Arquivos Brasileiros De Oftalmologia[JOURNAL]
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200 papers
Longitudinal evaluation of corneal stability and tear film changes in first-time soft-contact lens wearers.
Arslan N, Kakil ŞB, Aydoğdu B … +1 more , Telek HH
Arq Bras Oftalmol · 2025 · PMID 41092216 · Full text
PURPOSE: 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. METHODS: A retrospe...
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Clinical outcomes of quad-loop intraocular lenses: trifocal, bifocal and toric types.
Campelo CMC, Silva FAB, Marinho PM … +5 more , Casagrande D, Marcos AAA, Freitas LL, Yogi MS, Belfort Junior R
Arq Bras Oftalmol · 2025 · PMID 41092215 · Full text
PURPOSE: 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 vari...
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Impact of screen use on tear breakup time: associations with ophthalmological factors and break frequency in office workers.
Ece BŞD, Altındaş İ
Arq Bras Oftalmol · 2025 · PMID 41092214 · Full text
PURPOSE: To examine how ophthalmological features, screen exposure duration, and break habits among office employees affect ocular surface parameters. METHODS: This single-center cross-sectional study involved two assess...
PURPOSE: To examine how ophthalmological features, screen exposure duration, and break habits among office employees affect ocular surface parameters. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Dose adjustment of intravitreal medications and gases according to axial length and vitreous cavity volume.
Lira RPC, Silveira APT, Lira GR … +1 more , Gaete MIL
Arq Bras Oftalmol · 2025 · PMID 41092213 · Full text
PURPOSE: 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...
PURPOSE: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: 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.
Effectiveness of surgical training in ophthalmology residency programs in Brazil.
Kara-Júnior N, Magalhães-E-Silva R, Rossi S
Arq Bras Oftalmol · 2025 · PMID 41092212 · Full text
PURPOSE: In Brazil, it has traditionally been standard practice to teach a wide range of surgical techniques to all ophthalmology residents, with the aim of equipping them to manage most ocular conditions. However, with...
PURPOSE: In Brazil, it has traditionally been standard practice to teach a wide range of surgical techniques to all ophthalmology residents, with the aim of equipping them to manage most ocular conditions. However, with modern developments, access to subspecialists has expanded to nearly the entire country. This raises the question of whether it is still necessary to teach numerous surgical techniques to every resident. This study evaluates the effectiveness of surgical training in Brazilian ophthalmology residency programs to determine if comprehensive surgical training for all residents is truly effective, thereby providing evidence to inform educational policy decisions. METHODS: A cross-sectional study using a questionnaire distributed to physicians engaged in eye care. RESULTS: A total of 137 physicians responded to the survey, with 104 (76.0%) having already completed their specialization. The findings indicate that most practicing ophthalmologists received surgical training during residency in cataract, glaucoma, oculoplastic, and strabismus surgeries. Nonetheless, many of these specialists no longer perform most of these surgeries in practice, except for cataract surgery. While 53.8% of those who completed residency reported satisfaction with their training, 35.6% indicated that they wished they had received better surgical preparation. CONCLUSION: The training of ophthalmology specialists must be made more efficient. Training efficiency is reduced when time and resources are devoted to surgical procedures that many specialists will not perform in their careers.
Atypical presentation of sector retinitis pigmentosa.
Gontijo MC, Meirelles MGB, Guerra RLL
Arq Bras Oftalmol · 2025 · PMID 41092211 · Full text
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Trends in the management of anophthalmic sockets and external ocular prostheses among oculoplastic surgeons: a web-based study.
Galindo-Ferreiro A, Martinez-Fernandez E, Bigheti CP … +3 more , Zornoff DCM, Sanchez-Tocino H, Schellini SA
Arq Bras Oftalmol · 2025 · PMID 41092210 · Full text
PURPOSE: This study aimed to evaluate the practices employed by oculoplastic surgeons in the assessment and management of anophthalmic sockets and external ocular prostheses. METHODS: Oculoplastic surgeons from two count...
PURPOSE: This study aimed to evaluate the practices employed by oculoplastic surgeons in the assessment and management of anophthalmic sockets and external ocular prostheses. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Macular thickness measured via optic coherence tomography in healthy adults aged 45 years and older: The Brazilian Amazon Region Eye Survey.
Watanabe SES, Berezovsky A, Fernandes AG … +15 more , Marianelli BF, Furtado JM, Cypel M, Morales PH, Cohen MJ, Cunha CC, Mitsuhiro MH, Vasconcelos GC, Campos M, Ferraz NN, Sacai PY, Cohen JM, Muñoz S, Belfort R, Salomão SR
Arq Bras Oftalmol · 2025 · PMID 41092209 · Full text
PURPOSE: This study evaluated macular thickness using spectral-domain optical coherence tomography in healthy participants from a population-based eye survey. METHODS: The Brazilian Amazon Region Eye Survey was a populat...
PURPOSE: This study evaluated macular thickness using spectral-domain optical coherence tomography in healthy participants from a population-based eye survey. METHODS: The Brazilian Amazon Region Eye Survey was a population-based study assessing the prevalence and causes of visual impairment, blindness, and ocular diseases in adults aged ≥45 years from urban and rural areas of Parintins. A subgroup was selected based on inclusion criteria for both eyes: best-corrected visual acuity ≥20/32, normal eye examination results, and no prior ocular surgery. Scans were performed using the iVue optical coherence tomography device. Measurements were taken from the nine subfields defined by the Early Treatment Diabetic Retinopathy Study, examining the full retina as well as the inner and outer retinal layers. Associations of retinal thickness with age and sex were also analyzed. Statistical significance was set at p≤0.05. RESULTS: In total, 70 healthy participants (25 males), aged 45-65 years (mean=52 ± 5), were included. Mean central foveal thickness was 248.71 ± 18.73 μm. A significant age-related reduction in macular thickness was observed, particularly in the inner superior parafovea (p=0.036), nasal perifovea (p=0.001), superior perifovea (p=0.028), outer layer of inferior parafovea (p=0.049), and the inferior perifovea of the full retina (p=0.029). Males showed significantly greater thickness in the outer layer, especially in the outer parafovea (p=0.004) and perifovea (p<0.0001). CONCLUSIONS: This study established normative macular thickness values for healthy older adults in the Brazilian Amazon region using spectral-domain optical coherence tomography. Age and sex were found to significantly influence macular thickness and should be considered when interpreting measurements. These data will support future studies of retinal diseases in this population.
Perioperative subconjunctival steroid injection in dropless cataract surgery: a systematic review and meta-analysis.
Cyrino LG, Amaral D, Fujimura Júnior AY … +8 more , Parekh BJ, Bastos MMA, Gaio GS, Arteche MAT, Nascimento ASD, Ribeiro VEA, Guedes J, Hollaender MA
Arq Bras Oftalmol · 2025 · PMID 41092208 · Full text
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 ide...
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.
Factors associated with professionalism among ophthalmology medical residents.
Souza MVC, Moura AS
Arq Bras Oftalmol · 2025 · PMID 41092207 · Full text
PURPOSE: This study aimed to examine factors related to the professionalism of ophthalmology residents. METHODS: A cross-sectional study was carried out involving 48 ophthalmology residents in Brazil. Professionalism was...
PURPOSE: This study aimed to examine factors related to the professionalism of ophthalmology residents. METHODS: 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. RESULTS: 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). CONCLUSION: Professionalism scores among ophthalmology residents were associated with year of training, gender, type of undergraduate education, and level of interest in the topic.
Quality of life and treatment adherence in glaucoma: a cross-sectional analysis using the NEI-VFQ25 and MMAS-8 questionnaires.
Saito MS, Moscovici BK, Colombo-Barboza MN … +4 more , Colombo-Barboza GN, Colombo-Barboza LR, Guimarães CS, Nogueira PF
Arq Bras Oftalmol · 2025 · PMID 41092206 · Full text
PURPOSE: To analyze the quality of life and treatment adherence of patients with glaucoma at different disease stages, considering factors such as sex, visual acuity, disease severity, and treatment characteristics. METH...
PURPOSE: To analyze the quality of life and treatment adherence of patients with glaucoma at different disease stages, considering factors such as sex, visual acuity, disease severity, and treatment characteristics. METHODS: This cross-sectional study included 174 patients (346 glaucomatous eyes) recruited from clinical records and routine follow-ups at a specialized ophthalmology center. Their mean age was 39-90 years, and 60.9% of them were women. Their quality of life and adherence were assessed using the NEI-VFQ25 and MMAS-8 questionnaires, respectively. Complementary tests included 24:2 visual field test, retinography, and optical coherence tomography. Patients diagnosed with glaucoma for at least 6 months were included, whereas pregnant patients and those with ocular diseases were excluded. RESULTS: Among the participants, 59.2% adhered to the treatment whereas 40.8% showed low adherence. The mean quality of life score was 81.87. Patients with low adherence had slightly higher quality of life scores (mean 83.1) than those with good adherence (mean 81.0), but the difference was not statistically significant. Disease severity was associated with increased optic nerve cupping, reduced thickness of the nerve fiber and ganglion cell layers, and great visual field loss. No significant correlation was observed between adherence and quality of life, indicating the independence of these factors and the influence of psychological or social elements. CONCLUSION: The absence of a correlation between quality of life and treatment adherence highlights the need for tailored interventions for psychological and social aspects. These findings indicate the importance of a comprehensive approach to managing glaucoma, preserving visual function, strengthening doctor-patient relationships, and considering psychosocial factors to enhance quality of life and treatment adherence.
Outcomes and success predictors of micropulse transscleral cyclophotocoagulation in patients with refractory glaucoma.
Kanadani FN, Vieira JM, Ibrahim LF … +3 more , Silva SAR, Dorairaj S, Prata TS
Arq Bras Oftalmol · 2025 · PMID 41092205 · Full text
PURPOSE: This study aimed to report the surgical outcomes and success predictors of micropulse transscleral cyclophotocoagulation in eyes with refractory glaucoma. METHODS: This was a noncomparative, interventional case...
PURPOSE: This study aimed to report the surgical outcomes and success predictors of micropulse transscleral cyclophotocoagulation in eyes with refractory glaucoma. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Trends in female participation at the Brazilian Congress of Ophthalmology, 2016-2023.
Regueira SP, Araújo TMC, Santiago JMS … +3 more , Gameiro GR, Barboza WL, Ventura CV
Arq Bras Oftalmol · 2025 · PMID 41092204 · Full text
PURPOSE: To assess female participation in the Brazilian Congress of Ophthalmology. METHODS: This retrospective, descriptive-analytical study examined the profiles of individuals involved in the scientific program of the...
PURPOSE: To assess female participation in the Brazilian Congress of Ophthalmology. METHODS: This retrospective, descriptive-analytical study examined the profiles of individuals involved in the scientific program of the Brazilian Congress of Ophthalmology from 2016 to 2023. Data were provided by the Brazilian Council of Ophthalmology and were categorized by ophthalmology subspecialty, participant role, and geographic region of origin within Brazil. Roles were grouped into three main categories: coordinator, speaker, and moderator/discussant. RESULTS: Female participation at the congress increased from 33% in 2016 to 42% in 2023, showing an annual upward trend of 1.33 (p<0.001). Around 64% of female participants were from the Southeast region, while 16% were from the Northeast. The coordinator role showed the largest increase in female participation, rising from 22% in 2016 to 40% in 2023 (Slope: 2; p<0.001), followed by the speaker role, which increased from 34% to 44% (Slope: 1.5; p<0.001), and the moderator/discussant role, which rose from 32% to 38% (Slope: 1.24; p=0.0586). Changes in female representation across ophthalmology subspecialties were not statistically significant. CONCLUSION: From 2016-2023, female participation in the Brazilian Congress of Ophthalmology increased across most subspecialties and conference roles. Although gender disparity has narrowed, continuous efforts are needed to achieve greater gender equity and equality in ophthalmology conferences.
Chemical ocular trauma outbreak caused by cosmetic hair braiding and modeling ointments in Brazil.
Torres ACC, Nóbrega Filho GGD, Oliveira ABDC … +2 more , Virgolino CAC, Ventura CV
Arq Bras Oftalmol · 2025 · PMID 41092203 · Full text
PURPOSE: 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. METHODS: This descripti...
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
24-Month outcomes of gonioscopy-assisted transluminal trabeculotomy for congenital glaucoma.
Lemos MBC, Faria BM, Cunha MB … +6 more , Cordeiro FM, Ribeiro Júnior PHE, Scoralick ALB, Daga FB, Kanadani FN, Prata TS
Arq Bras Oftalmol · 2025 · PMID 41092202 · Full text
PURPOSE: To report the surgical outcomes of patients with primary congenital glaucoma who underwent gonioscopy-assisted transluminal trabeculotomy. METHODS: This retrospective, noncomparative, interventional study includ...
PURPOSE: To report the surgical outcomes of patients with primary congenital glaucoma who underwent gonioscopy-assisted transluminal trabeculotomy. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Case report: a two-step approach in the management of angle-closure glaucoma associated with Plateau iris configuration.
Prata TS, Resende ICTP, Ribeiro DM … +2 more , Kanadani FN, Almeida INF
Arq Bras Oftalmol · 2025 · PMID 40900570 · Full text
Angle-closure glaucoma is a major cause of visual impairment worldwide, with Plateau iris syndrome presenting management challenges. We present a case report of a 58-year-old woman with advanced, uncontrolled angle--clos...
Angle-closure glaucoma is a major cause of visual impairment worldwide, with Plateau iris syndrome presenting management challenges. We present a case report of a 58-year-old woman with advanced, uncontrolled angle--closure glaucoma and Plateau iris. Her history included laser peripheral iridotomy and three glaucoma medications in both eyes. Different treatments were implemented. For the eye with lower intraocular pressure, fewer peripheral anterior synechiae, and milder disease: phacoemulsification with intraocular lens implantation. For the eye with more advanced disease, a two-step approach was used: slow-coagulation transscleral cyclophotocoagulation using the double-arc protocol, followed by phacoemulsification with intraocular lens implantation 2 months later. Both eyes achieved improved visual acuity and intraocular pressure control with fewer medications, without significant complications. This case highlights transscleral cyclophotocoagulation followed by phacoemulsification as an alternative to combined surgeries in uncontrolled angle-closure glaucoma with Plateau iris, offering a simpler technique, more predictable refractive and pressure-control outcomes, and more straightforward postoperative management.
Impact of surgeon experience on corneal endothelial changes after cataract surgery.
Rizzuto UA, Magalhães LL, Trindade BLC
Arq Bras Oftalmol · 2025 · PMID 40802445 · Full text
PURPOSE: To compare endothelial corneal cell changes following cataract surgery performed by phacoemulsification with intraocular lens implantation, conducted by surgeons with varying levels of experience. METHODS: Two h...
PURPOSE: To compare endothelial corneal cell changes following cataract surgery performed by phacoemulsification with intraocular lens implantation, conducted by surgeons with varying levels of experience. METHODS: Two hundred and eighty-three eyes diagnosed with cataract were included. Lens opacity was classified into three categories (I, II, and III). Surgeons were categorized into four experience levels (1, 2, 3, and 4), based on years of practice and lifetime surgeries performed. Corneal endothelial characteristics were assessed using non-contact specular microscopy, with measurements taken before surgery and 30-60 days post-surgery. RESULTS: Preand postoperative endothelial analysis showed no significant differences between surgeon levels regarding visual acuity achieved, corneal thickness, and endothelial hexagonality. However, the central endothelial cell density index showed a significantly greater reduction among level 1 surgeons (p=0.026). Grade II cataracts exhibited significant variations in the central endothelial cell density (p=0.011) and average cell size, with level 1 surgeons showing the largest increases (p=0.024). CONCLUSIONS: The analysis revealed significant differences in visual acuity and endothelial indices between surgeon experience levels, with less experienced surgeons showing greater variations and poorer performance. Clinical protocols should consider these data to establish safer training protocols.
Intravitreal aflibercept alone versus combination with dexamethasone phosphate for diabetic macular edema: A randomized phase-2 clinical trial.
Neri VC, Lira RPC, Vasconcelos AAA … +3 more , Jorge PHL, Lira GR, Almeida VDCL
Arq Bras Oftalmol · 2025 · PMID 40699120 · Full text
PURPOSE: To compare the short-term (3-month) outcomes of intravitreal aflibercept injections versus intravitreal aflibercept combined with dexamethasone sodium phosphate in treating diabetic macular edema. METHODS: In th...
PURPOSE: To compare the short-term (3-month) outcomes of intravitreal aflibercept injections versus intravitreal aflibercept combined with dexamethasone sodium phosphate in treating diabetic macular edema. METHODS: In this Phase-2 clinical trial, 16 eyes of 16 participants with diabetic macular edema were randomly assigned to one of 2 groups. Participants in the aflibercept monotherapy group received 2 mg of intravitreal aflibercept (0.05 mL), while those in the combination therapy group received 2 mg of intravitreal aflibercept (0.05 mL) plus 0.04 mg dexamethasone sodium phosphate (0.01 mL). Identical injections were repeated after 30 and 60 days. The primary outcome was the change in central macular thickness, as measured by optical coherence tomography, from baseline to 1 month after the last injection. Secondary outcomes included changes in best-corrected visual acuity and intraocular pressure over the same period. RESULTS: The mean baseline central macular thickness was 444 ± 86 μm in the combination therapy group and 394 ± 96 μm in the aflibercept monotherapy group (p=0.293). By day 90, the mean reduction in central macular thickness was significantly greater in the combination therapy group (176 ± 129 μm) compared to the aflibercept monotherapy group (54 ± 49 μm; p=0.034). Best-corrected visual acuity also improved significantly more in the combination therapy group, with a median gain of 0.31 ± 0.16 LogMAR, whereas the aflibercept monotherapy group experienced a minimal change (-0.06 ± 0.13 LogMAR; p=0.020). Intraocular pressure remained stable in both groups, with no significant difference (p=0.855). None of the participants developed elevated intraocular pressure (>21 mmHg) or required ocular hypotensive medications. No significant ocular or systemic adverse events were reported. CONCLUSION: The addition of dexamethasone sodium phosphate to the standard intravitreal aflibercept regimen for diabetic macular edema can improve short-term structural and functional outcomes. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (RBR-7468j4q).
Iridodialysis.
Krasilchik G, Almeida NBM, Kara-Junior N
Arq Bras Oftalmol · 2025 · PMID 40699119 · Full text
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Analysis of factors influencing axial length changes in adolescents wearing corneal reshaping lenses.
Zhong G, Zheng R, Luo L
Arq Bras Oftalmol · 2025 · PMID 40699118 · Full text
PURPOSE: This study aimed to identify factors influencing axial length changes in adolescents wearing orthokeratology lenses. METHODS: A retrospective analysis was conducted on 84 adolescents (aged 9-17 yr) who wore orth...
PURPOSE: This study aimed to identify factors influencing axial length changes in adolescents wearing orthokeratology lenses. METHODS: A retrospective analysis was conducted on 84 adolescents (aged 9-17 yr) who wore orthokeratology lenses at our hospital. Axial length changes were calculated as the difference between the first and last visits. Patients were categorized into two groups based on axial length change: lower-than-average and higher-than-average. Data on sex, age at orthokeratology lens initiation, family history, initial equivalent spherical lens value, initial cylindrical lens value, initial average K value, and initial axial length were collected. Univariate and mixed-effects model analyses were performed to assess their influence on axial length changes. RESULTS: Age (p<0.05) and initial equivalent spherical value (p<0.05) were significant predictors of axial length changes in both eyes and the left eye. For the right eye, only age was a significant factor (p<0.05). The mixed-effects model revealed that the difference between the left and right eyes, duration of orthokeratology lens use, age, initial equivalent spherical lens value, and initial axial length significantly influenced axial length changes in adolescents (p<0.05). CONCLUSION: The factors influencing axial length changes in adolescents wearing orthokeratology lenses differ between the left and right eyes. These changes depend on the duration of lens wear, age, initial equivalent spherical lens value, and initial axial length. This study provides a theoretical basis for evaluating the clinical efficacy of orthokeratology lenses in managing myopia progression in adolescents.
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