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| Author(s): |
Paulo Augusto Penitente
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Araçatuba. 2022-05-09. |
| Institution: | Universidade Estadual Paulista (Unesp). Faculdade de Odontologia. Araçatuba |
| Defense date: | 2021-12-03 |
| Advisor: | Marcelo Coelho Goiato; Daniela Micheline Santos; Emily Vivianne Freitas Silva |
| Abstract | |
The ocular prosthesis has an important role in the psychosocial and physiological recovery of anophthalmic individuals. However, conjunctival irritation, biofilm adhesion, and complaints of dry eye or excessive tearing may occur. The aim of this clinical trial was to evaluate the influence of ocular prostheses repolishing on microbiological, inflammatory, sensory, and tear production aspects of unilateral anophthalmic volunteers. Sixteen subjects wearing the same ocular prosthesis for at least 2 years were divided into 2 groups: intervention (IN) (n = 10) and no intervention (NIN) (n = 6). In addition, a third group with volunteers without ocular disability was the positive control (PC) (n = 5). The anophthalmic cavity, contralateral eye, and ocular prosthesis surface of anophthalmic volunteers and the right eye of the PC group were evaluated at 3 periods (initial period and at 15 and 30 days after repolishing). The microbiological analysis evaluated by the colony forming units (CFU) of Candida albicans fungi, total bacteria, and of the Staphylococcus genus (Staphylococcus epidermidis and S. aureus). Exfoliative cytology was performed to quantify the appearance of conjunctival inflammatory cells in all volunteers. Sensory analysis was performed using a quantitative mechanical sensory test with nylon monofilaments in three points of the upper and lower eyelid of all volunteers and an internal central point of the anophthalmic cavity. Tear production was assessed by Schirmer's test. Conjunctival inflammation was clinically assessed. For comparison between groups in the initial period, the Kruskal Wallis test was used, except for inflammation level (Mann-Whitney test). For the analysis among periods in the IN group, the Friedman's test was performed. Qualitative data were submitted to descriptive statistics, and the Cochran's Q test was applied, when necessary. All analyzes were performed at a 5%-significance level. Microbiological analysis showed greater microorganism formation in both anophthalmic cavity and prosthesis than in the contralateral eye in the initial period. In the anophthalmic cavity of the IN group, the amount of all microorganisms evaluated was statistically higher in the initial period than in 15 and 30 days after repolishing. In the ocular prosthesis, there was a greater accumulation of total bacteria and Candida albicans in the initial period than at 15 and 30 days after repolishing. More eyelid inflammation was observed in the anophthalmic cavity than in the contralateral eye. There was a statistically significant reduction in clinical inflammatory signs at 15 and 30 days after repolishing in the IN group. Cytological analysis showed no significant reduction in inflammatory cell infiltrate at 15 and 30 days after repolishing. There was a difference in tear production, where the IN group - contralateral eye had lower tear production than the NIN group - anophthalmic cavity. In the eyelid sensitivity analysis, no statistical differences were observed between the groups, nor in relation to the analyzed periods in the IN group. It is possible to conclude that repolishing was beneficial in reducing microorganisms over time and in reducing clinical inflammatory signs. (AU) | |
| FAPESP's process: | 19/07295-2 - Anophthalmic cavity inflammation level and microbiological analysis of unilateral ocular prostheses users |
| Grantee: | Paulo Augusto Penitente |
| Support Opportunities: | Scholarships in Brazil - Master |