SÃ£o Paulo (SP) - Conselho Brasileiro de Oftalmologia

More documents

Recommendations

Info

Twenty-five gauge vitrectomy in uveitis experience using the t ransconjunctival sutureless vitrectomy system for vitreoretinal surgery. Ophthalmology. 2002;109(10):1814-20. 6. Fujii GY, De Juan E Jr, Humayun MS, Pieramici DJ, Chang TS, Awh C, et al. A new 25-gauge instrument system f or transconjunctival sutureless vitrectomy surgery. Ophthalmology. 2002;109(10):1807-12; discussion 1813. Erratum in: Ophthalmology. 2003; 110(1):9. 7. Kellner L, Wimpissinger B, Stolba U, Brannath W, Binder S. 25-gauge vs 20-gauge system for pars plana vitrec tomy: a prospective randomised clinical trial. Br J Ophthalmol. 2007;91(7):945-8. 8. Rizzo S, Genovesi-Ebert F, Murri S, Belting C, Vento A, Cresti F, Manca ML. 25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study. Graefes Arch Clin Exp Oph - thalmol. 2006;244(4):472-9. 9. Kadonosono K, Yamakawa T, Uchio E, Yanagi Y, Tamaki Y, Araie M. Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy. Am J Ophthalmol. 2006;142(3):513-5. 10. Ibarra MS, Hermel M, Prenner JL, Hassan TS. Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy. Am J Ophthalmol. 2005;139(5):831-6. 11. Jabs DA, Nussenblatt RB, Rosenbaum JT; Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005;140(3):509-16. 12. Nussenblatt RB, Palestine AG, Chan CC, Roberge F. Standardization of vitreal inflam - matory activity in intermediate and posterior uveitis. Ophthalmology. 1985;92(4):467-71. 13. Holladay JT. Proper method for calculating average visual acuity. J Refract Surg. 1997; 13(4):388-91. 14. Sonoda KH, Enaida H, Ueno A, Nakamura T, Kawano YI, Kubota T, et al. Pars plana vitrectomy assisted by triamcinolone acetonide for refractory uveitis: a case series study. Br J Ophthalmol. 2003;87(8):1010-4. 15. Lakhanpal RR, Humayun MS, de Juan E Jr, Lim JI, Chong LP, Chang TS, et al. Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology. 2005;112(5):817-24. 16. Miyahara T, Ohta K, Yamamoto Y, Ueno A, Murata T. 25-gauge vitrectomy to treat ocular complications of familial amyloid polyneuropathy. J Glaucoma. 2007;16(1):169-70. 17. Bosch-Driessen LH, Plaisier MB, Stilma JS, Van der Lelij A, Rothova A. Reactivations of ocular toxoplasmosis after cataract extraction. Ophthalmology. 2002;109(1):41-5. 18. Martidis A, Chang TS. Sutureless 25-gauge vitrectomy: risky or rewarding? Ophthalmology. 2007;114(12):2131-2. 19. Kunimoto DY, Kaiser RS; Wills Eye Retina Service. Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology. 2007;114(12):2133-7. Comment in Oph - thalmology. 2007;114(12):2131-2. 20. Chen JK, Khurana RN, Nguyen QD, Do DV. The incidence of endophthalmitis following transconjunctival sutureless 25- vs 20-gauge vitrectomy. Eye (Lond). 2009;23(4): 780-4. 21. Soheilian M, Mirdehghan SA, Peyman GA. Sutureless combined 25-gauge vitrectomy, phacoemulsification, and posterior chamber intraocular lens implantation for management of uveitic cataract associated with posterior segment disease. Retina. 2008;28(7):941-6. VI Congreso ALACCSA-R Asociación Latinoamericana de Cirujanos de Catarata, Segmento Anterior y Refractiva 04 a 06 de outubro de 2012 Hotel Hilton Puerto Madero Buenos Aires - Argentina Informações: Site: www.alaccsa-r.com 110 Arq Bras Oftalmol. 2012;75(2):107-10
Artigo Original | ORIGINAL ARTICLE Bupivacaine and botulinum toxin to treat comitant strabismus Bupivacaína e toxina botulínica para tratamento de estrabismo comitante LUISA MOREIRA HOPKER 1 , PRISCILA FERNANDES ZAUPA 1 , ACÁCIO ALVES DE SOUZA LIMA FILHO 2 , MONICA FIALHO CRONEMBERGER 1 , MARCIA KEIKO UYENO TABUSE 1 , CÉLIA REGINA NAKANAMI 1 , NORMA ALLEMANN 3 , TOMÁS SCALAMANDRÉ MENDONÇA 1 ABSTRACT Purpose: To evaluate the change in ocular motility and muscle thickness measured with ultrasonography after intramuscular injection of bupivacaine and botulinum toxin A. Methods: Eight patients (five female) were enrolled to measure ocular motility prior and 1, 7, 30 and 180 days after one injection of 2 ml of 1.5% bupivacaine and 2.5 U of botulinum toxin A in agonist and antagonist muscles, respectively, of eight amblyopic eyes. Muscle thickness was measured prior and on days 1, 7 and 30 after injection using 10-MHz ultrasonography (eyelid technique). Results: Mean change in alignment was 10 prism diopters after 180 days (n=6). An average increase of 1.01 mm in muscle thickness was observed after 30 days of bupivacaine injection and 0.28 mm increase was observed after botulinum toxin A injection, as measured by ultrasonography. Lateral rectus muscles injected with bupivacaine had a mean increase of 1.5 mm in muscle thickness. Conclusion: In this study, a change in ocular motility was observed after 180 days of intramuscular injection of bupivacaine and botulinum toxin in horizontal extraocular muscles. Overall, there was an increase of muscle thickness in both botulinum toxinum A and bupivacaine injected muscles after 30 days of injection when measured by ultrasonography. This change was more pronounced on lateral rectus muscles after bupivacaine injection. Keywords: Oculomotor muscles; Strabismus/diagnosis; Strabismus/drug therapy; Esotropia/drug therapy; Botulinium toxins, type A/administration & dosage; Botuli nium toxins, type A/therapeutic use; Bupivacaine/therapeutic use; Bupivacaine/administration & dosage; Injections, intramuscular; Ultrasonography RESUMO Objetivo: Avaliar a mudança na motilidade ocular e espessura dos músculos medida por ultrassonografia após injeção intramuscular de bupivacaína e toxina botulínica tipo A. Métodos: Oito pacientes (5 mulheres) foram incluidos para avaliar a mudança na motilidade ocular antes e após 1, 7, 30 e 180 dias da injeção de 2 ml de bupivacaína 1,5% e 2,5 U de toxina botulínica tipo A nos músculos agonista e antagonista, respectivamente, de 8 olhos amblíopes. A espessura muscular foi medida antes após 1, 7, 30 dias da injeção através de ultrassonografia ocular 10-MHz (técnica palpebral). Resultados: A média de mudança no alinhamento ocular foi igual a 10 dioptrias pris máticas após 180 dias (n=6). Foi observado um aumento médio de 1,01 mm na espessura muscular após 30 dias da injeção de bupivacaína e 0,28 mm após a injeção de toxina botulínica A medido pela ultrassonografia. Os músculos reto laterais injetados com bupivacaína tiveram um aumento médio de 1,5 mm na sua espessura. Conclusão: Neste estudo, observou-se uma mudança no alinhamento ocular após 180 dias de injeção intramuscular de bupivacaína e toxina botulínica A. Em geral, houve um aumento da espessura muscular de ambos os grupos de músculos injetados com toxina botulínica A e com bupivacaína após 30 dias da injeção. Essa mudança foi mais pronunciada nos músculos retos laterais após a injeção de bupivacaína. Descritores: Músculos oculomotores; Estrabismo/diagnostico; Estrabismo/quimioterapia; Esotropia/quimioterapia; Toxinas botulínicas tipo A/administração & dosagem; Toxinas botulínicas tipo A/uso terapêutico; Bupivacaína/uso terapêutico; Bupivacaína/administração & dosagem; Injeções intramusculares; Ultrassonografia INTRODUCTION Strabismus treatment traditionally includes the correction of re - fractive errors, amblyopia treatment, chemical weakening of the muscles with botulinum toxin A or a surgical procedure. Surgery is a procedure that presents some drawbacks such as conjunctival scars and changes in rotational forces which may limit ocular motility (1-3) . For this reason some attention has been given to new substances such as botulinum toxin A and more recently, bupivacaine. These medications may promote changes in muscle biomechanics not attainable with surgery (4) . These changes include modulation of muscle force without permanently changing the muscle insertion on the eye (5) . Bupivacaine is an anesthetic drug that has been used in peribulbar and retrobulbar anesthesia for a long time and presents few complications (6) . Many studies have shown that muscles in which bupivacaine was accidentally injected such as in anesthetic blocks for cataract surgery, presented a change in ocular alignment with subsequent diplopia (7) . Hypertrophy of such muscles after bupivacaine injection has been described (8-10) . Bupivacaine affects the extraocular muscles through selective damage to fibers while preserving cellular support structures, nerves and satellite cells. Through growth factors released by damaged tissue, the satellite cells proliferate and form new muscle fibers repairing the initial damage and causing muscle hypertrophy. This hypertrophy increases the stiffness and muscle contractility with consequences in ocular alignment. These changes are permanent, with alignment stability and muscle hypertrophy reported up to 500 days after injection (11) . For the purpose of ocular alignment, bupivacaine should be injected with an aid of a electroneuromiography (EMG) needle under topical anesthesia, used to determine the adequate position of the needle which would be used to inject the substance intramuscularly, in the posterior third of the muscle (4,11,12) . Submitted for publication: June 1, 2011 Accepted for publication: March 9, 2012 Study carried out at Department of Ophthalmology, Federal University of São Paulo - UNIFESP. 1 Physician, Pediatric Ophthalmology and Strabismus Service, Department of Ophthalmology, Federal University of São Paulo - UNIFESP - São Paulo (SP), Brazil. 2 Pharmaceutical, Ocular Pharmacology Service, Department of Ophthalmology, Federal University of São Paulo - UNIFESP - São Paulo (SP), Brazil. 3 Physician, Ocular Ultrasonography Service, Department of Ophthalmology, Federal University of São Paulo - UNIFESP - São Paulo (SP), Brazil. Funding: No specific financial support was available for this study. Disclosure of potential conflicts of interest: L.M.Hopker, None; P.F.Zaupa, None; A.A.S.Lima Filho, None; M.F.Cronemberger, None; M.K.U.Tabuse, None; C.R.Nakanami, None; N.Allemann, None; T.S.Mendonça, None. Comissão de Ética e Pesquisa Universidade Federal de São Paulo: Aprovado 1148/10. Correspondence address: Luisa Moreira Hopker. Rua Munhoz da Rocha 98, Apto. 31 - Curitiba (PR) - 80035-000 - Brazil - E-mail: luhopker@gmail.com Arq Bras Oftalmol. 2012;75(2):111-5 111
Page 1 and 2: ISSN 0004-2749 versão impressa A R
Page 3 and 4: SE VOCÊ ACHA QUE TODAS AS COMBINA
Page 5 and 6: Lançamento no Brasil! Olho Seco P
Page 8: Inscrições com desconto até 31/0
Page 12 and 13: PUBLICAÇÃO OFICIAL DO CONSELHO BR
Page 14 and 15: 122 126 Avaliação de corpos estra
Page 16 and 17: Editorial | Editorial Good reportin
Page 18 and 19: Comparação do teste modificado de
Page 20 and 21: Evaluation of silicon oil on bacter
Page 22 and 23: Artigo Original | ORIGINAL ARTICLE
Page 24 and 25: Estrabismo: detecção em uma amost
Page 26 and 27: Estrabismo: detecção em uma amost
Page 28 and 29: Obstrução de vias lacrimais assoc
Page 30 and 31: Obstrução de vias lacrimais assoc
Page 32 and 33: Impression cytologic analysis after
Page 38 and 39: Twenty-five gauge vitrectomy in uve
Page 42 and 43: Bupivacaine and botulinum toxin to
Page 44 and 45: Bupivacaine and botulinum toxin to
Page 48 and 49: Comparison of wavefront aberrations
Page 50 and 51: Comparison of wavefront aberrations
Page 54 and 55: Avaliação de corpos estranhos no
Page 58 and 59: Femtosecond assisted intrastromal c
Page 60 and 61: Femtosecond assisted intrastromal c
Page 62 and 63: Surgical treatment of globe subluxa
Page 64 and 65: Relatos de Casos | CASE REPORTS Les
Page 66 and 67: Lesões oculares por Pprocessionár
Page 68 and 69: Clinical and histopathological feat
Page 70 and 71: Relato de Caso | CASE REPORT Retini
Page 72 and 73: Retinite idiopática, vasculite, an
Page 74 and 75: Experimental models of autoimmune i
Page 76 and 77: Experimental models of autoimmune i
Page 78 and 79: Cartas ao Editor | LETTERS TO THE E
Page 80 and 81: AUTORIA Os critérios para autoria
Page 82 and 83: LISTA DE SÍTIOS DA INTERNET Interf
Page 84: Optifog é uma marca registrada da

SÃ£o Paulo (SP) - Conselho Brasileiro de Oftalmologia

Create successful ePaper yourself

Delete template?

Save as template?