MARCONY RODRIGUES DE SANTHIAGO
Projetos de Pesquisa
Unidades Organizacionais
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
107 resultados
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- The role of a femtosecond laser in congenital cataract associated with aniridia(2018) GAZZOLA, Luisa Nardino; GHEM, Mariela Regina Dalmarco; SERPE, Crislaine; SANTHIAGO, Marcony Rodrigues; MELLO, Glauco ReggianiA patient with bilateral aniridia and progressive congenital cataract was treated at the age of 7 years through phacoaspiration with femtosecond laser capsulotomy, in-the-bag intraocular lens implantation, and pars plana vitrectomy (combined with posterior capsulotomy). The diameter of the planned anterior capsulotomy was 4.7 mm; however, due to elevated tension in the young capsular bag, the capsulotomy diameter increased (to around 6 mm) shortly after release of the tension by the laser. In addition, the patient had a very flat and small cornea, causing the formation of air bubbles in the curved laser interface. This was addressed by filling the gap by using a viscoelastic. A very similar situation was observed in both eyes. Use of the femtosecond laser facilitated a successful outcome in a complex congenital cataract case with a safe capsulotomy that ensured in-the-bag intraocular lens placement.
- Author's reply to comments to: Comparison of eyedrop instillation technique with and without a delivery device in inexperienced patients(2017) SANTHIAGO, Marcony R.; GOMES, Beatriz Fiuza; MORAES, Haroldo Vieira
- Role of Corneal Epithelial Measurements in Differentiating Eyes with Stable Keratoconus from Eyes that Are Progressing(2023) SANTHIAGO, Marcony R.; STIVAL, Larissa R.; ARAUJO, Daniella C.; KARA-JUNIOR, Newton; TOLEDO, Marcia C.Purpose: To evaluate measures of corneal epithelium in eyes that showed documented signs of keratoconus (KC) progression and compare with stable eyes and healthy controls. Also, to determine the correlation of these epithelial parameters with maximum keratometry (K max) and pachymetry. Design: Prospective, observational, comparative study. Participants: One-hundred and fifty eyes from 150 patients. The study included 50 eyes from patients with documented KC progression, 50 eyes with stable KC, and 50 clinically normal eyes to serve as controls. Methods: A spectral-domain (SD)-OCT imaging was obtained in all eyes, and mean values were compared between the groups. The correlation of epithelial parameters with K max and thinnest pachymetry was also investigated. Main Outcome Measures: For the purposes of this study, the epithelial measures maximum, minimum, superior, and inferior values as well as the difference between the minimum and maximum (min-max) and epithelial standard deviation were considered, obtained from SD-OCT and compared between groups. Measurements of the thinnest point and min-max in pachymetry were also recorded. Results: The only epithelial parameter that presented a statistically significant difference between stable and progressive KC was epithelium min-max. Although stable KC presented epithelium min-max mean values of -18.2 +/- 6.6, progressive KC eyes presented mean values of -23.4 +/- 10.3 (P < 0.0001). Epithelial maximum (P = 0.16), minimum (P = 0.25), superior (P = 0.28), inferior (P = 0.23), and standard deviation (P = 0.25) values were not significantly different between stable and progressive eyes. Difference min-max pachymetry points in stable (-108.3 +/- 33.5) and progressive KC (-115.2 +/- 56.0) were not significantly different (P = 0.723). There was no significant correlation between epithelium min-max with corneal thinning (P = 0.39) or K max (P = 0.09) regardless of disease progression. Conclusions: Epithelial measures are useful to identify KC eyes that are progressing; the parameters that measure the difference between min-max epithelium points were significantly different between stable and progressive groups, unlike this difference in pachymetry. Finally, this epithelial parameter seems to be inde-pendent of corneal thinning and K max. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (c) 2022 by the American Academy of Ophthalmology.
- Screening for Keratoconus and Related Ectatic Corneal Disorders(2015) RANDLEMAN, J. Bradley; DUPPS JR., William J.; SANTHIAGO, Marcony R.; RABINOWITZ, Yaron S.; KOCH, Doug D.; STULTING, R. Doyle; KLYCE, Stephen D.
- Intrastromal Corneal Ring Segments Implantation and Descemet Membrane Endothelial Keratoplasty for Coexisting Keratoconus and Fuchs Endothelial Dystrophy(2020) BERTINO, Pedro; MAGALHAES, Renata Soares; CRIADO, Guilherme Garcia; NOVAIS, Gustavo Amorim; JR, Renato Ambrosio; SANTHIAGO, Marcony R.PURPOSE: To report two cases of coexisting keratoconus and Fuchs endothelial dystrophy treated with intrastromal corneal ring segments (ICRS) implantation and Descemet membrane endothelial keratoplasty (DMEK). METHODS: Two patients with coexisting keratoconus and Fuchs endothelial dystrophy underwent ICRS implantation and DMEK, in a two-stage procedure. Follow-up evaluation included Scheimpftug tomography and optical coherence tomography. RESULTS: In both cases, ICRS implantation improved corneal topography and DMEK restored normal corneal thickness. Corrected distance visual acuity improved from 20/100 to 20/30 and from 20/60 to 20/25. Urrets-Zavatia syndrome was diagnosed in one case and addressed with colored contact tens fitting. CONCLUSIONS: Low vision resulting from coexisting keratoconus and Fuchs endothelial dystrophy might be addressed more selectively with posterior lamellar keratoplasty and ICRS implantation. Urrets-Zavalia syndrome must be considered a possible complication after DMEK, especially in patients with keratoconus.
- Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up(2019) KOCH, Camila R.; KARA-JUNIOR, Newton; SANTHIAGO, Marcony R.; MORALES, MartaOBJECTIVES: To compare long-term postoperative complications of pediatric cataract surgery with primary intraocular lens (IOL) implantation associated with posterior capsulotomy (PC) and anterior vitrectomy (AV) between patients treated with a corneal or pars plicata/pars plana approach. METHODS: Children who underwent cataract surgery with in-the-bag primary IOL implantation were divided into two groups according to PC and AV surgical approach: a corneal approach (group 1) and a pars plicata/pars plana approach (group 2). Only patients with a follow-up duration of more than two years were included. Longterm surgical outcomes were retrospectively reported. RESULTS: The mean follow-up period was 10.00 +/- 3.13 years. No cases of glaucoma or retinal detachment were reported. The mean age at surgery was 34.57 +/- 22.66 months. Forty-six children were included (27 eyes in group 1 and 29 eyes in group 2). The most frequent postoperative complication was corectopia, followed by visual axis opacification. Both complications occurred more frequently in group 1 (p < 0.001). After cataract surgery, the rate of additional surgeries in group 1 was 51.9%, while in group 2, the rate was 27.6% (p=0.1132). CONCLUSION: The pars plicata/pars plana approach with PC and vitrectomy with primary in-the-bag IOL implantation for pediatric cataracts is a safe procedure.
- Long-term results of in-the-bag primary intraocular lens implantation in children younger than 24 months(2021) KOCH, Camila Ribeiro; KARA-JUNIOR, Newton; SANTHIAGO, Marcony Rodrigues; MORALES, MartaPurpose: The purpose of this study was to analyze the safety of primary intraocular lens implantation in a large number of eyes in children aged <24 months. Methods: The medical records of patients aged 5-24 months, who underwent primary intraocular lens implantation in the capsular bag, were reviewed. A foldable three-piece acrylic intraocular lens was implanted by the same surgeon using a single surgical technique. Patients who had <1 year of follow-up after the surgery were excluded. The main outcome measurements included visual acuity, myopic shift, follow-up complications, and additional surgeries. Results: Sixty-eight patients (93 eyes) were analyzed. The mean age of the patients at the time of surgery was 15.06 +/- 6.19 months (range: 5-24 months), and the spherical equivalent 1 month after surgery was 3.62 +/- 2.32 D. After 5.67 +/- 3.10 years, the spherical equivalent was -0.09 +/- 3.22 D, and the corrected distance visual acuity was 0.33 +/- 0.33 and 0.64 +/- 0.43 logMAR in bilateral and unilateral cases, respectively (p=0.000). The highest myopic shift was observed in infants who underwent surgery at ages 5 and 6 months. The most frequent complications included visual axis opacification and corectopia. Glaucoma and retinal detachment were not reported. Conclusion: Primary in-the-bag intraocular lens implantation in children aged 5-24 months is safe, and is associated with low rates of adverse events and additional surgery.
- OCT Study of the Femtosecond Laser Opaque Bubble Layer(2017) MARINO, Gustavo K.; SANTHIAGO, Marcony R.; WILSON, Steven E.PURPOSE: To characterize the location and regularity of the opaque bubble layer (OBL) in the corneal stroma after femtosecond laser-assisted LASIK (FS-LASIK) flap generation. METHODS: In this prospective study, 30 eyes of 15 patients who had FS-LASIK surgery for myopia, astigmatism, and/or hyperopia were included. Screen captures were obtained at the end of the flap creation and the eyes with hard type OBL were immediately imaged with anterior segment optical coherence tomography. RESULTS: The mean age of the 9 men and 6 women was 40 +/- 11.3 years (range: 22 to 60 years). Seven eyes (23.3%) developed hard type OBL that was typically localized in the central cornea beneath the LASIK flap and, in the majority of cases, located close to the hinge of the flap. Three of the seven eyes had OBL only within the laser cut, whereas the four other eyes had OBL in a spotty distribution within the stromal bed beneath the flap. None of the eyes had an accumulation of OBL within the flap itself. CONCLUSIONS: The excimer laser ablation of a stroma with OBL may be different from that of a stroma without OBL. Management of OBL when it occurs due to flap production, including allowing the bubble to dissipate when they overlie the pupil, is important to obtain the best outcomes with femtosecond laser-assisted LASIK.
bookPart Escrita científica(2015) SANTHIAGO, Marcony Rodrigues; MAIA, Maurício; JOSé JUNIOR, Newton Kara- Predictability and Vector Analysis of Laser In Situ Keratomileusis for Residual Errors in Eyes Implanted With Different Multifocal Intraocular Lenses(2016) SANTHIAGO, Marcony R.; VENTURA, Bruna V.; GHANEM, Ramon C.; KARA-JUNIOR, Newton; MORAES JR., Haroldo V.; GHANEM, EmirPurpose:To investigate potential differences in predictability, efficacy, and safety of corneal excimer laser to correct residual myopia, hyperopia, and astigmatism in eyes previously implanted with multifocal intraocular lenses using distinct optical surfaces and platforms for multifocality.Methods:This prospective comparative study included 37 eyes submitted to laser in situ keratomileusis correction for residual errors after implantation of either an apodized diffractive-refractive (Restor) or a full-diffractive (Tecnis) multifocal intraocular lens. Data analysis included investigation of predictability, efficacy, and safety of excimer laser surgery to correct residual errors. A double-angle plot, using vector analysis, was also created to evaluate predictability of astigmatism correction.Results:At 6-month follow-up, statistical analyses revealed a significant improvement when comparing preoperative (0.51 0.25 and 0.44 +/- 0.18) and postoperative values (0.17 +/- 0.10 and 0.09 +/- 0.07) of uncorrected distance visual acuity (P < 0.0001 and <0.0001), preoperative (0.92 +/- 0.61 and 1.02 +/- 0.45) and postoperative values (0.33 +/- 0.23 and 0.19 +/- 0.17) of manifest refractive spherical equivalent (P = 0.0006 and <0.0001), and preoperative (-1.08 +/- 0.70 and -0.65 +/- 0.42) and postoperative values (-0.25 +/- 0.28 and -0.14 +/- 0.21) of astigmatism (P < 0.0001 and <0.0001) in eyes implanted with Restor and Tecnis, respectively. Vector analysis revealed a predictable correction of astigmatism in all groups. Ninety-two percent of total eyes achieved a manifest refractive spherical equivalent within +/- 0.5 of emmetropia.Conclusions:Corneal excimer laser refractive surgery seems to be equally effective to correct different residual errors, including astigmatism, in eyes implanted with intraocular lenses with various platforms for multifocality.