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
10 resultados
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- Technology, teaching, and the future of ophthalmology and the ophthalmologist(2018) KARA-JUNIOR, Newton
- Evaluation of Corneal Parameters with Dual Scheimpflug Imaging in Patients with Systemic Sclerosis(2018) GOMES, Beatriz Fiuza; SANTHIAGO, Marcony R.; KARA-JUNIOR, Newton; MORAES JR., Haroldo VieiraPurpose: To evaluate the cornea of systemic sclerosis (SSc) patients with Dual Scheimpflug Imaging.Methods: Twenty consecutive SSc patients and 20 age and sex matched controls were enrolled in this cross-sectional study. Corneal measurements were acquired by dual Scheimpflug analyzer.Results: SSc patients had statistically significant steeper corneas than the control group. The mean anterior curvature-average (SimK) was 44.931.64 D (mean +/- standard deviation) in SSc and 43.61 +/- 0.99D in control group, p=0.01. Posterior curvature was also steeper in SSc patients compared to controls (p=0.02). There was no statistically significant difference regarding central average pachymetry (p=0.07), thinnest pachymetry (p=0.09).Conclusions: Patients with SSc present with steeper corneas than controls.
- Trends in corneal transplantation from 2001 to 2016 in Brazil(2018) ALMEIDA, Hirlana Gomes; HIDA, Richard Yudi; KARA-JUNIOR, NewtonA retrospective and analytical study was conducted by using data from the National Transplantation System on 184,575 corneal transplantations performed between January 2001 and December 2016 in order to analyze the trends in corneal transplantation from 2001 to 2016 in Brazil. The Cochran-Armitage test, analysis of variance, and Duncan's multiple comparisons were used to verify the existence of trends, compare the mean values between regions, and verify the mean differences, respectively. A significance level of 5% was used for all tests. The analysis showed that there was a 2.4-fold increase in the number of corneal transplantations (from 6,193 [35.2 per million people (pmp)] to 14,641 [71 pmp]; p<0.001), a 50.7% increase in the efficacy of meeting the population's demand for corneal transplantation (from 35.3% to 53.2%; p<0.001), an 11-fold increase in the number of corneal transplantation centers (from 32 to 356), and a 2.5-fold increase in the number of corneal transplantation teams (from 276 to 688) in Brazil during the period studied. The waiting list for corneal transplantation decreased by 45.4% (from 23,549 [123 pmp] to 12,865 [62.4 pmp]; p<0.001), and the corneal transplantation teams performed about 19 corneal transplantations per year. The best indices were observed in the southern, midwestern, and southeastern regions, and the worst indices were in the northern and northeastern regions. Brazil has been improving its capacity to perform corneal transplantation in the past 16 years, although this improvement varies across regions. However, the population's demand for corneal transplantation is yet to be satisfactorily met, primarily due to the low number of corneal donations.
- Anticoagulants and antiplatelet drugs during cataract surgery(2018) KARA-JUNIOR, Newton; KOCH, Camila Ribeiro; SANTHIAGO, Marcony Rodrigues de; FORNARI, Luciana; CARAMELLI, BrunoPatients undergoing cataract surgery are generally elderly, and many take drugs with systemic effects. The surgeon must be aware of the risks of continuing or discontinuing such medications perioperatively. Antiplatelet drugs and anticoagulants, prescribed to reduce the incidence of thromboembolic events, are often used in this population. This paper aims to review the perioperative use of antiplatelet and anticoagulant drugs in the setting of cataract surgery. Topical or intracameral anesthesia is preferred over anesthesia injected with needles. Aspirin can be safely continued in patients undergoing cataract surgery. Warfarin has been extensively studied, and the risk of hemorrhage associated with cataract surgery is low if the international normalized ratio is in the therapeutic range. Only a few studies of direct oral anticoagulants are available, and therefore no definite recommendations regarding those agents can be made at this time. Anesthesia in cataract surgery carries a low risk, even for patients taking anticoagulant or antiplatelet drugs. The discontinuation of this class of drugs before cataract surgery may increase the risk of thromboembolism.
- A 15-Year Review of Corneal Transplant in Brazil(2018) ALMEIDA, Hirlana Gomes; KARA-JOSE, Newton; HIDA, Richard Yudi; KARA-JUNIOR, NewtonPurpose: To analyze 15-year of corneal transplant in Brazil. Methods: Cross-sectional, retrospective, observational, and analytical study, between available data from the Brazilian Transplant Registry (January 2002-December 2016), collected by the Brazilian Association of Organ Transplantation was performed. The variables analyzed per year were number of corneal transplants, corneal transplants per million people (pmp), corneal transplant teams, and individuals on the waiting list for corneal transplants. Quantitative variables were expressed by their respective values. To verify the relationship of time with the variables, the Spearman correlation test was applied, adopting P<0.05 for rejection of the null hypothesis. Results: Evaluation of the data from 2002 to 2016 revealed an increase in number of (1) corneal transplants (4,976-14,534-approximately 292% in 15 years; P<0.0001); (2) corneal transplants pmp (29.4-71.1 pmp; P<0.0001); (3) productivity of corneal transplants teams (40.1-79 transplants by each team per year; P=0.067); (4) effectiveness in meeting the Brazilian population demand for corneal transplants per year (18.2%-57.0%; P<0.0001); (5) potential donors (P<0.0001), effective donors (P<0.0001), and nondonors (P<0.0001). There was a reduction in the number of patients on the waiting list (19,189-10,923; P=0.056). Conclusion: Despite the progress in the last decade, the number of corneal transplants in Brazil cannot meet the growing population demand. Thus, this study suggests the implementation of more effective public policies of corneal transplants in Brazil, to minimize disparities in national territory, adequately meet the population demand, and reduce the time in waiting lists for corneal transplants.
conferenceObject Medial Canthus Hyperpigmentation in Ocular Allergy(2018) DOMPIERI, Rodrigo Crispim C.; GONTIJO, Leonardo Cesar; CRUZ, Natasha; GONTIJO, Leonardo Coellho; GONTIJO, Aquiles Diniz; HIDA, Richard Y.; KARA JUNIOR, Newton- Análise crítica das diferentes fontes de dados sobre transplante de córnea no Brasil(2018) ALMEIDA, Hirlana Gomes; KARA-JUNIOR, NewtonAbstract Corneal diseases account for about 4 to 5% of reversible blindness in the world. Corneal transplantation is the most transplanted tissue in the world and the only widely accepted treatment to promote corneal transparency and restore vision. Monitoring was incorporated into the field of Public Health, with the objective of systematically monitoring teams’ performance and production data, through the creation of norms, periodic evaluation inspections and monitoring of quality indicators. The critical analyzes of the results aim to point out flaws and risks involved in the process, and to undertake actions capable of modifying the negative findings, in order to improve the quality of the services provided to the population. In Brazil, there are different sources of data on corneal transplants and ocular tissue banks. In this review, the accuracy of the data and the reliability of the information disclosed by the National Transplant System by the Brazilian Organ Transplant Association and the National Sanitary Surveillance Agency on the situation of corneal transplantation in Brazil were evaluated in order to guide governments, public health managers and researchers.
- Long-term results of secondary intraocular lens implantation in children under 30 months of age(2018) KOCH, Camila R.; KARA-JUNIOR, Newton; SERRA, Alicia; MORALES, MartaPurpose To report the long-term outcome of early secondary intraocular lens (IOL) implantation following congenital cataract extraction in a large number of eyes. Methods Data of aphakic children under 30 months of age who underwent secondary IOL implantation and had at least one year of follow-up after the surgery was reviewed. In all of the patients, a foldable three-piece acrylic IOL was implanted in the ciliary sulcus by the same surgeon using the same technique. The database studied included refractive and visual acuity (VA) outcomes and complications. Results Fifty patients (75 eyes) were included. The average age at the time of cataract extraction was 94.20 +/- 44.94 days and 20.7 +/- 6.0 months in the secondary IOL implantation. After 82.32 +/- 48.91 months, the VA was 0.58 +/- 0.35 LogMAR and the spherical equivalent was -2.20 +/- 4.19 D. There was a negative correlation between a longer follow-up period and myopia at the SE measured (P = .001). The most frequent complications included glaucoma and corectopia. Performing the secondary IOL implantation 20 months of age was not a risk factor for glaucoma development (P = 0.095). Conclusion Secondary IOL implantation under 30 months of age is an option for children with unsatisfactory management of the optic treatment. A predictable IOL power calculation and satisfactory visual outcomes compared to results of later secondary IOL implantation are possible.
bookPart Bases da Terapêutica Ocular(2018) JOSé JUNIOR, Newton Kara; SANTHIAGO, Marcony Rodrigues; GOMES, Beatriz de Abreu Fiuza- Is there an association between glaucoma and capillaroscopy in patients with systemic sclerosis?(2018) GOMES, Beatriz Fiuza; SOUZA, Rebeca; VALADAO, Thiago; KARA-JUNIOR, Newton; MORAES, Haroldo Vieira; SANTHIAGO, Marcony R.Purpose To evaluate the relationship between glaucoma diagnosis and the nailfold capillaroscopy pattern in patients with systemic sclerosis. Methods An observational study in a cohort of patients with SSc was conducted. Patients with at least one nailfold videocapillaroscopy and one ophthalmology examination at the same year were included. Data collected were: age, sex; type of systemic sclerosis according to the degree of skin impairment, self-reported ethnicity, disease duration, current use and dosage of systemic corticosteroid, current use and dosage of bosentan (R), intraocular pressure, central corneal thickness, diagnosis of glaucoma and capillaroscopy pattern. Results Thirty-one patients with systemic sclerosis were enrolled, 23% had glaucoma. There was no statistically significant association between glaucoma diagnosis and the capillaroscopic pattern (p = 0.86). There was also no significant difference (p = 0.66) regarding intraocular pressure between patients with mild (13.9 +/- 3.8 mmHg) and severe capillaroscopic pattern (14.4 +/- 2.8 mmHg). The odds ratio of glaucoma for severe capillaroscopic pattern compared to mild was 1.6 (95% confidence interval: 0.3-9.5). Conclusion Up to 23% of patients with SSc have glaucoma. The high prevalence of glaucoma in SSc suggests a possible systemic vascular disturbance as the cause. However, there seems to be no significant association between the capillaroscopy pattern and glaucoma in systemic sclerosis. Further research is required to improve the understanding of glaucoma in the context of systemic sclerosis.