Publications by authors named "Nadyr Damasceno"

20 Publications

  • Page 1 of 1

The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes.

Clin Ophthalmol 2020 17;14:2353-2359. Epub 2020 Aug 17.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

Purpose: To report both the unoperated clinical course and the surgical outcomes of eyes with a central foveal bouquet (CB) secondary to idiopathic epiretinal membranes (iERMs).

Design: Retrospective, consecutive, and observational case series.

Methods: All patients examined between January 1, 2014, and December 31, 2019, for evaluation of epiretinal membrane with a CB lesion identified on spectral domain optical coherence tomography (SD-OCT) were included. Exclusion criteria included vitreoretinal comorbidities associated with secondary ERMs and an absence of CB lesions on SD-OCT. Patients were divided into two groups: those who were followed with observation (Group I) and those who received surgery (Group II). Each group had 3 different types of mechanical abnormalities of the CB previously described as cotton ball sign, subfoveal detachment, or acquired vitelliform lesion, without a subanalysis discrimination.

Main Outcome Measures: Best-corrected visual acuity (BCVA) at baseline and last follow-up, subjective metamorphopsia, central retinal thickness (CMT), mechanical stress lesions of the CB, and resolution or evolution of the CB lesions during the follow-up interval.

Results: Two hundred seventy-six eyes with iERM were reviewed, and 46 eyes met the inclusion criteria. Among these, 21 of 46 (46%) were observed, and 25 of 46 (54%) underwent surgery. Metamorphopsia was identified in 61.9% of patients in Group I and 81.2% of patients in Group II, at baseline. The mean BCVA was 0.19 ± 0.17 (20/30) in Group I and 0.31 ± 0.33 (20/40) in Group II at presentation. At the final exam, patients in Group I achieved a mean BCVA of 0.24 ± 0.18 (20/30), while patients in Group II obtained a mean BCVA of 0.15 ± 0.21 (20/30). Spontaneous resolution of the CB sign occurred in 5 of 21 eyes (23.8%) that were observed, whereas, after surgery, the CB sign resolved in 16 of 25 eyes (61.5%). Mean CMT was 422 ± 84.2μm in Group I and 531 ± 143.9μm in Group II, at baseline, while at the latest follow-up, the mean CMT was 400 ± 40.8μm in the cases followed with observation and 454 ± 148.7μm in the surgical cases.

Conclusion: The clinical course and surgical outcomes of CB findings in iERM are favorable in terms of visual acuity. However, those receiving surgery had an increase in visual acuity and resolution of the CB abnormality.
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http://dx.doi.org/10.2147/OPTH.S254544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493214PMC
August 2020

Treatment of Radiation Retinopathy with Intravitreal Injection of Ranibizumab (Lucentis).

Int Med Case Rep J 2020 11;13:27-32. Epub 2020 Feb 11.

Department of Ophthalmology, Universidade Federal Fluminense, Niteroi, Brazil.

To report a treatment of radiation retinopathy in a patient exposed to ionizing radiation for a period of 2 years. A 26-year-old female patient with no comorbidities diagnosed with myelodysplasia confirmed by bone marrow biopsy. She presented a complaint of bilateral progressive visual acuity reduction. At the ophthalmologic examination, she presented alterations suggestive of radiation retinopathy as well as macular thickness to optical coherence tomography (OCT) of over 500 µm. The patient underwent intravitreal injection (0.05 mL) of ranibizumab (Lucentis) monthly in both eyes and follow-up through visual acuity and OCT examination. She presented reduction of macular edema as well as a slight improvement of visual acuity. In this case, the treatment of radiation retinopathy with intravitreal injection of ranibizumab (Lucentis) was relatively useful, with a slight improvement of visual acuity, due to the regression of macular edema, not being curative.
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http://dx.doi.org/10.2147/IMCRJ.S191654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023963PMC
February 2020

The Clinical Course of Patients with Idiopathic Epiretinal Membranes and Good Visual Acuity Managed Without Surgery.

Clin Ophthalmol 2019 12;13:2469-2475. Epub 2019 Dec 12.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, FL, USA.

Background/aims: To report the clinical course of patients with idiopathic epiretinal membranes (iERMs) and good baseline best-corrected visual acuity (BCVA) managed without surgical treatment.

Methods: Retrospective, observational case series of patients with iERMs and 20/50 or better BCVA who did not undergo surgery between January 2014 and December 2017 with a 1-year follow-up. Secondary epiretinal membranes were excluded. iERMs were stratified into two groups: Group I (BCVA 20/30 or better) and Group II (BCVA 20/40 to 20/50). The main outcome measures included baseline and final follow-up BCVA, central macular thickness (CMT) on OCT.

Results: The study included 174 eyes (145 patients): 139 eyes (79.8%) had typical iERMs and 35 eyes (18%) had LMH. For Group I typical iERMs, the logMAR baseline and final mean BCVA were 0.09 ± 0.1 (Snellen equivalent 20/25) and 0.10 ± 0.1 (20/25) respectively (p = 0.22). In this group, the baseline and final mean CMT were 335 ± 73µm and 342 ± 78µm, respectively (p = 0.47). For Group II typical iERMs, the logMAR baseline and final mean BCVA were 0.3 ± 0.1 (20/44) and 0.4 ± 0.2 (20/45) respectively (p = 0.31). In this group, the baseline and final mean CMT were 386 ± 95µm and 391 ± 93µm, respectively (p = 0.84).

Conclusion: The clinical course of patients with iERM and good baseline BCVA is generally favorable without surgery and includes stable BCVA and OCT measurements after at least one year.
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http://dx.doi.org/10.2147/OPTH.S218662DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914657PMC
December 2019

Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony.

Clin Ophthalmol 2019 4;13:1703-1710. Epub 2019 Sep 4.

Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.

Purpose: To evaluate diathermy to minimize sclerotomy leakage during small-gauge vitrectomy and prevent ocular hypotony.

Methods: This observational prospective study included 327 patients (327 eyes) who underwent diathermy to close the sclerotomy sites during 23-gauge pars plana vitrectomy (PPV). All patients were operated by a single surgeon (ED) and evaluated at 30 and 60 days postoperatively. Patients with glaucoma, topical/systemic steroids use exceeding 30 days, ocular inflammation, or trauma were excluded. Chi-square, Kruskal-Wallis, Fisher Exact test, and multivariate statistical analyses were performed to evaluate potential risk factors. The primary outcomes were open sclerotomies, leakage, and ocular hypotony.

Results: Sclerotomies remained open in 12 (3.6%) and 2 (0.6%) patients, respectively, at 30 and 60 days postoperatively, revealing no case of ocular hypotony. Leakage only occurred in four patients (1.2%) during week 1 postoperatively. Multivariate analysis indicated that additional vitreoretinal surgeries and longer surgeries were risk factors for persistent sclerotomy opening.

Conclusion: Diathermy was safe and feasible to close sclerotomies. Vitreoretinal surgery reoperations and longer surgeries were the most significant (<0.05) risk factors for persistent sclerotomy opening, which may be functionally closed without evidence of leakage or ocular hypotony.
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http://dx.doi.org/10.2147/OPTH.S209813DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732740PMC
September 2019

Comparative study of the clinical profile of chronic dacryocystitis and chronic rhinosinusitis after external dacryocystorhinostomy.

Clin Ophthalmol 2019 16;13:1267-1271. Epub 2019 Jul 16.

Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.

Purpose: To compare the clinical profile of patients with chronic dacryocystitis (CDC) with and without associated chronic rhinosinusopathies who had been submitted to external dacryocystorhinostomy (EDCR).

Methods: This was a retrospective, observational, and longitudinal study that included all patients diagnosed with CDC who were submitted to EDCR at the Antonio Pedro University Hospital. Patients were divided into two groups, with and without rhinosinusopathies (Group I and Group II, respectively). The following variables were assessed to compare the Group I and Group II: age, ethnicity, epiphora, discharge by expression of the lacrimal sac, duration of the CDC, and previous history of CDC exacerbation.

Results: The study included a total of 78 patients, 22 patients (28.2%) in Group I and 56 patients (71.8%) in Group II. The mean age was 64.3 (±19.7) years. In Group I and II predominated elderly, female, and White (=0.93, =0.38, =0.77). In relation to the clinical characteristics, most of the patients presented epiphora and discharge by compression of the lacrimal sac in both Groups (=0.61, =0.44). In relation to a previous history of exacerbations of the CDC, six patients in Group I and four patients in Group II presented it as purulent discharge (=0.04).

Conclusion: Chronic rhinosinusopathies may favor episodes of exacerbations of chronic dacryocystitis in particular with the presence of purulent discharge.
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http://dx.doi.org/10.2147/OPTH.S200923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643063PMC
July 2019

Outer Retinal Tubulation and Neovascular Age-Related Macular Degeneration: A Review of the Pathogenesis and Clinical Implications.

Ophthalmic Surg Lasers Imaging Retina 2018 11;49(11):870-876

Outer retinal tubulation (ORT) is a retinal finding that can mimic intraretinal fluid and has been identified with spectral-domain optical coherence tomography in patients with age-related macular degeneration (AMD). The purpose of this review is to summarize the findings related to the pathogenesis of ORT and its clinical implications. Studies reporting the pathogenesis and the clinical implications of ORT in patients with AMD were identified and summarized. A total of 18 studies were included in this review. The body of evidence to date regarding ORT in patients with AMD indicates that ORT is a structure associated with advanced macular diseases that does not require anti-vascular endothelial growth factor treatment. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:870-876.].
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http://dx.doi.org/10.3928/23258160-20181101-08DOI Listing
November 2018

Scleral wound healing with cross-link technique using riboflavin and ultraviolet A on rabbit eyes.

Clin Ophthalmol 2017 6;11:1265-1272. Epub 2017 Jul 6.

Ophthalmology Department, Universidade Federal Fluminense, Niterói, Brazil.

Purpose: The aim of study was to evaluate the cross-link using riboflavin and ultraviolet A (UVA) for improving scleral wound healing.

Materials And Methods: This was an experimental study involving four New Zealand rabbits (eight eyes). Therapy procedure was chosen for the right eye and control procedure for the left one. UVA irradiation of 365 nm with a surface irradiance of 3 mW/cm and a photosensitizer of riboflavin drops were applied for 30 minutes on the right eye at 2 mm from the limbus. Sclerotomy incision was performed at 2 mm from the limbus in both right (on the cross-link-treated area) and left eye. Then, 30 days after surgery, a morphological analysis and histological staining with hematoxylin-eosin and picrosirius red were performed, and the sclerotomy cicatrization of right and left eyes was compared. The variables investigated were as follows: sclerotomy incision pictures and measurements were made using the ImageJ Software. Scleral thickness was measured (employing the anterior optical coherence tomography and the digital caliper). Collagen fiber density stained with picrosirius red staining was measured using the Image Pro Plus software.

Results: The morphological analysis showed that in all samples, the right eye presented sclerotomy closure, and in two eyes, among them, there were no visible edges of the sclerotomies incision. The left eye presented sclerotomy closure and incision edges. The Image Pro demonstrated a higher density of collagen fibers in the right eye when compared to the one. The statistical analysis was significant when compared to the collagen fiber density in the treated eyes with the control eyes.

Conclusion: The cross-link procedure resulted in a better sclerotomy wound healing.
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http://dx.doi.org/10.2147/OPTH.S139657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505616PMC
July 2017

Evaluation of a simulation tool in ophthalmology: application in teaching funduscopy.

Arq Bras Oftalmol 2016 Apr;79(2):131

Hospital Naval Marcílio Dias, Rio de Janeiro, RJ, Brazil.

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http://dx.doi.org/10.5935/0004-2749.20160040DOI Listing
April 2016

Prevalence and factors associated with scleral hyaline plaque: clinical study of older adults in southeastern Brazil.

Clin Ophthalmol 2015 30;9:1187-93. Epub 2015 Jun 30.

Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.

Purpose: To investigate the prevalence of scleral hyaline plaque among older adults in the city of Niterói in southeastern Brazil. A second goal was to assess the correlation between scleral hyaline plaque and several age-related diseases, including eye diseases and systemic diseases.

Methods: The study sample comprised 667 participants who were followed for 15 months. The study had a prospective, longitudinal, observational design that established inclusion and exclusion criteria. The following variables were selected for correlation with scleral hyaline plaque: sex, age, age range, iris color, ethnicity, presence of cataract, moderate to high myopia, age-related macular degeneration (AMD), diabetes mellitus, systemic arterial hypertension, degenerative arthritis, and osteoporosis. These correlations were assessed by means of the χ (2) test and Student's t-test. Multivariate analysis was performed to exclude factors that were potentially associated with aging exclusively but that did not have a direct relationship with hyaline plaque. Binary logistic regression was used to calculate odds ratios, significance, and confidence intervals.

Results: Scleral hyaline plaques were found in 177 patients (17.54%). There was a statistically significant association between the presence of hyaline plaques and sex (female), age range (≥70 years old), ethnicity (Caucasian), cataract, moderate to high myopia, systemic arterial hypertension, degenerative arthritis, and osteoporosis (P<0.05). On multivariate binary logistic regression analysis, only female sex, age range (≥70 years), moderate to high myopia, and degenerative arthritis exhibited significant correlation.

Conclusion: The prevalence of scleral hyaline plaque in the present study was higher than in previous reports in the medical literature. Several age-related diseases exhibited a correlation with scleral hyaline plaque. The most significant factors associated with scleral hyaline plaque were advanced age, female sex, moderate to high myopia, and degenerative arthritis.
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http://dx.doi.org/10.2147/OPTH.S82421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494614PMC
July 2015

Ocular diseases at geriatric clinics in Rio de Janeiro: social and epidemiological considerations among patients with motor locomotion deficit.

Arq Bras Oftalmol 2015 Jan-Feb;78(1):40-3

Department of Ophthalmology, Fluminense Federal University, Niterói, RJ, Brazil.

Objective: To identify the causes of low visual acuity and systemic morbidities that limit ambulation and access to eye care in geriatric clinics in Rio de Janeiro.

Methods: This cross-sectional study evaluated 187 patients from three geriatric clinics in Rio de Janeiro between January 2010 and January 2011. The inclusion criteria were individuals with a visual acuity of less than of equal to 20/200 in either eye (118 individuals), without optical correction. The exclusion criteria were individuals who refused to participate and those unable to undergo screening because of mental disabilities (6 individuals). Of the 187 individuals evaluated, 63 had visual acuity above 20/200.

Results: A total of 118 individuals with a visual acuity of ≤20/200 effectively participated in the study after meeting the inclusion and exclusion criteria. In addition, 57 participants (48.3%) presented systemic disabling morbidities. Of the 118 individuals with low visual acuity, 27.96% had cataract and 26.27% had refractive errors.

Conclusion: Most of the patients from geriatric clinics experienced ocular morbidities, but their proper treatment resulted in improved visual acuity. A more socially oriented problem associated with eye care involved the difficulty of access to ophthalmologic consultations.
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http://dx.doi.org/10.5935/0004-2749.20150011DOI Listing
July 2015

Leuconostoc as a Cause of Endophthalmitis Post-intravitreal Injection of Ranibizumab.

Ocul Immunol Inflamm 2016 21;24(1):118-9. Epub 2014 Apr 21.

b Department of Ophthalmology School of Medicine - Universidade Federal Fluminense , Niteroi , Brazil.

Purpose: The authors report a case of endophthalmitis after intravitreal injection of ranibizumab.

Methods: After searching for extensive laboratory tests to isolate the etiologic agent Results: The agent was determined as Leuconostoc mesenteroides, gram-positive cocci, vancomycin resistant.

Discussion: Considerations regarding this bacterium were done by calling attention to its rarity, difficulty of isolation, and action on secondary comorbidities as opportunistic pathogen.
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http://dx.doi.org/10.3109/09273948.2014.898073DOI Listing
November 2016

Emphysema following vitrectomy with fluid-gas exchange: description of a rare complication.

Clin Ophthalmol 2014 11;8:401-3. Epub 2014 Feb 11.

Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

Purpose: To report a case of subcutaneous emphysema involving the orbit, mediastinum, and face after pars plana vitrectomy with fluid-gas exchange.

Methods: Case report of a 55-year-old man who presented with bilateral eyelid and face edema and dysphagia in the immediate postoperative period after pars plana vitrectomy. Orbital and chest computed tomographies were performed, revealing emphysema of the orbit and soft tissue of the face, extending from the neck to the upper chest.

Results: The patient with a retinal detachment in the right eye underwent 23-gauge vitrectomy surgery with fluid-gas exchange and an implantation of silicone oil. The patient had a previous history of facial trauma for more than 20 years with an orbital fracture. After surgery, the patient developed emphysema of the orbit, soft tissue of the face and upper chest. Systemic prophylactic antibiotics associated with antibiotics and steroid drops performed a satisfactory evolution.

Conclusion: The fluid-gas exchange during pars plana vitrectomy in patients with orbital fracture can lead to emphysema of the face, chest, and soft tissue.
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http://dx.doi.org/10.2147/OPTH.S56083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929265PMC
March 2014

Scleral buckling surgery and eye pain: assessment of chronic eye pain during the postoperative period of scleral buckling surgery.

Retina 2014 Jun;34(6):1083-90

*Department of Ophthalmology, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; and †Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.

Purpose: To assess the progression of eye pain after scleral buckling surgery to treat rhegmatogenous retinal detachment and to investigate the occurrence and characteristics of chronic eye pain.

Methods: This was a longitudinal, prospective, and observational study. Eye pain was measured according to a numerical analog scale (range, 0-10) for 6 months after scleral buckling surgery. The sample was divided into two groups, with or without chronic eye pain, to perform statistical analyses. For this study, chronic eye pain was defined as postoperative pain beyond 30 days. The following variables were assessed to investigate the etiology of chronic eye pain: age, gender, ethnicity, degree of myopia, visual acuity, intraocular pressure, and degree of scleral indentation.

Results: A total of 100 patients were assessed in this study. One particular sequence of levels on the pain analog scale, specifically 3-2-1-0-0 (intensity of eye pain on postoperative Days 1, 14, 30, 60, and 180, respectively), was identified more frequently during the progression of eye pain in the 180-day follow-up period. The pain resolved for 72% of patients within 30 days. Chronic eye pain occurred in 18% of the patients. Scleral indentation was the only statistically significant variable investigated relative to the etiology of chronic eye pain (P < 0.05).

Conclusion: Chronic eye pain correlated significantly with large scleral indentation. Patients with more intense pain at the onset of the postoperative period tended to develop chronic eye pain.
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http://dx.doi.org/10.1097/IAE.0000000000000057DOI Listing
June 2014

Anterior uveitis after treatment of age-related macular degeneration with ranibizumab and bevacizumab: uncommon complication.

Clin Ophthalmol 2012 31;6:1201-5. Epub 2012 Jul 31.

Ophthalmology Department, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil.

The authors describe one case of anterior uveitis after treatment of age-related macular degeneration with both antiangiogenic drugs: ranibizumab and bevacizumab. The case is described as a complication of ranibizumab and bevacizumab due to an inflammatory process. Several reasons are suggested to explain this possibility, and the authors conclude that the main cause remains unknown.
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http://dx.doi.org/10.2147/OPTH.S31239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422141PMC
October 2012

Anterior uveitis after treatment of hepatitis C with alpha interferon: the recurrence of a previous inflammatory process due to presumed ocular toxocariasis.

Ocul Immunol Inflamm 2012 Feb;20(1):53-5

Objective: To report a case of recurrent unilateral presumed ocular toxocariasis after treatment of hepatitis C.

Design: Case study.

Methods: Clinical findings, ultrasonography, computed tomography, and serological tests were performed. Once diagnosis was made, effective treatment was administered.

Results: A 46-year-old woman with a long history of decreased unilateral visual acuity presented with anterior uveitis after the use of interferon alpha and ribavirin for treatment of hepatitis C. A biomicroscopic examination revealed active anterior uveitis, with ultrasonography and computed tomography demonstrating a central granuloma due to partially calcified toxocariasis. After treatment with corticosteroids and cycloplegics, the symptoms were alleviated.

Conclusion: immunostimulation could cause a relapse of the inflammatory reaction found in uveitis due to toxocariasis.
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http://dx.doi.org/10.3109/09273948.2011.615448DOI Listing
February 2012

Combined hamartoma of the retina and retinal pigment epithelium associated with optic coloboma.

Clin Ophthalmol 2011 15;5:353-4. Epub 2011 Mar 15.

The authors relate an uncommon case of combined hamartoma of the retina and retinal pigment epithelium associated with optic coloboma.
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http://dx.doi.org/10.2147/OPTH.S15272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065579PMC
July 2011

Acquired unilateral rubella retinopathy in adult.

Clin Ophthalmol 2010 Dec 16;5:3-4. Epub 2010 Dec 16.

Department of Ophthalmology, Universidade Federal Fluminense, Niterói, RJ, Brazil.

The authors report an uncommon case of unilateral rubella retinopathy in an adult patient, described for the first time in medical literature. A 28-year-old healthy white man acquired a case of vasculitis and retinitis on his right eye with sudden vision loss, preceded by an acute viral disease (best correct visual acuity was 20/200). Serology examinations on several viral diseases reveled positive signs to rubella. The treatment was based on corticoids therapy due to macular commitment with final visual acuity of 20/60. Serology concluded rubella etiology, with positive levels in the acute initial stage of viral infection, even during viral retinopathy.
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http://dx.doi.org/10.2147/OPTH.S15273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032996PMC
December 2010

New eye speculum for pars plana vitrectomy.

Retina 2010 Oct;30(9):1549-50

Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.

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http://dx.doi.org/10.1097/IAE.0b013e3181f04957DOI Listing
October 2010

Pyogenic granuloma after retinal detachment surgery with scleral buckle: case report.

Arq Bras Oftalmol 2009 Jul-Aug;72(4):543-4

Departamento de Oftalmologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

The authors relate an uncommon case of pyogenic granuloma restricted to tarsal conjunctiva post retinopexy with scleral buckle.
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http://dx.doi.org/10.1590/s0004-27492009000400021DOI Listing
March 2010