MARCONY RODRIGUES DE SANTHIAGO
Projetos de Pesquisa
Unidades Organizacionais
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
87 resultados
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- 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.
- 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.
- 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.
- Regeneration of Defective Epithelial Basement Membrane and Restoration of Corneal Transparency After Photorefractive Keratectomy(2017) MARINO, Gustavo K.; SANTHIAGO, Marcony R.; SANTHANAM, Abirami; TORRICELLI, Andre A. M.; WILSON, Steven E.PURPOSE: To study regeneration of the normal ultrastructure of the epithelial basement membrane (EBM) in rabbit corneas that had -9.00 D photorefractive keratectomy (PRK) and developed late haze (fibrosis) with restoration of transparency over 1 to 4 months after surgery and in corneas that had incisional wounds. METHODS: Twenty-four rabbits had one of their eyes included in one of the two procedure groups (-9.00 D PRK or nearly full-thickness incisional wounds), whereas the opposite eyes served as the unwounded control group. All corneas were evaluated with slit-lamp photographs, transmission electron microscopy, and immunohistochemistry for the myofibroblast marker alpha-smooth muscle actin and collagen type III. RESULTS: In the -9.00 D PRK group, corneas at 1 month after surgery had dense corneal haze and no evidence of regenerated EBM ultrastructure. However, by 2 months after surgery small areas of stromal clearing began to appear within the confluent opacity (lacunae), and these corresponded to small islands of normally regenerated EBM detected within a larger area of the excimer laser-ablated zone with no evidence of normal EBM. By 4 months after surgery, the EBM was fully regenerated and the corneal transparency was completely restored in the ablated zone. In the incisional wound group, the two dense, linear corneal opacities were observed at 1 month after surgery and progressively faded by 2 and 3 months after surgery. The EBM ultrastructure was fully regenerated at the site of the incisions, including around epithelial plugs that extended into the stroma, by 1 month after surgery in all eyes. CONCLUSIONS: In the rabbit model, spontaneous resolution of corneal fibrosis (haze) after high correction PRK is triggered by regeneration of EBM with normal ultrastructure in the excimer laser-ablated zone. Conversely, incisional wounds heal in rabbit corneas without the development of myofibroblasts because the EBM regenerates normally by 1 month after surgery.
- 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.
- 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.