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
9 resultados
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article 14 Citação(ões) na Scopus Expectation and knowledge among patients with keratoplasty indication(2011) KARA-JUNIOR, Newton; MOURAD, Paula de Camargo Abou; ESPINDOLA, Rodrigo Franca de; ABILRUSS, Heloisa HelenaPurpose: To know characteristics and difficulties to access patients' treatment selected to keratoplasty in community projects carried out in a university hospital in Sao Paulo. Methods: A questionnaire was applied on patients in two keratoplasty campaigns performed by the hospital. Was analyzed the following variables: gender, age, income, education, number of previous ophthalmologists 'appointment, visual acuity in the better eye, diagnosis, indication for keratoplasty, knowledge about it, the eye disease and the existence of limitations on lifestyle and possible complications after surgery, expectation of rehabilitation, among others. Results: Most of the 99 patients interviewed (57.8%) had left the job because of visual difficulty and dependent on outside help for everyday activities. From the 90 patients who already had early indication of a keratoplasty (91.0%), half of them had not even managed to join the list of eye banks. From the patients with previous indication for keratoplasty, 18.9% didn't know what was their eye problem, 27.8% didn't know what was keratoplasty, 18.7% were not aware of possible complications during and after the surgery and 32, 2% ignored the existence of limitations in lifestyle after surgery. Conclusion: The patients' unknowledge about their condition and treatment is clear. It is extremely important to emphasize that to obtain a satisfactory surgical result, there is a need of an appropriate patient selection and guidance about their eye problem, the proposed surgery, care and risk per and post operative as well as the visual rehabilitation perspective.article 9 Citação(ões) na Scopus Dificuldades de acesso ao tratamento de pacientes com indicação de cirurgia de catarata nos Sistemas de Saúde Público e Privado(2011) KARA-JUNIOR, Newton; DELLAPI JR., Roberto; ESPINDOLA, Rodrigo Franca dePurpose: To identify the difficulties in access to diagnosis and treatment of cataract in patients attended during a cataract campaign. Methods: A questionnaire was administered to patients selected for cataract surgery. We evaluated, among others, the following variables: prior access to ophthalmologists (public or private), reason(s) for not having surgery early in the initial service, the average cost charged by cataract surgery and intraocular lens (IOL) (private services and agreements). Results: A total of 627 patients was evaluated. Most of them - 595 (95%) had previously attended an ophthalmologist, and in 63% of cases (375 patients) the consultation had been held for less than a year. The last evaluation was performed by the Brazilian Public Health System (SUS) in 52% of the cases (307 patients). Regarding the reason for not having surgery in the initial service, the high cost of the surgery (R$ 2.000 - R$ 4.000) and the cost of IOLs (R$ 1.000 - R$ 1.500) was the main obstacle for most attended services and private covenants. Conclusion: The results of this study suggest that the routine of ophthalmologic care in SUS at Sao Paulo is not prepared to answer the demand for cataract surgeries and private healthcare system still excludes a portion of the population. It is important to continue the implementation of community campaigns to serve the population that would be unable to access the surgery through conventional ways.- 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
- Central Corneal Thickness in Patients With Systemic Sclerosis: A Controlled Study(2011) GOMES, Beatriz de A. F.; SANTHIAGO, Marcony R.; KARA-JUNIOR, Newton; NOE, Rosangela A. M.; AZEVEDO, Mario N. L. de; MORAES JR., Haroldo V.Purpose: To compare the central corneal thickness (CCT) of patients with systemic sclerosis (SSc) and control subjects. Methods: The study group comprised 37 consecutive patients with SSc, and the control group comprised 23 healthy individuals similar in age and sex. CCT value was measured by ultrasound pachymetry. Results: In the SSc group, the mean CCT in the right eye was 534.9 +/- 33.5 mu m and 536.9 +/- 32.4 mu m in the left eye. In the control group, the mean CCT was 533.0 +/- 32.9 mu m in the right eye and 533.1 +/- 33.6 mu m in the left eye. The mean CCT was not significantly different in the SSc group compared with the control group for both the right (P = 0.83) and left (P = 0.67) eyes. Conclusions: CCT measurements do not significantly differ in patients with SSc compared with healthy control subjects.
- Ocular findings in patients with systemic sclerosis(2011) GOMES, Beatriz de A. F.; SANTHIAGO, Marcony R.; MAGALHAES, Priscilla; KARA-JUNIOR, Newton; AZEVEDO, Mario N. L. de; MORAES JR., Haroldo V.OBJECTIVE: To evaluate the frequency and characteristics of ocular manifestations in outpatients with systemic sclerosis. METHODS: In this cross-sectional study, 45 patients with systemic sclerosis were enrolled. Data regarding demographics, disease duration and subtype, age at diagnosis, nailfold capillaroscopic pattern and autoantibody profile were collected, and a full ophthalmic examination was conducted. Parametric (Student's t-test) and nonparametric (Mann-Whitney U test) tests were used to compare continuous variables. Fisher's exact test was used to compare categorical data. P values < 0.05 were considered significant. RESULTS: Twenty-three subjects (51.1%) had eyelid skin changes; 22 (48.9%) had keratoconjunctivitis sicca, 19 (42.2%) had cataracts, 13 (28.9%) had retinal microvascular abnormalities and 6 (13.3%) had glaucoma. Eyelid skin changes were more frequent in patients with the diffuse subtype of systemic sclerosis and were associated with a younger age and an earlier age at diagnosis. Cataracts were presumed to be age-related and secondary to corticosteroid treatment. There was no association between demographic, clinical or serological data and keratoconjunctivitis sicca. The retinal microvascular abnormalities were indistinguishable from those related to systemic hypertension and were associated with an older age and a severe capillaroscopic pattern. CONCLUSIONS: Eyelid skin abnormalities and keratoconjunctivitis sicca were the most common ocular findings related to systemic sclerosis. Some demographic and clinical data were associated with some ophthalmic features and not with others, showing that the ocular manifestations of systemic sclerosis are characterized by heterogeneity and reflect the differences in the implicated pathophysiological mechanisms.
- 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
- Effects of blue light-filtering intraocular lenses on the macula, contrast sensitivity, and color vision after a long-term follow-up(2011) KARA-JUNIOR, Newton; ESPINDOLA, Rodrigo F.; GOMES, Beatriz A. F.; VENTURA, Bruna; SMADJA, David; SANTHIAGO, Marcony R.PURPOSE: To evaluate the possible side effects and potential protection 5 years after implantation of an intraocular lens (IOL) with a blue-light filter (yellow tinted). SETTING: Ophthalmology Department, University of Sao Paulo, Sao Paulo, Brazil. DESIGN: Prospective randomized clinical study. METHODS: Patients with bilateral visually significant cataract randomly received an ultraviolet (UV) and blue light filtering IOL (Acrysof Natural SN60AT) in 1 eye and an acrylic UV light filtering only IOL (Acrysof SA60AT) in the fellow eye. The primary outcome measures were contrast sensitivity, color vision, and macular findings 5 years after surgery. RESULTS: The study enrolled 60 eyes of 30 patients. There were no significant clinical or optical coherence tomography findings in terms of age-related macular degeneration in any eye. There were no statistically significant differences in central macular thickness between the 2 IOL groups (P=.712). There were also no significant between-group differences under photopic or scotopic conditions at any spatial frequency studied. No statistically significant differences in the color discrimination test were found between the 2 IOL groups (P=.674). CONCLUSIONS: After 5 years, there were no significant differences in color perception, scotopic contrast sensitivity, or photopic contrast sensitivity between the blue light filtering (yellow-tinted) IOL and the IOL with a UV-light filter only (untinted). The potential advantage of the tinted IOL in providing protection to macular cells remains unclear.
article Status of the phacoemulsification teaching in Brazil(2011) KARA-JUNIOR, Newtonarticle 3 Citação(ões) na Scopus Importância do centro cirúrgico ambulatorial para a realização de cirurgias de catarata em larga escala(2011) KARA-JUNIOR, Newton