Abstract
Objetivo Comparar a acuidade visual (AV) final dos pacientes submetidos a cirurgia de catarata com e sem complicacoes intraoperatorias e possiveis fatores que contribuiram para o resultado ao final do pos-operatorio. Metodos Analise dos prontuarios de 179 pacientes, retrospectivo, longitudinal, operados de fevereiro a julho de 2013 no Instituto Dr. Suel Abujamra, pela tecnica de facoemulsificacao (FACO), divididos em dois grupos: com e sem complicacoes intraoperatorias. Os dados obtidos foram analisados pelos metodos teste-t para duas amostras ou Analise de Variância (ANOVA). Os criterios de exclusao foram pacientes com cirurgia ocular previa, retinopatia diabetica proliferativa ou nao proliferativa grave, outras retinopatias, escavacao do disco optico igual ou maior que 0,7x0,7 ou uso de mais de dois hipotensores oculares, olho unico, catarata secundaria a uveite, traumatica ou congenita. Resultados Dos 179 pacientes, 37 (20,7%) tiveram complicacoes intraoperatorias e 142 (79,3%) nao tiveram complicacoes intraoperatorias. A media da idade dos pacientes foi de 70,33 anos. O olho direito foi o operado em 49,7% dos casos, e o olho esquerdo em 50,3%. O diabetes mellitus estava presente em 29,05% dos casos, sendo 29,73% de pacientes com complicacao e 28,87% sem complicacoes. Do total, 77,65% atingiram uma AV final 20/40 ou melhor, sendo que nos pacientes com complicacao a media para esta AV foi de 59,46% e no grupo sem complicacoes foi de 82,40%. A principal complicacao foi ruptura de capsula posterior. Conclusao Apos toda a analise, verificamos que os fatores que implicaram com significância estatistica em menor AV final foram as complicacoes intraoperatorias e a idade dos pacientes.
Highlights
C ataracts are the leading cause of reversible blindness in the developing countries
The assessment of patients in the Diabetes Mellitus group shows that the development of visual acuity in patients with diabetes and without diabetes was very similar, with the diabetes group having a slightly higher mean development, but there is no significant difference between mean developments. (Graphs 7 and 8)
When the variables are analyzed separately, the factors involved with the statistical significance in a worse final visual acuity were the intraoperative complications and the patient age; no other variable was studied with statistical significance
Summary
C ataracts are the leading cause of reversible blindness in the developing countries. WHO estimated in 2010 that there are almost 18 million people bilaterally blind from cataract in the world, representing almost half of the causes of blindness due to eye diseases. The blindness ratio due to cataract in relation to all other eye diseases ranges from 5%. The gradual increase of life expectancy in our country caused a subsequent increase in the prevalence of this disease in the last decades.(1) Despite popular belief, the majority of the population believes that cataract surgery is a definitive treatment to restore the vision (2,3) , allowing an improvement in the quality of life and reintegration into the labor market(4). Cataract extraction is the most commonly performed surgery in the USA, with 1.7 million surgeries perfomed annually, and phacoemulsification (FACO) is the chosen technique(5). Studies carried out worldwide in the past 20 years have shown that the phacoemulsification is a safe and effective procedure to treat patients with mild to advanced cataracts(6,7)
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