MARCONY RODRIGUES DE SANTHIAGO

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

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Autor: KARA-JUNIOR, Newton ×

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  • article 1 Citação(ões) na Scopus
    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.
  • article 7 Citação(ões) na Scopus
    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, Marta
    OBJECTIVES: 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.
  • article 0 Citação(ões) na Scopus
    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, Marta
    Purpose: 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.
  • article 6 Citação(ões) na Scopus
    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, Emir
    Purpose: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.
  • article 69 Citação(ões) na Scopus
    Microkeratome versus femtosecond flaps: accuracy and complications
    (2014) SANTHIAGO, Marcony R.; KARA-JUNIOR, Newton; WARING, George O.
    Purpose of review To update the knowledge on differences between mechanical microkeratome and femtosecond flaps for laser in-situ keratomileusis (LASIK) in terms of accuracy and complications. Recent findings Corneal flaps created with the femtosecond laser present a more planar architecture and provide greater precision in flap diameter and thickness; a more uniform flap thickness across the flap diameter and it allows the surgeon to programme the angulation of the flap periphery. Femtosecond LASIK flaps are classically related to complications derived from a more intense inflammatory response, such as diffuse lamellar keratitis and transient light-sensitivity syndrome. Newer femtosecond models allow for much lower energy delivery to cut the flap, to the point the overall inflammatory response is not significantly different from the microkeratome. The incidence of complications such as epithelial defect and flap dislocations is higher with microkeratome flaps. Summary This review examines the accuracy and complications of flaps created with femtosecond and microkeratome. Both femtosecond and microkeratome are able to create accurate LASIK flaps. Femtosecond LASIK flaps represent significant improvement in morphology and predictability with implications for safety.
  • article 4 Citação(ões) na Scopus
    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 Vieira
    Purpose: 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.
  • article 1 Citação(ões) na Scopus
    Analysis of ocular cyclotorsion in lying position after peribulbar block and topical anesthesia
    (2014) KARA-JUNIOR, Newton; MOURAD, Paula C.; MORAES, Renata L. B.; MORAES, Renata L. B.; PIVA, Caroline; SANTHIAGO, Marcony Rodrigues
    Purpose: Evaluate the magnitude of cyclotorsion during cataract surgery in patients with indication for intraocular toric lenses comparing the results after peribulbar and after topical anesthesia. Methods: This prospective study comprised 112 eyes that underwent cataract surgery with implantation of toric intraocular lens by topical anesthesia or peribulbar block. We estimated how many degrees of cyclotorsion occurred after topical anesthesia and peribulbar block with the patient in supine position. A tag was performed in the position of 180 degrees of the right eye and zero degrees of the left eye, with the patient seated. Afterwards, it was requested a change to the supine position and then a new dial in 180 and zero degrees respectively from right and left eye were made. Results: The current study demonstrated that patients submitted to cataract surgery with implantation of toriclens under local anesthesia showed approximately 6.89 degrees of incyclotorsion (82 eyes) and 6.93 degrees of excyclotorsion (38 eyes) and a mean of cyclotorsion of 6.91 degrees. Patients undergoing peribulbar block showed 5.68 degrees of incyclotorsion (73 eyes) and 4.81 degrees of excyclotorsion (47 eyes) and a mean of cyclotorsion of 4.92 degrees. Conclusion: Through the study we can see that the movement of incyclotorsion in patients undergoing peribulbar anesthesia was lower when compared to topical anesthesia. This is relevant since the greater the incyclotorsion, the lower the predictability of the surgery and the lower the chance of obtaining excellent results in the final refractometric.
  • article 5 Citação(ões) na Scopus
    Safety of warfarin therapy during cataract surgery under topical anesthesia
    (2015) KARA-JUNIOR, Newton; SANTHIAGO, Marcony R.; ALMEIDA, Hirlana Gomes; RAIZA, Ana Carolina
    Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30) and a control (n=30) group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications in both the groups. At 1-month postoperative follow-up, 90.0% of patients presented spectacle-corrected visual acuity of at least 20/40. Conclusion: Cataract surgery by phacoemulsification with topical anesthesia can be successfully conducted without discontinuing warfarin.
  • article 3 Citação(ões) na Scopus
    Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry
    (2012) ESPINDOLA, Rodrigo Franca de; SANTHIAGO, Marcony Rodrigues de; KARA-JUNIOR, Newton
    Purpose: To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL) on contrast sensitivity and blue-on-yellow perimetry. Methods: This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes) received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes) received ultraviolet and blue light filter (yellow tinted) IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD]) investigated two years after surgery. The results were compared intra-individually. Results: There was a statistically significant between-group (aspherical and spherical intraocular lens) difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens) under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. Conclusion: Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.
  • article 13 Citação(ões) na Scopus
    A clinical comparison between DisCoVisc and 2% hydroxypropylmethylcellulose in phacoemulsification: a fellow eye study
    (2012) ESPINDOLA, Rodrigo F.; CASTRO, Emerson F. S.; SANTHIAGO, Marcony R.; KARA-JUNIOR, Newton
    OBJECTIVE: This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification. METHODS: This prospective, randomized clinical trial comprised 78 eyes (39 patients) that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate or 2.0% hydroxypropylmethylcellulose on the first eye. The other eye was treated later and received the other viscoelastic agent. Preoperative and postoperative examinations (5, 24 and 48 hours; 7 and 14 days; 3 and 6 months) included measurements of the total volume of the ophthalmic viscosurgical device, ultrasound and washout times to completely remove the ophthalmic viscosurgical device, intraocular pressure, central corneal thickness and best-corrected visual acuity. The corneal endothelial cell count was measured at baseline and at six months postoperatively. ClinicalTrials.gov:NCT01387620. RESULTS: There were no statistically significant differences between groups in terms of cataract density or ultrasound time. However, it took longer to remove 2.0% hydroxypropylmethylcellulose than 1.6% hyaluronic acid/4.0% chondroitin sulfate, and the amount of viscoelastic material used was greater in the 2.0% hydroxypropylmethylcellulose group. In addition, the best-corrected visual acuity was significantly better in the hyaluronic acid/chondroitin sulfate group, but this preferable outcome was only observed at 24 hours after the operation. There were no statistically significant differences between the two ophthalmic viscosurgical devices regarding the central corneal thickness or intraocular pressure measurements at any point in time. The corneal endothelial cell count was significantly higher in the hyaluronic acid/chondroitin sulfate group. CONCLUSION: The ophthalmic viscosurgical device consisting of 1.6% hyaluronic acid/4.0% chondroitin sulfate was more efficient during phacoemulsification and was easier to remove after IOL implantation than 2.0% hydroxypropylmethylcellulose. In addition, the corneal endothelial cell count was significantly higher following the use of hyaluronic acid/chondroitin sulfate than with hydroxypropylmethylcellulose, which promoted an improved level of corneal endothelium protection.