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Revista Spo N4 2012 Edicao C Oftalmologia - Vol. 36 Oftalmologia REVISTA DA SOCIEDADE PORTUGUESA DE OFTALMOLOGIA Publicação Trimestral | Vol. 36 | Outubro - Dezembro 2012 Editor Conselho Redactorial José Henriques António Campos [email protected] Cristina Seabra Isabel Lopes Cardoso João de Deus João Segurado Marinho Santos Olga Berens Pedro Cruz Ricardo Faria Rui Proença Sociedade Portuguesa de Oftalmologia Comissão Central Conselho Fiscal Presidente Manuel Vinagre Manuela Carmona Luís Agrelos João Filipe da Silva Vice-Presidente Paulo Torres Coordenadores das Secções da S.P.O. Grupo Português de Retina-Vítreo Tesoureiro João Nascimento Augusto Magalhães Grupo Português de Inflamação Ocular Ana Paula Sousa Vogais Eduardo Silva Grupo Português de Oftalmologia Pediátrica e Estrabismo Rufino Silva Rita Dinis da Gama Secretária-Geral Adjunto Cirurgia Implanto-Refractiva de Portugal Ana Amaral Francisco Loureiro Secretário-Geral Grupo Português de Contactologia José Pedro Silva Miguel Amaro Grupo Português de Glaucoma Mesa da Assembleia Geral Manuela Carvalho Presidente Jorge Breda Grupo Português de Neuroftalmologia Ivone Cravo Vice-Presidente Nuno Canas Mendes Grupo Português de Patologia, Oncologia e Genética Ocular João Cabral 1ª Secretária Grupo Português de Ergoftalmologia Sandra Moniz Fernando Bivar 2° Secretário Editor da página da S.P.O na Internet Barros Madeira Helena Filipe SUBLINHADO Publicações e Publicidade Unipessoal - R. Prof. Vieira de Almeida, 38 - Lj. A - Bloco B - Piso 0 - 1600-371 LISBOA - Tel.: 21 757 81 35 | Depósito Legal 93 889/95 - ISSN 1646-6950 Vol. 36 - Nº 4 - Outubro-Dezembro 2012 | I Oftalmologia - Vol. 36 Índice Editorial V Complicações Hemorrágicas após Injecções Manuela Carmona Intravítreas em Doentes Hipocoagulados e/ou Antiagregados – Estudo Retrospectivo 411 Nota do Editor VII Cláudia Loureiro, Ana Bastos Carvalho, José Henriques Joana Valadares, Joaquim Prates Canelas, Manuel Monteiro Grillo Artigos de Revisão Agentes Biológicos nas Uveítes Pediátricas Disfunção Iridiana Traumática: Implantação Não Infecciosas 337 Secundária de Lente De Suspensão Escleral Miranda V.P., Maia S., Oliveira L., Guedes M., com Íris Artificial 417 Menéres P. Mariana Seca, Mafalda Macedo, Pedro Borges, Natália Ferreira, Angelina Meireles Laser Fototérmico e sua Interacção com a Retina Humana 353 Espessura Foveal Central (EFC) da Retina José Henriques, João Nascimento, Paulo Caldeira medida por Tomografia de Coerência Óptica Rosa, Fernando Trancoso Vaz, Miguel Amaro (OCT) por Time Domain (Stratus) e Spectral Domain (Heidelberg) 425 Artigos Originais Maria Picoto, José Galveia, Joana Portelinha, Implante Intravítreo de Dexametasona: António Rodrigues, Fernanda Vaz Os Nossos primeiros 100 casos 365 Ana Travassos, Dídia Proença, Isaura Regadas, Coriorretinopatia Serosa Central Crónica – Isabel Pires, António Travassos, Rui Proença Uma Doença Idiopática? 433 Marta Guedes, António Travassos, Phenotypical and Genetic Analysis of 12 Ricardo Oliveira, Miguel Ribeiro, Portuguese Patients with CFEOM Syndrome 377 Júlia Veríssimo, Rui Proença Inês R Gante, Mariana Almeida, Miguel Ribeiro, Dalila Salomé Coelho, Lígia Gomes Cardoso, Comunicações Curtas e Casos Clínicos Eduardo D. Silva Doença de Best. Casos clínicos 439 Juan E. Cedrún, Eva Chamorro, Carlos Orduna, Multifocalidade - Seleccionar para Resultar 387 Mercedes Maza, Isabel Portero João Paulo Cunha, Arnaldo Santos, Joana Ferreira, Duarte Amado, Margarida Marques Membrana Neovascular Bilateral Secundária a Estrias Angióides com Pseudoxantoma Efeito da Aplicação Matinal vs. Nocturna de Elasticum – Caso Clínico 443 Maleato de Timolol em Doentes Medicados Cláudia Bacalhau, Gonçalo Almeida, com Prostaglandina nas Curvas de Pressão Margarida Santos, David Martins Intraoculares Diurnas e de Pressão Arterial nas 24 Horas 393 Segurança e Estabilidade da Lente Fáquica Pedro Barros, Gabriel Morgado, Paula Tenedório, de Suporte Angular Acrysof Cachet® – Joana Martins, Josefina Serino, Bruna Vieira, 2 Anos de Follow-Up 447 João Neves Martins Pedro Reimão, Pedro Borges, Ricardo Parreira, Fernando Vaz, Ramiro Salgado, Maria Céu Pinto Ângulo Estreito: Facoemulsificação versus Iridotomia Laser 405 Síndrome de Goldenhar – Caso Clínico e Joana Ferreira, Luís Abegão Pinto, Revisão da Literatura 455 Isabel Domingues, José Pedro Silva, Rita Reis, Vasco Miranda, Ricardo Parreira, João Paulo Cunha, Maria Reina Pedro Menéres, Maria Araújo Vol. 36 - Nº 4 - Outubro-Dezembro 2012 | III Termo de Consentimento Informado para Cirurgia de Catarata 463 Leonor Duarte Almeidao Caso Clínico Mistério Resposta ao Caso do Número Anterior 467 Tânia Rocha, António Mendes Carvalho, Mário Neves, João Filipe Silva, António Roque Loureiro Secção Histórica e Iconográfica - Histórias da Oftalmologia Portuguesa Orgulho e Preconceito 469 João Segurado Indicações aos Autores e Normas de Publicação 471 IV | Revista da Sociedade Portuguesa de Oftalmologia Oftalmologia - Vol. 36 Editorial Em final de mandato, fujo ao balanço que só o tempo deve fazer . A Sociedade Portuguesa de Oftalmologia contraria algumas tendências que fragilizam muitas das instituições que conhece- mos. Em várias áreas existe um alheamento e afastamento entre os decisores e todos os outros. A SPO tem prestígio científico, é uma instituição respeitada e, sobretudo, os seus sócios, na esmagadora maioria, identificam-se com a “sua sociedade”. A of- talmologia está mais interventiva, os jovens participam e interessam-se pelo destino da sociedade, existe uma participação em actos eleitorais invejável. Em termos económicos está sólida, tem a sede totalmente paga e continua a ter resultados positivos num contexto adverso. O respeito e o tratamento equitativo dado a todos os sócios, a qualidade das reuniões científicas, a melhoria verificada na revista, o trabalho de comunicação junto dos sócios, junto de outros intervenientes como a OM, sociedades científicas, deciso- res políticos e, através da comunicação social, esclarecendo e educando para a saúde a população, devem continuar a ser uma prioridade. Num tempo conturbado e de grande desespero de muitos, a independência e isenção da SPO em relação a interesses privados ou de grupos é indispensável. Temos oftalmologistas com qualidade e em número suficiente, aliás em número superior, à recomendação da OMS. Este número tremendamente elevado de oftalmologistas, muitíssimo bem preparados e maioritariamente jovens, é sinal de vitalidade mas não pode continuar a aumentar a este ritmo. A colaboração institucional e um bom relacionamento da SPO com o Colégio de Oftalmologia é fundamental. Importa cuidar a formação e manter um número equilibrado de oftalmologistas. Mas a SPO não é uma ilha. Hoje o conceito de oftalmologia global é uma realidade na qual as sociedades científicas se devem posicionar. Abrem-se novos horizontes, surgem novas alianças também científicas. A SPO pode e deve ser a impulsio- nadora dum conceito de Oftalmologia de língua portuguesa. O português está a ter uma influência crescente a nível mundial e essa “onda” deve também levar a Oftalmologia. Vemos com agrado a PAAO revitalizada acompanhando o dinamismo das economias da América Latina. A SPO, sem esquecer o seu espaço europeu, pode e deve acarinhar esta ligação. Constatamos que os problemas que hoje enfrentamos são transversais aos países desenvolvidos: a destruição do exercício da medicina como profissão liberal tornando os médicos assalariados e transformando os doentes em clientes. A descrição magistral desta realidade, feita pelo Dr. António Travassos no editorial anterior, é um grito de alerta. Um grito de alerta deve ser ouvido e deve impor uma actuação. O momento das palavras e dos lamentos está esgotado. É hora de actuar. A SPO por si nada pode, aliás este não é um pro- blema da Oftalmologia mas de toda a medicina. Deve existir uma posição concertada de todas as Sociedades científicas e dos vários colégios liderada pela Ordem dos Médicos. Estou certa que a OM e o Sr. Bastonário, com o apoio de todos, estão à altura do desafio. Tendo presente os vários desafios que enfrentamos importa melhorar os estatutos da SPO: colocá-los de acordo com a legis- lação em vigor e libertá-los de amarras datadas. A Sociedade Portuguesa de Oftalmologia continuará assim a reflectir o sentir de cada um dos seus sócios – os oftalmologistas portugueses. Manuela Carmona Presidente da SPO Vol. 36 - Nº 4 - Outubro-Dezembro 2012 | V Oftalmologia - Vol. 36 Nota do Editor José Henriques PRODUÇÃO & PUBLICAÇÃO CIENTÍFICAS EM OFTALMOLOGIA – balanço e novas oportunidades! A produção científica faz parte da actividade normal de uma unidade de saúde, embora esta área não seja tida em conta como indicador de produção nos contratos-programa das unidades públicas com a ACSS! Mas desde sempre, e à semelhança do que se faz internacionalmente, deixar de estar subjugado exclusivamente à actividade assistencialista e produzir ciência é uma boa prática. Incrementar o conhecimento técnico-científico ou de processo, auditar a actividade clínica através da análise da casuística do serviço e seus resultados, comparar e melhorar a eficácia e a efectividade no sentido de menor variabilidade e de aproximação dos padrões e resultados de outros grupos clínicos da mesma área de especialização ou sub-especialização, são medidas de melhoria de qualidade, de maior eficiência e de busca da EXCELÊNCIA que cada unidade de saúde procura. Mas tudo o que se fizer, se não se publicar, é quase como se não tivesse existido. Por isso é fundamental que se dedi- quem recursos, humanos e tempo para a actividade de
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