ALLAN CHRISTIAN PIERONI GONCALVES

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
  • bookPart
    Doenças da Órbita
    (2016) MONTEIRO, Mário Ribeiro; ANGOTTI-NETO, Hélio; GONçALVES, Allan C. Pieroni; KREUZ, André Carvalho
  • article 4 Citação(ões) na Scopus
    A randomized comparative study of inferomedial vs. balanced orbital decompression. Analysis of changes in orbital volume, eyelid parameters, and eyeball position
    (2022) PEREIRA, Thais de Sousa; LEITE, Cristiane de Almeida; KUNIYOSHI, Cristina Hiromi; GEBRIM, Eloisa M. M. S.; MONTEIRO, Mario L. R.; GONCALVES, Allan C. Pieroni
    Background/objectives The objective of this study is to investigate and compare changes in orbital volume, eyelid parameters, and eyeball position after inferomedial and balanced (medial + deep lateral walls) orbital decompression (OD) in patients with Graves' orbitopathy (GO). Subjects/methods Prospective interventional trial. Forty-two patients with inactive GO and clinical indication for OD were randomly assigned to inferomedial or balanced OD. Preoperative and postoperative Hertel exophthalmometry, standardized photography, and computed tomography were used to evaluate upper and lower eyelid margin reflex distances (MRD1 and MRD2), orbital expansion, and changes in eyeball position. Results Clinical and radiological exophthalmometry improved significantly after OD with both surgical techniques (p < 0.001), but more so with balanced OD (p = 0.02). Concurrent eyeball descent (p = 0.01) and orbital volume expansion (p < 0.001) were observed with both techniques. The mean decompression volume was similar for the medial wall and the lateral wall but significantly smaller for the inferior wall (p < 0.05). Significant correlation coefficients were found for Hertel reduction vs. total decompression volume (p < 0.05). In the multivariate linear analysis, lateral wall decompression volume (LWDV) was predictive of exophthalmos reduction (p < 0.05). The two techniques produced a similar reduction in MRD1 and MRD2. A significant correlation was also found between Hertel reduction and lower lid elevation (p < 0.05). Conclusions Both inferomedial and balanced OD successfully expanded orbit capacity, but the latter was more efficient at reducing exophthalmos probably due to the inclusion of the lateral wall. Upper and lower eyelid retraction improved after OD, but only lower eyelid elevation was correlated with exophthalmos reduction.
  • bookPart
    Investigação da proptose
    (2022) GINGUERRA, Maria Antonieta; MATAYOSHI, Suzana; GONçALVES, Allan C. Pieroni
  • conferenceObject
    A RANDOMIZED COMPARATIVE STUDY OF SURGICAL CORRECTION OF GRAVES UPPER EYELID RETRACTION THROUGH CONJUNCTIVAL OR BLEPHAROTOMY APPROACH
    (2014) GONCALVES, Allan Christian Pieroni; NOGUEIRA, Thiago Machado; GONCALVES, Ana Carolina A.; SILVA, Luzia D.; MONTEIRO, Mario L. R.
  • bookPart
    Retração palpebral
    (2022) GINGUERRA, Maria Antonieta; MATAYOSHI, Suzana; GONçALVES, Allan C. Pieroni
  • article 19 Citação(ões) na Scopus
    Customized Minimally Invasive Orbital Decompression Surgery Improves Lower Eyelid Retraction and Contour in Thyroid Eye Disease
    (2017) GONCALVES, Allan C. Pieroni; GUPTA, Shivani; MONTEIRO, Mario L. R.; DOUGLAS, Raymond S.
    Purpose: To investigate the outcome of a customized approach with targeted zygomatic basin bone removal orbital decompression in lower eyelid retraction and contour of patients with thyroid eye disease. Methods: In a comparative case series, clinical charts and photos of a consecutive sample of 92 patients with thyroid eye disease submitted to different types orbital decompression were studied. Exophthalmos, midpupil to lower eyelid margin distances (MRD2) at 11 meridians, and globe position were measured and compared according to the types of decompression. Each eyelid was also labeled as within or outside normal limits regarding both contour pattern analysis and MRD2 compared with a control normal range. Eyelid contour and globe position from patients with orbital decompression with zygomatic basin removal were compared with those without basin removal. Results: A total of 105 orbits from 57 patients met the study inclusion criteria. Ninety-eight orbits had lateral orbital wall decompression and in 53% of these cases, bone in the zygomatic basin was removed. Removal of the zygomatic basin did not significantly enhance decrease in proptosis, but significantly induced vertical globe descent and improved MRD2 (p < 0.05). Preoperatively, 37% of the eyelids were in the normal MRD2 range and 18% within the normal contour range. Preoperatively, 77% had normal MRD2 and 55% normal contour range. Conclusions: Our study findings support the practical utility of incorporating a customized approach to orbital decompression, and suggest that an individualized approach with targeted bone removal may obviate the need for additional surgeries such as lower eyelid retraction repair.
  • bookPart
    Apresentação
    (2022) GINGUERRA, Maria Antonieta; MATAYOSHI, Suzana; GONçALVES, Allan C. Pieroni
  • article 7 Citação(ões) na Scopus
    A Comparative Study of Full-Thickness Blepharotomy Versus Transconjunctival Eyelid Lengthening in the Correction of Upper Eyelid Retraction in Graves' Orbitopathy
    (2018) GONCALVES, Allan C. Pieroni; NOGUEIRA, Thiago; GONCALVES, Ana Carolina Arato; SILVA, Luzia Diegues; MATAYOSHI, Suzana; MONTEIRO, Mario L. R.
    The study was designed to compare the outcome of full-thickness blepharotomy and transconjunctival eyelid lengthening in the correction of upper eyelid retraction (UER) in patients with Graves' orbitopathy (GO). This is a prospective randomized interventional study. Following ophthalmic examination, determination of the ocular surface disease index (OSDI) and photography, 27 patients with UER were randomly assigned to either graded full-thickness blepharotomy (G1) or transconjunctival Muller muscle recession and graded disinsertion of the levator palpebrae superioris muscle (G2). Six months later, patients were reevaluated. Digital images were analyzed with the assistance of customized software. A standardized ""normal range"" of upper eyelid height and contour was calculated based on healthy controls. The outcome of the two groups was compared. Forty-seven eyelids of 27 patients (19 female) with UER were included. Twenty-seven eyelids (15 patients) were allocated to G1 and 20 eyelids (12 patients) to G2. On average, surgery lasted 37.46 +/- 5.73 min in G1 and 32.70 +/- 8.39 min in G2. Based on the margin reflex distance, 93% of the eyelids in G1 and 85% in G2 were within the normal range after surgery. The corresponding figures for lid contour were 63 and 55%. Both groups displayed significant improvement in OSDI scores. No significant difference was observed in the overall comparison. The two surgical techniques were equally effective in the treatment of UER from GO. Postoperative contour outcomes were considerably worse in patients with severe UER than in patients with mild or moderate UER, regardless of group.
  • conferenceObject
    A Comparative Study of Pre- and Postoperative Quantification of Upper Eyelid Retraction in Graves Orbitopathy Using Margin Reflex Distance and Digital Eyelid Image Processing Methods
    (2014) NOGUEIRA, Thiago Machado; GONCALVES, Allan Pieroni; GONCALVES, Ana Carolina Arato; SILVA, Luzia Diegues; MONTEIRO, Mario Luiz Ribeiro