RODRIGO FRANCA DE ESPINDOLA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Cataract surgery: emotional reactions of patients with monocular versus binocular vision(2012) MARBACK, Roberta Ferrari; ESPINDOLA, Rodrigo Franca de; SANTHIAGO, Marcony Rodrigues de; TEMPORINI, Edmea Rita; KARA-JUNIOR, NewtonPurpose: To analyze emotional reactions related to cataract surgery in two groups of patients (monocular vision - Group 1; binocular vision - Group 2). Methods: A transversal comparative study was performed using a structured questionnaire from a previous exploratory study before cataract surgery. Results: 206 patients were enrolled in the study, 96 individuals in Group 1 (69.3 +/- 10.4 years) and 110 in Group 2 (68.2 +/- 10.2 years). Most patients in group 1 (40.6%) and 22.7% of group 2, reported fear of surgery (p<0.001). The most important causes of fear were: possibility of blindness, ocular complications and death during surgery. The most prevalent feelings among the groups were doubts about good results and nervousness. Conclusion: Patients with monocular vision reported more fear and doubts related to surgical outcomes. Thus, it is necessary that phisycians considers such emotional reactions and invest more time than usual explaining the risks and the benefits of cataract surgery.
- Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry(2012) ESPINDOLA, Rodrigo Franca de; SANTHIAGO, Marcony Rodrigues de; KARA-JUNIOR, NewtonPurpose: To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL) on contrast sensitivity and blue-on-yellow perimetry. Methods: This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes) received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes) received ultraviolet and blue light filter (yellow tinted) IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD]) investigated two years after surgery. The results were compared intra-individually. Results: There was a statistically significant between-group (aspherical and spherical intraocular lens) difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens) under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. Conclusion: Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.
- A clinical comparison between DisCoVisc and 2% hydroxypropylmethylcellulose in phacoemulsification: a fellow eye study(2012) ESPINDOLA, Rodrigo F.; CASTRO, Emerson F. S.; SANTHIAGO, Marcony R.; KARA-JUNIOR, NewtonOBJECTIVE: This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification. METHODS: This prospective, randomized clinical trial comprised 78 eyes (39 patients) that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate or 2.0% hydroxypropylmethylcellulose on the first eye. The other eye was treated later and received the other viscoelastic agent. Preoperative and postoperative examinations (5, 24 and 48 hours; 7 and 14 days; 3 and 6 months) included measurements of the total volume of the ophthalmic viscosurgical device, ultrasound and washout times to completely remove the ophthalmic viscosurgical device, intraocular pressure, central corneal thickness and best-corrected visual acuity. The corneal endothelial cell count was measured at baseline and at six months postoperatively. ClinicalTrials.gov:NCT01387620. RESULTS: There were no statistically significant differences between groups in terms of cataract density or ultrasound time. However, it took longer to remove 2.0% hydroxypropylmethylcellulose than 1.6% hyaluronic acid/4.0% chondroitin sulfate, and the amount of viscoelastic material used was greater in the 2.0% hydroxypropylmethylcellulose group. In addition, the best-corrected visual acuity was significantly better in the hyaluronic acid/chondroitin sulfate group, but this preferable outcome was only observed at 24 hours after the operation. There were no statistically significant differences between the two ophthalmic viscosurgical devices regarding the central corneal thickness or intraocular pressure measurements at any point in time. The corneal endothelial cell count was significantly higher in the hyaluronic acid/chondroitin sulfate group. CONCLUSION: The ophthalmic viscosurgical device consisting of 1.6% hyaluronic acid/4.0% chondroitin sulfate was more efficient during phacoemulsification and was easier to remove after IOL implantation than 2.0% hydroxypropylmethylcellulose. In addition, the corneal endothelial cell count was significantly higher following the use of hyaluronic acid/chondroitin sulfate than with hydroxypropylmethylcellulose, which promoted an improved level of corneal endothelium protection.
- Cancelamento de cirurgias de catarata em um hospital público de referência(2012) MAGRI, Micheli Patricia de Fatima; ESPINDOLA, Rodrigo Franca de; SANTHIAGO, Marcony Rodrigues de; MERCADANTE, Elisabeth Frolich; KARA JUNIOR, NewtonPurpose: To report the incidence and causes of cataract surgery cancellations in a public hospital. Methods: This is a retrospective study, which examined the number of cancellations of cataract surgery during 2009. We analyzed the type of procedure suspended (phacoemulsification or extracapsular extraction), type of anesthesia, gender, age, covenant (public/private) and the main reasons for suspension of the surgeries (clinical causes, institutional or personal). Results: We analyzed 2,965 scheduled cataract surgeries, with 650 cancellations (21.92%). The main reason for the suspension of the procedure was clinical causes (86.90%). The winter months had the highest suspension rates of cataract surgery. Conclusion: The cancellation rate of cataract surgery in Brazilian public system seems to be the same as 10 years ago. The main cause of the suspension should be in clinical conditions (hypertension, diabetes, lack of exams, etc.).
- Facoemulsificação versus extração extracapsular no sistema público de saúde: análise de custos para o hospital, para o governo e para a sociedade(2012) KARA-JUNIOR, Newton; SANTHIAGO, Marcony Rodrigues de; ESPINDOLA, Rodrigo Franca dePurpose: To compare the costs of cataract surgery for a public hospital, the government and the society between the techniques of phacoemulsification (PHACO) and extracapsular cataract extraction (EECP). Methods: A review based on several clinical studies between 2002 and 2010 at the Ambulatorial Surgical Center of the University of Sao Paulo. Results: The estimated expenses associated with medical supplies used for surgery were R$ 468.92 and R$ 259.96 in the PHACO and EECP groups respectivelly. The hospital expenditures in the postoperative follow-up was approximately R$ 16.40 (42%) lower in the PHACO. Regarding the estimated spending for Social Security, the EECP group cost an average, US$ 44.58 per patient more than the PHACO group.