NEWTON KARA JOSE JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
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- Intracorneal Ring Segments Implantation for Corneal Ectasia(2016) GIACOMIN, Natalia T.; MELLO, Glauco R.; MEDEIROS, Carla S.; KILIC, Alyin; SERPE, Cristine C.; ALMEIDA, Hirlana G.; KARA-JUNIOR, Newton; SANTHIAGO, Marcony R.PURPOSE: To provide an overview of the predictability, safety, and efficacy of intrastromal corneal ring segment (ICRS) implantation as a tool to improve visual acuity and its association with other techniques such as corneal collagen cross-linking (CXL), addressing biomechanical outcomes, models, surgical planning and technique, indications, contraindications, and complications in ectatic corneas. METHODS: Literature review. RESULTS: ICRSs have been used to regularize the corneal shape and reduce corneal astigmatism and higher order aberrations, improve visual acuity to acceptable limits, and delay, or eventually prevent, a corneal keratoplasty in keratoconic eyes. Changes in ICRS thickness and size, combination of techniques, and the addition of femtosecond lasers to dissect more foreseeable channels represent an improvement toward more predictable results. Several studies have shown, over time, the long-term efficacy and safety of ICRS treatment for keratoconus, with variable predictability, maintaining the early satisfactory outcomes regarding visual acuity, keratometry, and corneal thickness. It is just as important to ensure that the disease will not progress as it is to improve the visual acuity. Therefore, many studies have shown combined techniques using ICRS implantation and CXL. Also, further limitations of ICRS implantation can be addressed when associated with phakic intraocular lens implantation and photorefractive keratectomy. CONCLUSIONS: ICRS implantation has shown effectiveness and safety in most cases, including combined procedures. In properly selected eyes, it can improve both refraction and vision in patients with keratoconus.
- Outcomes of Toric Iris-Claw Phakic Intraocular Lens Implantation After Deep Anterior Lamellar Keratoplasty for Keratoconus(2017) TIVERON JR., Mauro C.; BARRIO, Jorge L. Alio del; KARA-JUNIOR, Newton; PLAZA-PUCHE, Ana Belen; ABU-MUSTAFA, Sabat K.; ZEIN, Ghassan; ALIO, Jorge L.PURPOSE: To assess visual and refractive outcomes of toric iris-claw phakic intraocular lens (IOL) implantation in patients who had previously undergone deep anterior lamellar keratoplasty (DALK). METHODS: Retrospective case series including 24 eyes of 24 patients implanted with toric Artiflex or Artisan (Ophtec BV, Groningen, Holland) phakic IOL following DALK for keratoconus. During a 12-month follow-up, the main outcome measures were uncorrected and corrected distance visual acuities (UDVA and CDVA), refractive error components, topographic parameters, and endothelial cell count. Alpins vectorial analysis was performed. RESULTS: At the last follow-up, the spherical equivalent (SE) was within +/- 0.50 diopters (D) in 71% of eyes and within +/- 1.00 D in 92% of eyes. Mean refractive astigmatism was reduced from -4.92 +/- 1.55 D (range: -2.50 to -8.00 D) preoperatively to -0.66 +/- 0.61 D (range: -2.00 to 0.00 D) after treatment, and 76.5% of cases were within +/- 1.00 D. No significant differences (P =.123) were detected in spherical equivalent values between 3-and 12-month follow-up visits. No eyes lost lines in CDVA, and 54% of eyes gained one or more lines. Postoperative UDVA was 20/40 or better in 88% of eyes. Efficacy and safety indexes at 12 months were 0.93 and 1.00, respectively. Mean endothelial cell loss was 6.10% at 12 months postoperatively. No intraoperative or postoperative complications were noted over the follow-up period. CONCLUSIONS: The implantation of a toric iris-claw phakic IOL has shown high efficacy and safety in this series and may be considered as a reasonable option for the management of refractive errors after DALK.
- Visual Performance of an Apodized Diffractive Multifocal Intraocular Lens With+3.00-D Addition: 1-year Follow-up(2011) SANTHIAGO, Marcony R.; WILSON, Steven E.; NETTO, Marcelo V.; ESPINDOLA, Rodrigo F.; SHAH, Ravindra A.; GHANEM, Ramon C.; BECHARA, Samir J.; KARA-JUNIOR, NewtonPURPOSE: To determine whether implantation of a multifocal intraocular lens (IOL) with a lower addition (+3.00 diopters [D]) at the lens plane results in better intermediate visual acuity 1 year after surgery compared with a multifocal IOL with higher addition (+4.00 D). METHODS: This prospective, randomized, double-masked study included 80 eyes from 40 patients. Twenty patients were implanted bilaterally with the ReSTOR +3.00-D add IOL and 20 patients were implanted bilaterally with the ReSTOR +4.00-D add IOL. Primary outcome measures were distance, intermediate, and near visual acuity. Secondary outcomes were defocus curves, best reading distance, mesopic and photopic contrast sensitivity, quality of life, and spectacle independence. Monocular and binocular visual acuity were measured as uncorrected and corrected distance visual acuity at 4 m, uncorrected near and distance-corrected near visual acuity at 40 cm, and uncorrected intermediate visual acuity and distance-corrected intermediate visual acuity at 50, 60, and 70 cm. RESULTS: Twelve months postoperatively, no statistically significant difference between groups in distance and near visual acuity was noted. The ReSTOR +3.00-D add group performed better than the ReSTOR +4.00-D add group at all intermediate distances studied. The ReSTOR +4.00-D group chose a reading distance 8 cm closer than the +3.00-D group. Both groups performed similarly with respect to contrast sensitivity, quality of life, and spectacle independence rates. CONCLUSIONS: Patients implanted with a multifocal IOL with lower addition (ReSTOR +3.00 D) had better performance at intermediate distances compared with the ReSTOR +4.00-D add IOL with similar performance for distance and near visual acuity, contrast sensitivity, and quality of life. [J Refract Surg. 2011;27(12):899-906.] doi:10.3928/1081597X-20110816-01
- Optical Quality in Eyes Implanted With Aspheric and Spherical Intraocular Lenses Assessed by NIDEK OPD-Scan: A Randomized, Bilateral, Clinical Trial(2011) SANTHIAGO, Marcony R.; NETTO, Marcelo V.; BARRETO JR., Jackson; GOMES, Beatriz A. F.; OLIVEIRA, Cristiane D.; KARA-JUNIOR, NewtonPURPOSE: To determine whether implantation of an intraocular lens (IOL) with an aspheric surface (Akreos AO, Bausch & Lomb Inc) results in reduced ocular aberrations (spherical aberration) and improved Strehl ratio and modulation transfer function (MTF) after cataract surgery. METHODS: In an intraindividual, randomized, double-masked, prospective study of 50 eyes (25 patients) with bilateral cataract, an IOL with modified anterior and posterior surfaces (Akreos AO) was implanted in one eye and a biconvex IOL with spherical surfaces (Akreos Fit, Bausch & Lomb Inc) implanted in the fellow eye. Ocular aberrations, Strehl ratio, and MTF curve with 4.5-, 5.0-, and 6.0-mm pupils were measured with a NIDEK OPD-Scan dynamic retinoscopy aberrometer 3 months after surgery. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) were also measured. RESULTS: No statistically significant difference was noted between eyes in postoperative UDVA and CDVA at 1 month. At 3 months, the Akreos AO IOL group obtained statistically significant lower values of higher order and spherical aberrations with 4.5-, 5.0-, and 6.0-mm pupil diameters than the Akreos Fit IOL group (P<.05). The value of Strehl ratio was statistically significantly higher in eyes with the Akreos AO IOL for 4.5- and 6.0-mm pupils (P<.05). The MTF curve was better in the Akreos AO IOL group in 4.5-, 5.0-, and 6.0-mm pupils (P<.05). CONCLUSIONS: The aspheric Akreos AO IOL induced significantly less spherical aberration than the Akreos Fit IOL for 4.5-, 5.0-, and 6.0-mm pupils. Modulation transfer function and Strehl ratio were also better in eyes implanted with the Akreos AO IOL than the Akreos Fit. [J Refract Surg. 2011;27(4):287-292.] doi:10.3928/1081597X-20100714-01