoagulation: a novel cyclophotocoagulation technique for refractory glaucoma patients in a safety-net eye hospital in Mexico.
Moreno PS, Rivera AQ, Fernández MB … +3 more , Flores JMA, Lansingh VC, Nguyen V
Arq Bras Oftalmol · 2026 · PMID 41637370 · Publisher ↗
PURPOSE: Glaucoma is one of the leading causes of irreversible blindness worldwide. When topical hypotensive agents or laser trabeculoplasty fail to adequately control the disease, escalation of therapy becomes necessary...
PURPOSE: Glaucoma is one of the leading causes of irreversible blindness worldwide. When topical hypotensive agents or laser trabeculoplasty fail to adequately control the disease, escalation of therapy becomes necessary, with transscleral cyclophotocoagulation being one of the available options. Several variations of transscleral cyclophotocoagulation exist, including traditional continuous wave, MicroPulse, and slow-coagulation techniques. We propose a novel variation - custom slow-coagulation transscleral cyclophotocoagulation - which combines elements of both continuous wave and slow-coagulation approaches. This study aimed to evaluate the outcomes of this technique in patients with refractory glaucoma. METHODS: This retrospective, interventional study included 104 eyes of 83 patients with refractory glaucoma who underwent custom slow-coagulation transscleral cyclophotocoagulation. Changes in intraocular pressure, visual acuity, the number of glaucoma medications, and postoperative complications were analyzed. A paired t test was used to compare changes in intraocular pressure and visual acuity, while the Wilcoxon signed-rank test was applied to categorical variables. Success rates following custom slow-coagulation transscleral cyclophotocoagulation were estimated using Kaplan-Meier survival analysis. RESULTS: Mean intraocular pressure decreased significantly from 38.9 ± 15.8 mmHg at baseline to 16.3 ± 9.9 mmHg at Month 12 (p<0.001). The mean number of glaucoma medications also decreased significantly from 3.6 ± 0.6 to 1.8 ± 1.4 (p<0.001). No significant reduction in mean visual acuity was observed during follow-up. CONCLUSIONS: Custom slow-coagulation transscleral cyclophotocoagulation effectively reduced baseline intraocular pressure and the number of glaucoma medications, with a low rate of complications and no decline in visual acuity over a 12-month follow-up period. This novel technique demonstrated a high safety profile in a Hispanic population and represents a low-cost, minimally invasive procedure with rapid recovery and promising efficacy in intraocular pressure control.
Band keratopathy.
Laranjeira JV, Almeida NBM, Kara-Junior N
Arq Bras Oftalmol · 2025 · PMID 41417313 · Full text
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Regional inequalities in the supply of ophthalmologists and the volume of cataract surgeries between the public and private health sectors in Brazil.
Scheffer M, Moreira JPL, Bahia L … +4 more , Borges SAM, Cassenote AJF, Gameiro GR, Belfort R
Arq Bras Oftalmol · 2025 · PMID 41294173 · Publisher ↗
PURPOSE: This study aimed to evaluate disparities in the distribution of ophthalmologists and the volume of ca-ta-ract surgeries across Brazil, considering public and private health sectors and the country's federative u...
PURPOSE: This study aimed to evaluate disparities in the distribution of ophthalmologists and the volume of ca-ta-ract surgeries across Brazil, considering public and private health sectors and the country's federative units. METHODS: Data on ophthalmologists were obtained from the National Medical Residency Commission and the Associação Médica Brasileira. Information on cataract surgeries performed through the Unified Health System was collected from the DATASUS database, while data on procedures covered by private health plans were retrieved from the National Supplementary Health Agency. Population estimates from the 2024 Demographic Census of the Brazilian Institute of Geography and Statistics were used to calculate physician density and surgery rates per 100,000 inhabitants. Associations between the number of ophthalmologists and cataract surgery volume were analyzed using Spearman's correlation coefficient. RESULTS: Brazil has 16,784 ophthalmologists, representing 8.96 specialists per 100,000 inhabitants. Marked disparities were observed: large cities (>500,000 inhabitants) had 18.75 ophthalmologists per 100,000 residents, whereas municipalities with <50,000 inhabitants had fewer than one. Across federative units, physician density ranged from 19.18 per 100,000 in the Federal District to 4.22 in Maranhão. In 2024, cataract surgery rates varied widely, from 1,012.61 per 100,000 inhabitants in the Southeast to 435.00 in the North. Nationally, Unified Health System performed 736.30 surgeries per 100,000 inhabitants, compared with 1,276.79 in the private sector. On average, each ophthalmologist performed 96.92 cataract surgeries annually. CONCLUSION: Significant inequalities persist in the geographic distribution of ophthalmologists and in cataract surgery provision, with higher surgical volumes concentrated in the private sector. Targeted policies are required to address regional disparities and improve the equity and efficiency of cataract care delivery in Brazil.
Different formulations of corticosteroid eye drops at different treatment times in the control of inflammation and prevention of cystoid macular edema after cataract surgery: randomized clinical trial.
Feitosa AM, Albano MCF, Lopes SP … +6 more , Miranda JEO, Oliveira TCB, Rodriguez PJY, Machado AJ, Feitosa MM, Ribeiro JCML
Arq Bras Oftalmol · 2025 · PMID 41294172 · Publisher ↗
PURPOSE: To evaluate the efficacy of different corticosteroid eye drop formulations (prednisolone acetate 1.0%, dexamethasone 1.0%, and loteprednol etabonate 0.5%) administered for different treatment durations (10 vs. 2...
PURPOSE: To evaluate the efficacy of different corticosteroid eye drop formulations (prednisolone acetate 1.0%, dexamethasone 1.0%, and loteprednol etabonate 0.5%) administered for different treatment durations (10 vs. 28 days) in controlling postoperative inflammation following uncomplicated cataract surgery. METHODS: This randomized, masked clinical trial was conducted at the Instituto Cearense de Oftalmologia. Eligible participants were aged ≥50 yr and scheduled for routine cataract surgery. Exclusion criteria included preexisting ocular disease (elevated intraocular pressure, retinopathy, maculopathy, or uveitis) or concurrent medication use that could confound results. Patients were randomized to receive prednisolone acetate (1.0%), dexamethasone (1.0%), or loteprednol etabonate (0.5%) four times daily for 28 days (with tapering) or for 10 days. Medication bottles, prescriptions, and examiners were masked. Postoperative assessments included ocular symptoms, visual acuity, intraocular pressure, anterior chamber cell count and flare, pachymetry, endothelial cell density, and macular thickness over a 30-day follow-up. RESULTS: A total of 140 eyes from 140 patients were analyzed (29 prednisolone acetate 1.0%, 18 dexamethasone 1.0%, and 21 loteprednol etabonate 0.5% for 28 days; 28 prednisolone acetate 1.0%, 22 dexamethasone 1.0%, and 22 loteprednol etabonate 0.5% for 10 days). No significant differences were found among the six groups during follow-up. However, eyes treated with dexamethasone (1.0%) showed greater intraocular pressure fluctuations, particularly on Days 7 and 30, and a higher incidence of rebound inflammation in the 28-day regimen. Structural cystoid macular edema without visual impact was observed in 5.9% of eyes in the 28-day groups and 14.2% of eyes in the 10-day groups, as detected by optical coherence tomography at 30 days. CONCLUSION: Equivalent postoperative inflammation control can be achieved using different corticosteroid eye drop formulations at varying treatment durations following cataract surgery. Brazilian Registry of Clinical Trials (ReBEC): RBR-2frpntv.
Outcomes of strabismus surgery in patients with Down syndrome.
Leite A, Cunha RPD
Arq Bras Oftalmol · 2025 · PMID 41294171 · Publisher ↗
PURPOSE: This study aimed to evaluate the outcomes of strabismus surgical correction in patients with Down syndrome. METHODS: We conducted a retrospective chart review of patients with Down syndrome who underwent strabis...
PURPOSE: This study aimed to evaluate the outcomes of strabismus surgical correction in patients with Down syndrome. METHODS: We conducted a retrospective chart review of patients with Down syndrome who underwent strabismus surgery between January 1997 and May 2024 at an Ophthalmology Outpatient Clinic in São Paulo, Brazil. The data collected included age, sex, medical and ocular history, surgical details, and follow-up outcomes. The patients were categorized by strabismus type into esotropia, fourth nerve palsy, and mixed groups. Surgical success was defined as final alignment within 10∆ of orthotropia and, where applicable, whether there was resolution of abnormal head posture of ocular origin. Patients with postoperative follow-up <6 months were excluded. RESULTS: A total of 37 patients (21 females) were included. Of these, 22 (59.5%) were in the esotropia group, 10 (27.0%) in the fourth nerve palsy group, and 5 (13.5%) in the mixed group. The surgical success rate in the esotropia group was 86.4%, with a mean preoperative deviation of 35.2 (± 6.5)∆, and mean surgical correction of 30.1 (± 10.4)∆. The success rate in the fourth nerve palsy group was 40.0%, with a mean preoperative deviation of 10.4 (± 4.3)∆. Overall, success was achieved with a single surgical procedure in 73.0% of the sample. No significant associations were found between surgical success and the clinical and demographic variables, including sex, age at surgery, oblique muscle overaction, pattern strabismus, visual acuity, amblyopia, preoperative deviation, or postoperative follow-up duration (p>0.05). CONCLUSIONS: When standard surgical tables are applied, strabismus surgery in patients with Down syndrome appears to be safe and effective. We found high success rates, particularly among patients with esotropia. We observed no tendencies toward overor under-correction. These findings support the use of conventional surgical protocols with this patient population.
Modified suture-less flanged intrascleral intraocular lens fixation approach accessible for novice retinal surgeons.
Hwang BE, Whang WJ, Park YH
Arq Bras Oftalmol · 2025 · PMID 41294170 · Publisher ↗
PURPOSE: To evaluate whether two simplified mo-difications of flanged intrascleral fixation techniques (Yamane and Canabrava) provide comparable refractive outcomes and complication rates while reducing surgical complexi...
PURPOSE: To evaluate whether two simplified mo-difications of flanged intrascleral fixation techniques (Yamane and Canabrava) provide comparable refractive outcomes and complication rates while reducing surgical complexity in tro-car-assisted vitrectomy. METHODS: This retrospective observational study included 88 patients who underwent flanged fixation surgery with vitrectomy. In the modified Yamane technique, a single-path sclerotomy with bilateral symmetry was performed instead of an angled sclerotomy. In the modified Canabrava technique, the intraocular lens was inserted first, followed by the creation of a circular polypropylene loop with 2-mm flange spacing. Postoperative refractive parameters, including intraocular lens astigmatism, and complications such as intraocular lens iris capture were analyzed. RESULTS: Of the 88 patients, 70 underwent the modified Yamane technique, and 18 underwent the modified Canabrava technique. No significant differences were observed between the two techniques regarding refractive outcomes or postoperative complications, except for surgical duration, which was significantly shorter (p<0.001) in one technique. Mean intraocular lens astigmatism was -0.675 D for Yamane and -0.666 D for Canabrava. CONCLUSION: Optimizing needle engagement for symmetry in the Yamane technique and narrowing flange spacing while ensuring a circular polypropylene configuration in the Canabrava technique may reduce surgical complexity and improve postoperative outcomes.
Real-world evidence of the use of Cloudscaper optotypes versus LEA symbols for virtual or digital visual acuity measurement in children aged 3 to 16 years.
Ronconi CS, Rossetto JD, Hopker LM … +3 more , Carneiro ACSB, Ventorin BS, Schor P
Arq Bras Oftalmol · 2025 · PMID 41294169 · Publisher ↗
PURPOSE: This cross-sectional study compared best-corrected visual acuity obtained using Cloudscaper symbols, a novel optotype developed according to ETDRS specifications for children's virtual screening, with that obtai...
PURPOSE: This cross-sectional study compared best-corrected visual acuity obtained using Cloudscaper symbols, a novel optotype developed according to ETDRS specifications for children's virtual screening, with that obtained using LEA symbols. METHODS: A total of 560 children aged 3-16 yr underwent visual acuity test with both Cloudscaper symbols and LS. The test application was standardized using the EyeSpy algorithm. Additionally, 147 participants were tested with the standard Snellen E paper chart. Paired t tests were performed to assess the clinical significance of logMAR visual acuity differences. RESULTS: The mean logMAR visual acuity with LEA symbols was 0.12 (standard deviation [SD]=0.18; range, -0.10 to 0.80), while with Cloudscaper symbols it was 0.18 (SD=0.19; range, -0.10 to 0.80). The mean difference between Cloudscaper symbols and LEA symbols was 0.099 logMAR (approximately 0.5 optotypes; SD=0.08; range, 0.0-0.14; p<0.0001). Cloudscaper symbols slightly underestimated visual acuity compared to LEA symbols. Visual acuity measured by both methods was highly correlated (Spearman's r=0.74, p<0.0001). The mean visual acuity difference between Cloudscaper symbols and the Snellen E chart was 0.0045 (p=0.805; 95% confidence interval [95% CI]), whereas the difference between LEA symbols and Snellen E was 0.0883 (p<0.001; 95% CI). CONCLUSIONS: Cloudscaper symbols provide a reliable tool for visual screening in children. Although they slightly underestimate visual acuity compared to LEA symbols - a finding also reported when comparing ETDRS letters with LEA symbols - Cloudscaper symbols show strong agreement with Snellen E chart measurements. This suggests that Cloudscaper symbols allow precise visual acuity assessment comparable to the gold standard.
Association between axial length and perfluoropropane gas duration after pars plana vitrectomy with fixed-volume pure gas injection.
Lira RPC, Silveira APT, Lira GR … +1 more , Gaete MIL
Arq Bras Oftalmol · 2025 · PMID 41259461 · Full text
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Ongoing reepithelialization after keratopigmentation.
Garottii G, Almeida NBM, Kara-Junior N
Arq Bras Oftalmol · 2025 · PMID 41259460 · Full text
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Should each university department have only one postgraduate program?
Kara-Junior N, Santhiago MR, Sennes LU … +1 more , Ribeiro-Monteiro ML
Arq Bras Oftalmol · 2025 · PMID 41259459 · Full text
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Diagnostic accuracy of a deep learning model for pterygium detection in Barcelos, Brazilian Amazon.
Casagrande D, Gobira M, Fernandes AG … +10 more , Cohen MJ, Marinho PM, Carvalho KWP, Luttecke-Anders A, Stauber BA, Ferraz NN, Cohen JM, Berezovsky A, Salomão SR, Belfort R
Arq Bras Oftalmol · 2025 · PMID 41172514 · Full text
PURPOSE: This pilot study evaluated the diagnostic accuracy of a deep learning model for detecting pterygium in anterior segment photographs taken using smartphones in the Brazilian Amazon. The model's performance was be...
PURPOSE: This pilot study evaluated the diagnostic accuracy of a deep learning model for detecting pterygium in anterior segment photographs taken using smartphones in the Brazilian Amazon. The model's performance was benchmarked against assessments made by experienced ophthalmologists, considered the clinical gold standard. METHODS: In this cross-sectional study, 38 participants (76 eyes) from Barcelos, Brazil, were enrolled. Trained nonmedical health workers captured high-resolution anterior segment images using smartphones. These images were analyzed using a deep learning model based on the MobileNet-V2 convolutional neural network. Diagnostic metrics-including sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve-were calculated and compared with the ophthalmologists' evaluations. RESULTS: The deep learning model achieved a sensitivity of 91.43%, specificity of 90.24%, positive predictive value of 88.46%, negative predictive value of 92.79%, and an area under the curve of 0.91. Logistic regression revealed no statistically significant association between pterygium and demographic variables such as age or gender. CONCLUSIONS: The deep learning model demonstrated high diagnostic performance in identifying pterygium in a remote Amazonian population. These preliminary findings support the potential use of artificial intelligence-based tools to facilitate early detection and screening in underserved regions, thereby enhancing access to ophthalmic care.
Efficacy of povidone and propylene glycol-based artificial tears in the treatment of dry eye disease.
Santos LCD, Affonso A, Belfort R … +1 more , Freitas D
Arq Bras Oftalmol · 2025 · PMID 41092218 · Full text
PURPOSE: This clinical study aimed to assess the effectiveness of microemulsion artificial tears containing povidone and propylene glycol in the management of dry eye disease. Secondary objectives included evaluating imp...
PURPOSE: This clinical study aimed to assess the effectiveness of microemulsion artificial tears containing povidone and propylene glycol in the management of dry eye disease. Secondary objectives included evaluating improvements in tear-film stability, measured by tear break-up time and corneal staining scores, along with the tolerability and safety of the formulation. METHODS: This was a prospective, single-arm interventional study involving 30 participants (52 eyes) diagnosed with dry eye disease. Participants self-administered the investigational eye drops twice daily for 28 consecutive days. Primary and secondary outcomes included changes in the Ocular Surface Disease Index, tear break-up time, and corneal staining scores. Adverse events were documented throughout the study period. RESULTS: Significant improvements in Ocular Surface Disease Index scores were observed, reflecting a reduction in dry eye disease symptoms. Tear break-up time increased notably between baseline and follow-up assessments, with the proportion of eyes exhibiting tear break-up time ≥10 s rising from 25.0% to 63.5%. Additionally, the percentage of eyes with a corneal staining score of zero improved from 23.1% to 69.2%. Conjunctival staining also decreased, with the proportion of eyes with scores of 2 and 3 dropping from 11.5% to 3.8% and 5.8% to 0%, respectively. CONCLUSIONS: The findings suggest that povidone and propylene glycol-based artificial tears significantly enhance tear-film stability and alleviate symptoms in patients with mild to moderate dry eye disease, with minimal adverse effects. This formulation represents a safe and effective short-term treatment option for dry eye disease management.
Intrastromal autologous blood injection for treating corneal hydrops.
Tochetto LB, Hirai FE, Oliveira ÍP … +3 more , Tyrrasch K, Wakamatsu TH, Gomes JÁP
Arq Bras Oftalmol · 2025 · PMID 41092217 · Full text
PURPOSE: To describe the technique and outcomes of intrastromal autologous blood injection in patients with severe corneal hydrops. METHODS: Nineteen patients with corneal hydrops underwent intrastromal autologous blood...
PURPOSE: To describe the technique and outcomes of intrastromal autologous blood injection in patients with severe corneal hydrops. METHODS: Nineteen patients with corneal hydrops underwent intrastromal autologous blood injection. Postoperative assessments included best-corrected visual acuity and time to resolution of corneal edema. RESULTS: Corneal edema resolved within 1 week in 5 patients, within 1 month in 11, and within 3 months in 3. The mean duration of edema persistence was 37.94 ± 33.05 days (range, 6-124). Corneal thickness decreased from 2.06 ± 0.71-mm preoperatively to 1.34 ± 0.65-mm at day 7, 0.85 ± 0.56-mm at day 30, and 0.57 ± 0.13-mm at day 90 (p<0.001). Descemet's membrane (DM) detachment decreased from 1.01 ± 0.75-mm to 0.44 ± 0.57-mm, 0.24 ± 0.36-mm, and 0.08 ± 0.11-mm on postoperative days 7, 30, and 90, respectively (p<0.001). DM break size decreased from 1.12 ± 1.19-mm to 0.62 ± 0.84-mm at 3 months (p<0.005). Three patients developed hematocornea; no other major complications were observed. At 3 months, mean best-corrected visual acuity improved from 2.37 ± 0.66 to 0.41 ± 0.17 logMAR with hard contact lenses (p<0.001). CONCLUSIONS: Intrastromal autolo gous blood injection is an effective treatment for severe corneal hydrops, promoting faster edema resolution and visual improvement with minimal complications.
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