ADRIANA MUKAI TOYOTA

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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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  • article 9 Citação(ões) na Scopus
    Predictors of Early Postoperative Pain After Photorefractive Keratectomy
    (2016) GARCIA, Renato; TORRICELLI, Andre Augusto Miranda; MUKAI, Adriana; PEREIRA, Vinicius Borges Porfirio; BECHARA, Samir Jacob
    Purpose: To compare the profiles of postoperative photorefractive keratectomy (PRK) pain between both eyes under the same conditions and to verify the preoperative predictors of pain such as gender, anxiety, knowledge of the procedure, and spherical equivalent refractive error (SERE). Methods: This prospective study included 86 eyes of 43 patients with myopia who underwent PRK in both eyes at an interval of 14 days between the procedures. Before surgery, subjects answered the State Anxiety Inventory. After surgery, usual PRK pain treatment was given. Subjects answered the Visual Analog Scale, the Brief Pain Inventory (BPI), and the McGill Pain Questionnaire at 1, 24, 48, 72, and 96 hours after surgery. Pain scores and anxiety were compared between each eye using the Wald test and paired Student t test, respectively. The Wald test was performed for gender and SERE for each eye separately. Results: There were no statistically significant differences between both eyes for all time points regarding the Visual Analog Scale, BPI, and McGill Pain Questionnaire Pain Rating Index pain scores. Subjects were less anxious on average before the second surgery compared with before the first surgery (P < 0.001); however, it was not related to pain ratings after surgery. Gender did not significantly affect any scale of pain, and the SERE between 3 diopters (D) and 5 D (P = 0.035) revealed effects on the BPI. Conclusions: The profiles of postoperative pain after PRK were similar between both eyes under the same conditions. In this study, a high SERE was the only predictor for increased pain after PRK.
  • bookPart
    O papel do tecnólogo oftálmico na cirurgia refrativa
    (2022) TOYOTA, Adriana Mukai
  • article 29 Citação(ões) na Scopus
    Advances in femtosecond laser technology
    (2016) CALLOU, Thais Pinheiro; GARCIA, Renato; MUKAI, Adriana; GIACOMIN, Natalia T.; SOUZA, Rodrigo Guimaraes de; BECHARA, Samir J.
    Femtosecond laser technology has become widely adopted by ophthalmic surgeons. The purpose of this study is to discuss applications and advantages of femtosecond lasers over traditional manual techniques, and related unique complications in cataract surgery and corneal refractive surgical procedures, including: LASIK flap creation, intracorneal ring segment implantation, presbyopic treatments, keratoplasty, astigmatic keratotomy, and intrastromal lenticule procedures.
  • article 21 Citação(ões) na Scopus
    Quality of vision in refractive and cataract surgery, indirect measurers: review article
    (2013) PAREDE, Tais Renata Ribeira; TORRICELLI, Andre Augusto Miranda; MUKAI, Adriana; NETTO, Marcelo Vieira; BECHARA, Samir Jacob
    Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality. Therefore, refractive and cataract surgeries have the responsibility of achieving quality results. It is difficult to define quality of vision by a single parameter, and the main functional-vision tests are: contrast sensitivity, disability glare, intraocular stray light and aberrometry. In the current review the different components of the visual function are explained and the several available methods to assess the vision quality are described.
  • article 13 Citação(ões) na Scopus
    Codeine Plus Acetaminophen for Pain After Photorefractive Keratectomy: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial
    (2017) PEREIRA, Vinicius B. P.; GARCIA, Renato; TORRICELLI, Andre A. M.; MUKAI, Adriana; BECHARA, Samir J.
    Background: Pain after photorefractive keratectomy (PRK) is significant, and the analgesic efficacy and safety of oral opioids in combination with acetaminophen has not been fully investigated in PRK trials. Purpose: To assess the efficacy and safety of the combination of codeine plus acetaminophen (paracetamol) versus placebo as an addon therapy for pain control after PRK. Study design: Randomized, double-blind, placebo-controlled trial. Setting: Single tertiary center. Methods: One eye was randomly allocated to the intervention, whereas the fellow eye was treated with a placebo. Eyes were operated 2 weeks apart. The participants were adults older than 20 years with refractive stability for >= 1 year, who underwent PRK for correction of myopia or myopic astigmatism. Codeine (30 mg) plus acetaminophen (500 mg) was given orally 4 times per day for 4 days after PRK. The follow-up duration was 4 months. The study outcomes included pain scores at 1 to 72 hours, as measured by the visual analog scale, McGill Pain Questionnaire, and Brief Pain Inventory, as well as adverse events and corneal wound healing. Results: Of the initial 82 eyes, 80 completed the trial (40 intervention, 40 placebo). Median (interquartile range) pain scores as measured by the visual analog scale were statistically and clinically lower during treatment with codeine/acetaminophen compared with the placebo: 1 hour: 4 (2-4) versus 6 (3-6), P, 0.001; 24 hours: 4 (3-6) versus 7 (6-9), P < 0.001; 48 hours: 1 (02) versus 3 (2-5), P < 0.001; and 72 hours: 0 (0-0) versus 0 (0-2), P = 0.001. Virtually identical results were obtained by the McGill Pain Questionnaire and Brief Pain Inventory scales. The most common adverse events with codeine/acetaminophen were drowsiness (42%), nausea (18%), and constipation (5%). No case of delayed epithelial healing was observed in both treatment arms. Conclusions: When added to the usual care therapy, the oral combination of codeine/acetaminophen was safe and significantly superior to the placebo for pain control after PRK.
  • article 11 Citação(ões) na Scopus
    Improved Evaluation of Postoperative Pain After Photorefractive Keratectomy
    (2016) GARCIA, Renato; HOROVITZ, Roberto Novaes Campello; TORRICELLI, Andre Augusto Miranda; MUKAI, Adriana; BECHARA, Samir Jacob
    Purpose:Postoperative pain remains an important limiting factor to the selection of photorefractive keratectomy (PRK). There is a consensus in neurology pain research that pain should be evaluated as a multidimensional concept, which differs from current practice in ophthalmology. The purpose of this paper was to validate the use of multidimensional questionnaires, such as the Brief Pain Inventory (BPI) and the McGill Pain Questionnaire (MPQ), to provide an improved analysis of pain after PRK and to better describe its temporal profile.Methods:This prospective study included 43 eyes of 43 myopic patients who underwent unilateral PRK. After surgery, usual pain treatment was administered. All of the participants responded to the Visual Analogue Scale (VAS), the BPI and the MPQ 1, 24, 48, 72, and 96 hours after surgery. The internal consistency was evaluated, different postoperative periods were compared, and convergent validity was assessed using correlation testing.Results:The Cronbach alpha test showed high internal consistency for each of the questionnaire subscales. Patients reported higher postoperative pain values at the first measurement of the VAS (4.93 2.38), MPQ-pain rating index (26.95 +/- 10.58), BPI-pain severity index (14.53 +/- 7.36), and BPI-pain interference index (22.30 +/- 15.13). Almost all of the scales and subscales showed a statistically significant direct correlation with the VAS at all of the evaluation periods.Conclusions:This study validated the utility of multidimensional questionnaires to expand the assessment of the PRK postoperative pain profile, including intensity and other qualitative aspects.
  • article 0 Citação(ões) na Scopus
    Preoperative Predictors for Acute Pain After Photorefractive Keratectomy
    (2022) TOYOTA, Adriana M.; GARCIA, Renato; TORRICELLI, Andre A. M.; SILVA, Valquiria A.; GALHARDONI, Ricardo; TEIXEIRA, Manoel J.; ANDRADE, Daniel C. de; BECHARA, Samir J.
    Purpose: The aim of this study was to identify preoperative predictors for the occurrence of early severe postoperative pain in patients undergoing photorefractive keratectomy (PRK). The implementation of preoperative screening methods may facilitate more specific or aggressive pain therapies specifically targeted to individuals at a high risk of experiencing severe postoperative pain. Methods: This was exploratory research that included patients who underwent PRK. Before PRK, patients were administered a sociodemographic questionnaire, the Pain Catastrophizing Scale, and the State-Trait Anxiety Inventory and underwent corneal sensitivity and conditioned pain modulation (CPM) tests. Post-PRK pain was assessed using a pain intensity visual analog scale (VAS), and the short-form McGill Pain Questionnaire (SF-MPQ) was completed 21 days before PRK and 1, 24, 48, and 72 hours after PRK. Spearman correlations were calculated for pain scores and preoperative predictors. Results: This research included 34 eyes of 34 patients. Preoperative corneal sensitivity was positively correlated with post-PRK pain scores as assessed by VAS and SF-MPQ (rho = 0.39 and rho = 0.41, respectively, P < 0.05). No correlations were found between Pain Catastrophizing Scale, State-Trait Anxiety Inventory, and CPM scores and post-PRK pain scores (P > 0.05). Conclusions: Abnormal presurgical corneal sensitivity was a protective marker for severe pain after PRK, while scores as assessed by VAS and SF-MPQ and CPM were not related to postoperative pain.
  • article 0 Citação(ões) na Scopus
    Epi-LASIK e PRK: um ano de estudo comparativo em olhos contralaterais
    (2013) CRESTANA, Francisco Penteado; BECHARA, Samir Jacob; BLASBALG, Fabiana Tambasco; NETTO, Marcelo Vieira; MUKAI, Adriana
    Objective: Compare PRK and Epi-LASIK techniques regarding postoperative visual recovery and symptoms. Methods: Interventional case series study including 38 eyes of 19 patients with myopia up to 5DE and astigmatism up to 1DC. Study included patients with similar refractive errors to be submitted to PRK in one eye and Epi-LASIK in the fellow eye at the same time. Follow-up was 1 year and included refractive error analysis and postoperative discomfort. Results: During the first 12 hours after surgery, 79% (P=0,0003) of patients reported more pain and discomfort in the eye submitted to Epi-LASIK. Twenty-four hours after surgery 63,2% (P=0,012) of patients still referred more pain in the eye submitted to Epi-LASIK and only 10,5% in the contralateral eye. Uncorrected visual acuity was better on the PRK group at the 1(th) day (p=0.034). No difference was observed at the other postoperative days after surgery. Postoperative corneal haze 0,5 (Fantes) was observed in three eyes of the PRK group and in two days of the Epi-LASIK group. Conclusion: Both groups presented good visual refractive results, but the Epi-LASIK group presented more discomfort immediately after surgery.