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  1. Article ; Online: Predictors of Glaucoma After Pediatric Cataract Surgery.

    Vilares-Morgado, Rodrigo / Ferreira, Margarida / Godinho, Gonçalo / Melo, António Benevides / Barbosa-Breda, João / Magalhães, Augusto / Estrela-Silva, Sérgio

    Journal of glaucoma

    2023  Volume 33, Issue 5, Page(s) 317–324

    Abstract: Prcis: Glaucoma after pediatric cataract surgery is common and challenging. Age at surgery and the presence of microcornea or other anterior segment (AS) abnormalities can be used to identify those at greatest risk.: Objective: To establish risk ... ...

    Abstract Prcis: Glaucoma after pediatric cataract surgery is common and challenging. Age at surgery and the presence of microcornea or other anterior segment (AS) abnormalities can be used to identify those at greatest risk.
    Objective: To establish risk factors for developing glaucoma after pediatric cataract surgery [glaucoma following cataract surgery (GFCS)].
    Methods: Single-center, retrospective, longitudinal study of patients who underwent lensectomy for pediatric cataracts from 2008 to 2020. Included eyes presented with congenital or acquired pediatric cataracts or an anterior form of persistent fetal vasculature, and a follow-up of at least 1 year. Exclusion criteria were the presence of preexisting intraocular pressure elevation, congenital glaucoma, syndromic cataracts, and a history of trauma or uveitis. Demographic and clinical data were collected. Our primary outcome was the development of GFCS. Multivariable logistic regression with generalized estimating equations was used to model the association between potential predictors and the risk of GFCS.
    Results: A total of 110 eyes from 74 patients were included, 38 with unilateral and 36 with bilateral pediatric cataract surgery. The average surgery age was 24.71 ± 37.26 months, with 74 eyes (67.3%) undergoing surgery ≤12 weeks of age. Patients were followed for 9.96 ± 3.64 years after surgery. Twenty-eight eyes (25.45%) developed GFCS, all requiring glaucoma surgery. In multivariable analysis, surgery before 12 weeks of age [odds ratio (OR): 34.74; P < 0.001], presence of microcornea (OR: 12.90; P = 0.002), and presence of other AS abnormalities (OR: 52.71; P < 0.001) were significantly associated with the development of GFCS.
    Conclusions: The development of GFCS is a common and relevant adverse event after pediatric cataract surgery whose management is challenging. Age at surgery, the presence of microcornea, and the presence of other AS abnormalities can be used to identify those at greatest risk.
    MeSH term(s) Humans ; Male ; Female ; Retrospective Studies ; Cataract Extraction/adverse effects ; Child, Preschool ; Risk Factors ; Infant ; Intraocular Pressure/physiology ; Glaucoma/etiology ; Postoperative Complications ; Cataract/congenital ; Child ; Visual Acuity/physiology ; Follow-Up Studies
    Language English
    Publishing date 2023-12-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 913494-3
    ISSN 1536-481X ; 1057-0829
    ISSN (online) 1536-481X
    ISSN 1057-0829
    DOI 10.1097/IJG.0000000000002345
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  2. Article: Effect of Prior Phacoemulsification Surgery in Trabeculectomy Surgery Outcomes.

    Torres-Costa, Sónia / Melo, António Benevides / Estrela-Silva, Sérgio / Falcão-Reis, Fernando / Barbosa-Breda, João

    Clinical ophthalmology (Auckland, N.Z.)

    2022  Volume 16, Page(s) 357–367

    Abstract: Purpose: To evaluate whether previous clear-cornea phacoemulsification surgery affects the surgical outcomes of trabeculectomy in open-angle glaucoma (OAG).: Methods: We performed a retrospective cohort study, which included 82 patients with OAG that ...

    Abstract Purpose: To evaluate whether previous clear-cornea phacoemulsification surgery affects the surgical outcomes of trabeculectomy in open-angle glaucoma (OAG).
    Methods: We performed a retrospective cohort study, which included 82 patients with OAG that underwent trabeculectomy between January 1, 2010, and December 31, 2017. The primary outcome was the probability of surgical failure. Failure was defined as IOP >21 mmHg or reduced <20% from baseline, IOP ≤5 mmHg in three consecutive visits, need for further glaucoma surgery, phthisis or loss of light perception vision due to glaucoma.
    Results: Eighty-two eyes (58 phakic and 24 pseudophakic) were included. Phakic group patients were younger than those in the pseudophakic group, 65.8 ± 11.7 vs 76.2 ± 7.9 years (p < 0.001). The most common type of glaucoma was primary OAG [59% (n = 34) phakic vs 63% (n = 15) pseudophakic], followed by exfoliative and pigmentary glaucomas. The mean preoperative IOP was not significantly different between groups nor was the number of preoperative hypotensive medications. The rate of surgical failure was not significantly different between groups at year 1 [17% (n = 10) phakic vs 29% (n = 7) pseudophakic; p = 0.361] nor at year 2 [28% (n = 16) phakic vs 46% (n = 11) pseudophakic; p = 0.110]. No significant differences were observed regarding the postoperative IOP or any secondary outcome measures at year 1 or 2.
    Conclusion: Previous clear-cornea phacoemulsification surgery does not lead to statistically significant differences in the rate of trabeculectomy failure. Despite not being significant, clinically relevant differences were observed between groups. Future studies with a larger sample and/or randomized are needed to clarify this association.
    Language English
    Publishing date 2022-02-09
    Publishing country New Zealand
    Document type Journal Article
    ISSN 1177-5467
    ISSN 1177-5467
    DOI 10.2147/OPTH.S348364
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Effect of Repeated Intravitreal Injections in Glaucoma Spectrum Diseases.

    Vilares-Morgado, Rodrigo / Correia, Vera / Ferreira, Ana Margarida / Alves, Flávio / Melo, António Benevides / Estrela-Silva, Sérgio / Araújo, Joana / Tavares-Ferreira, João / Silva, Marta / Rocha-Sousa, Amândio / Carneiro, Angela / Barbosa-Breda, João

    Clinical ophthalmology (Auckland, N.Z.)

    2023  Volume 17, Page(s) 3613–3627

    Abstract: Purpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD).: Methods: Single-center, ...

    Abstract Purpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD).
    Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received ≥8 IVI in only one eye during the study period; (2) had ≥2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model.
    Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68±21.77 years with a follow-up of 3.66±1.89 years and 25.12±14.49 IVI. RNFL thickness decreased significantly from 80.92±15.78 to 77.20±17.35 μm (
    Conclusion: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed.
    Language English
    Publishing date 2023-11-22
    Publishing country New Zealand
    Document type Journal Article
    ISSN 1177-5467
    ISSN 1177-5467
    DOI 10.2147/OPTH.S441500
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Implementing ICHOM standard set for cataract surgery at IPO-Porto (Portugal): clinical outcomes, quality of life and costs.

    Queirós, Lara / Redondo, Patrícia / França, M / Silva, Sérgio Estrela / Borges, Pedro / de Melo, António Benevides / Pereira, Nuno / da Costa, Paulo Freitas / Carvalho, Nazaré / Borges, Marina / Sequeira, Isabel / Gonçalves, Francisco Nuno Rocha / Lemos, José

    BMC ophthalmology

    2021  Volume 21, Issue 1, Page(s) 119

    Abstract: Background: This paper fills a gap in the applied research field, for a local context, by addressing the topics of describing cataract surgery' clinical outcomes; quality of life (QoL); and costs of the patients treated after the implementation of the ... ...

    Abstract Background: This paper fills a gap in the applied research field, for a local context, by addressing the topics of describing cataract surgery' clinical outcomes; quality of life (QoL); and costs of the patients treated after the implementation of the ICHOM standard set.
    Methods: This is a retrospective observational study using real-world data (RWD). We included all patients subjected to cataract surgery at the Portuguese Institute of oncology - Porto (IPO-Porto), Portugal, after 3 months follow up period completed between 5th June 2017 and 21st May 2018. The following inclusion criteria: corrected visual acuity of ≤ 6/10 or other significant visual disturbance due to lens opacity or the existence of a large anisometropia. A circuit was implemented based on the ICHOM standard for cataract, to measure clinical variables (e.g. visual acuity) and QoL (CATQUEST-9SF) before and after surgery, and cost of treatment. The results were explored by means of a paired-sample t-test, considering normality assumptions.
    Results: Data refers to 268 patients (73 P25-P75:32-95 years old), regarding 374 eyes. The cataract surgery had a positive effect on visual acuity (p < 0.001), refraction (right and left cylinder; p < 0.001) and all QoL dimensions. The vast majority of patients, around 98%, reported improvements in QoL. Based on IPO-Porto administrative records, the direct cost of treating cataracts (per eye) is of 500€, representing a total cost of 187,000€ for the number of patients operated herein.
    Conclusion: This study reports the successful implementation of the ICHOM standard set for cataracts in a Portuguese institution and confirms that cataract surgery provides a rapid visual recovery, with excellent visual outcomes and minimal complications in most patients, while also having a positive impact on patients' quality of life.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Cataract/complications ; Cataract Extraction ; Humans ; Middle Aged ; Portugal ; Quality of Life ; Visual Acuity
    Language English
    Publishing date 2021-03-05
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2050436-6
    ISSN 1471-2415 ; 1471-2415
    ISSN (online) 1471-2415
    ISSN 1471-2415
    DOI 10.1186/s12886-021-01887-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Cyclodialysis cleft treatment using a minimally invasive technique.

    Pinheiro-Costa, João / Melo, António Benevides / Carneiro, Ângela Maria / Falcão-Reis, Fernando

    Case reports in ophthalmology

    2015  Volume 6, Issue 1, Page(s) 66–70

    Abstract: Purpose: To report a case of a cyclodialysis cleft that was successfully managed with gas endotamponade and cyclocryotherapy.: Methods: A 37-year-old male victim of a severe blunt ocular trauma was referred to our service for evaluation and treatment ...

    Abstract Purpose: To report a case of a cyclodialysis cleft that was successfully managed with gas endotamponade and cyclocryotherapy.
    Methods: A 37-year-old male victim of a severe blunt ocular trauma was referred to our service for evaluation and treatment of a left eye hypotony. Clinical examination revealed an intraocular pressure of 2 mm Hg, a cyclodialysis cleft extending from the 11 to 1 o'clock positions and a hypotonic maculopathy. Left eye best corrected visual acuity (BCVA) was 3/10. The patient failed to respond to conservative treatment with atropine 1%, so a single bubble of 16% C2F6 was injected into the vitreous cavity, followed by superior quadrant transconjunctival cyclocryotherapy.
    Results: After gas absorption, the intraocular pressure increased to 11 mm Hg and became steady during the 24 months of follow-up. His hypotonic maculopathy resolved, and the BCVA improved to 9/10. Complete closure of the cyclodialysis cleft was documented with ultrasound biomicroscopy.
    Conclusion: Cryotherapy associated with gas endotamponade is a minimally invasive technique that could be considered for patients with cyclodialysis clefts that fail to respond to medical therapy.
    Language English
    Publishing date 2015-02-17
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2577666-6
    ISSN 1663-2699
    ISSN 1663-2699
    DOI 10.1159/000375442
    Database MEDical Literature Analysis and Retrieval System OnLINE

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