Sebastião Cronemberger

• Full Professor of Ophthalmology
• Professor (Full) at Federal University of Minas Gerais

Purpose:: The relationship between clinical data and genetic ancestry in Brazilian patients with primary congenital glaucoma (PCG) was studied. Patients and methods:: Thirty patients with PCG and 60 unrelated controls underwent a complete ophthalmological examination. The PCG inclusion criterion was prior surgery with a minimum follow-up of 6 mo...

To compare morphometric features between fellow acute primary angle-closure (APAC) eyes and glaucomatous or suspect eyes with narrow angle (NA). Fellow eyes of 30 patients with unilateral APAC and 30 with NA were evaluated by ultrasound biomicroscopy (UBM) under light and dark conditions. UBM parameters such as anterior chamber depth (ACD), angle o...

Phakic intraocular lens (IOL) implantation represents a major technique for the correction of high myopia. The STAAR collamer posterior chamber phakic IOL--trade named Implantable Contact Lens--is an emerging technology in refractive surgery. We studied the relative position of the posterior chamber phakic IOL using ultrasound biomicroscopy. The po...

The purpose of this article is to review the plateau iris configuration demonstrating the importance of ultrasound biomicroscopy in the diagnosis. The possible non-pupillary block mechanism of angle-closure glaucoma and its management are also discussed.

The aim of this study was to develop and evaluate the effects of chitosan inserts for sustained release of the angiotensin-converting enzyme 2 (ACE2) activator, diminazene aceturate (DIZE), in experimental glaucoma. Monolayer DIZE loaded inserts (D+I) were prepared and characterized through swelling, attenuated total reflectance Fourier transformed...

Implantation of glaucoma drainage devices is a valuable therapeutic option, particularly in children with glaucoma refractory to primary surgical treatment. Glaucoma drainage devices are typically used when conjunctival scarring hampers filtration surgery or prior angle procedures are not effective in controlling intraocular pressure. Despite known...

Aim This study reports the bilateral association of Peters' anomaly and congenital aniridia in monozygotic twins subsequently diagnosed with Wilms tumour (WAGR syndrome). Methods Two monozygotic female twins were referred at age 2 months with bilateral corneal opacity. A diagnosis of Peters' anomaly associated to aniridia was made in both eyes of...

Purpose: The involvement of the ocular anterior segment by SARS-CoV-2 has been the subject of many studies, however, the repercussions on the pos- terior segment, particularly on the different layers of the retina and optic nerve, are still little known. The purpose of this study was to evaluate the im- pact of severe COVID-19 on the retinal gangli...

Purpose Eyelid spasms might be associated with elevated intraocular pressure (IOP) in hemifacial spasm (HFS) patients. IOP assessment using a Goldmann applanation tonometer (GAT) is often compromised by eyelid spasms. This study aimed to assess the effect of HFS on IOP measurements using the transpalpebral tonometer Diaton® before and after treatme...

Introduction Bilateral acute iris transillumination (BAIT) is a relatively new syndrome whose etiopathogenesis is still not fully understood. It is characterized by acute bilateral onset of intense pigment dispersion in the anterior chamber, iris depigmentation with severe transillumination defects, accentuated pigment deposition in the angle, and...

Background: Traboulsi syndrome is a rare disease clinically characterized by facial dysmorphism, abnormal spontaneous filtering blebs, ectopia lentis (EL) and multiple anterior segment abnormalities. Material and methods: An 18-year-old female was referred to the Emergency Service of Hospital São Geraldo (HSG) claiming decreased right eye (RE) v...

Purpose In patients with primary congenital glaucoma (PCG), elevated intraocular pressure (IOP) causes abnormal eye growth. This study compared the outcomes of children with PCG who underwent ab externo trabeculotomy (TROC) at age ≤ 6 months (early TROC) and of those who underwent TROC at age > 6 months (delayed TROC). Methods Intraocular pressure...

Objective To evaluate structural and visual field (VF) changes after ≥1 year of a single acute primary angle closure (APAC) attack using spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP). Methods Patients with a single unilateral APAC crisis at least 1 year ago were included consecutively from 2013 to 201...

Glaucoma drainage devices are important therapeutic options for cases of refractory glaucoma, in which trabeculectomy with antimetabolites has shown high risk of failure. There are devices with different sizes, designs and materials, and several studies have been conducted to test their safety and effectiveness. Despite known complications, their u...

Purpose: No previous studies have evaluated the scarring of the conjunctiva and Tenon's Capsule (TC) separately when only the conjunctiva is removed, and TC is preserved in the upper part of the bulb: the site designated for trabeculectomy. Thus, this cohort interventional study aims to investigate the scarring of the donnor area after Autologous L...

Aim: To assess intraocular pressure (IOP) during the daily curve of intraocular pressure (DCPo) in keratoconic eyes and compare Goldmann applanation tonometer (GAT), without and with astigmatism correction (nGAT and cGAT) and Tono-Pen AVIA (TPA) assessment methods. Methods: Thirty-nine keratoconic eyes of 24 patients were assessed. DCPo was eval...

This chapter in Portuguese reports a basic routine of an ocular examination.

Purpose: To use machine learning to predict the risk of intraocular pressure peaks at 6 a.m. in primary open-angle glaucoma patients and suspects. Methods: This cross-sectional observational study included 98 eyes of 98 patients who underwent a 24-hour intraocular pressure curve (including the intraocular pressure measurements at 6 a.m.). The di...

ADDITION CERTIFICATE No. C1 0803807-4 The NATIONAL INSTITUTE OF INDUSTRIAL PROPERTY grants this CERTIFICATE OF ADDITION OF INVENTION, which grants its holder property of improvement or development introduced in the patented invention, as detailed in this title, throughout the national territory, guaranteeing the rights arising therefrom, provided...

The author addresses the Diagnosis and Management of Childhood Glaucoma since some historical notes up to prognosis.

Prcis: Tono-pen AVIA intraocular pressure (IOP) values are different from those taken with handheld Goldmann applanation tonometer in primary congenital glaucoma (PCG). These differences indicate both tonometers cannot be used interchangeably for measuring IOP in PCG. Purpose: To compare intraocular pressure (IOP) measurements obtained using Ton...

Background No previous studies have evaluated the scarring of the conjunctiva and Tenon’s capsule (TC) separately when only the conjunctiva is removed, and TC is preserved in the upper part of the bulb: the site designated for trabeculectomy. Thus, this cohort interventional study aims to investigate the scarring of the donor area after autologous...

Background The most common treatment for primary open-angle glaucoma (POAG) is the daily use of eye drops. Sustained-release drug delivery systems have been developed to improve patient adherence by achieving prolonged therapeutic drug concentrations in ocular target tissues while limiting systemic exposure. The purpose of this study is to compare...

Introduction: Diabetic retinopathy (DR) is neglected in the planning of health services in Brazil. The purpose of this study was to investigate the frequency of Diabetic Retinopathy in patients with type 2 diabetes mellitus (DM2) registered in the Unified Health System (SUS) of the semi-arid of Pa-raíba (PB-Brazil), using a score developed by the r...

P rimary open-angle glaucoma (POAG) is an age-old disease that remains enigmatic. Millions of people worldwide still lose their sight due to POAG and the prediction is that, with longer life expectancy, more people will be diagnosed with it. (1) Over the years, glaucoma has undergone changes in concept, workup and treatment. Up to now, the concept...

Purpose To analyze the relationship between retinal nerve fiber layer thickness (RNFLT) and intraocular pressure (IOP) variation in glaucoma suspects (GS) and patients with primary open-angle glaucoma (POAG). Methods Thirty-one GS and 34 POAG patients underwent ophthalmologic examination and 24-h IOP measurements. GS had IOPs ranging from 19 to 24...

The substance 4-Aminobenzamidine dihydrochloride (4-AD) is one of the degradation products of diminazene aceturate and has demonstrated antiglaucomatous potential. Glaucoma is the second leading cause of blindness worldwide; thus, new therapeutic alternatives must be studied, for example, the molecule 4-AD vehiculated into polymeric inserts for pro...

In this interview, the author answers some questions about the differential diagnosis between the tilted optic disc and the initial primary open-angle glaucoma.

In this article, the author reports step by step how glaucoma medications should be associated.

To explain the importance of correct investigation of IOP in glaucoma

O autor analisa a indicação da lasertrabeculoplastia com argônio como tratamento primário para o glaucoma primário de ângulo aberto.

Os autores analisaram pelo perfil da curva diária de pressão intra-ocular a importância da medida da pressão intra-ocular ãs 6 horas no leito para o diagnóstico e o controle do glaucoma crônico simples.

Os autores avaliaram a eficácia da lasertrabeculoplastia com argônio e a sua influência na espessura central da córnea

To demonstrate that Early Trabeculotomy performed at age equal to or less than 6 months of life is more effective and provides better IOP control and, especially can maintain normal eye growth and/or prevent exaggerated eye growth along with anterior segment changes.

Description Purpose: Correct assessment of intraocular pressure (IOP), horizontal corneal diameter (HCD), central corneal thickness (CCT) and axial length (AL) are critical for accurate diagnosis and follow-up of children with PCG. In PCG, the value of IOP may be influenced by CCT, corneal edema, Descemet's membrane ruptures and corneal opacities a...

A benzamidine derivative from diminazene was tested for a novel activity: treatment of primary open‐angle glaucoma. This drug was incorporated into mucoadhesive polymeric inserts prepared using chitosan (Chs) and chondroitin sulfate (CS). Of current interest is the mucoadhesion, which increases the contact time with the ocular surface, resulting in...

In this chapter, the authors discuss the three subclinical aspects, the workup, the treatment and the follow-up of a same disease called iridocorneal endothelial membrane syndrome.

We describe the main findings, workup and treatment of the epithelium invasion and fibrous proliferation which are nowadays very rare in the practice of Ophthalmology.

The authors discuss the pathogenesis, clinical and surgical treatment, prevention and prognosis of uveitic glaucoma in childhood.

In this chapter, the author discuss the causes, workup and treatment of Traumatic Glaucoma in Childhood.

Book chapter about Corticosteroid-induced glaucoma in Childhood (Traduction for English).

Presentation in Ecuador at Trinational Glaucoma Meeting

Purpose: To investigate the presence of the variants of lysyl oxygenase (LOX) and superoxide dismutase 1 (SOD1) genes in Brazilian patients with advanced keratoconus. Methods: Donor genomic DNA extracted from blood samples was screened for 5'UTR, exonic LOX, and SOD1 variants in a subset of 26 patients presenting with advanced keratoconus (KISA >...

The use of chitosan as a pharmaceutical excipient in the ocular field is already established. Nevertheless, some aspects related to its ocular administration, such as sterilization and excipient's pharmacokinetics, remain unclear. So, in this study, we evaluated those two relevant aspects, related to chitosan administration in eye. We used chitosan...

Numerous technical and pharmacological advances have recently taken place in Ophthalmology, bringing enormous benefits to the patients. Specifically in glaucoma, which causes irreversible damage to the optic nerve, the early diagnosis is essential to prevent blindness. In spite of the advances, too many people still become blind due to this disease...

Numerous technical and pharmacological advances have recently taken place in Ophthalmology, bringing enormous benefits to the patients. Specifically in glaucoma, which causes irreversible damage to the optic nerve, the early diagnosis is essential to prevent blindness. In spite of the advances, too many people still become blind due to this disease...

Purpose: Appropriate IOP evaluation in keratoconic eyes remains a challenge. This study aims to assess correlations between IOP measurements obtained by GAT and Tono-Pen AVIA® during DCPo Methods: The diagnostic keratoconus criteria was (1 sign or a combination of signs): Munson's sign; biomicroscopic signs: stromal thinning, conical protrusion, Fl...

Purpose: One episode of acute primary angle-closure might cause irreversible ocular damage. In this prospective study we investigate the relationship between changes in retinal nerve fiber layer (RNFL) thickness and visual field defects after unilateral acute primary angle closure (APAC) in Brazilians. Methods: Patients with unilateral APAC were el...

Purpose: The adequate control of IOP is fundamental in POAG treatment. In some patients, the prostaglandin analog, isolated or associated with other antiglaucoma drugs, may not reverse the IOP peak at 6AM in 24-hour IOP measurements. In these patients we have substituted the prostaglandin analog by one drop of 2% pilocarpine and tested its effectiv...

Purpose: It is well known that the rate of unsuccessful trabeculectomy (TRAB) is higher in patients who underwent surgical procedures involving conjunctival transfixion. In this study, we evaluate the healing evolution of conjunctiva and Tenon after autografting used in pterygium excision. Methods: Eleven eyes who underwent pterygium excision and l...

The evaluation of the intraocular pressure (IOP) peak remains a great challenge for diagnosing and progression of primary open-angle glaucoma (POAG). 1-3 secronem@gmail.com [P-WT-065] IOP peak at 6am could be predicted with high accuracy by the CART method using IOP measurements at 8am, 9am and 11am. The greatest advantage of the classification tre...

This paper proposes a customized and versatile optical setup to evaluate the optical performance of different commercially available intraocular lenses (IOLs). The setup was used to measure the wavefront error induced by different IOL models, verifying and analyzing the magnitude of low- and high-order aberrations induced by currently available IOL...

Objective To assess the feasibility of a novel surgical technique in painful blind eyes. Design A prospective safety study conducted at the Federal University of Minas Gerais, Brazil. Participants/samples A total of 15 end-stage glaucomatous eyes without light perception vision. Methods After implantation, conjunctival hyperemia, discharge, eros...

El libro demostra, de modo simple, pero práctico, nuestra experiencia de más de 15 años trabajando con este método de imagen. En su contenido hay imágenes de muchas enfermedades oculares intentando aclarar su diagnóstico. Con la ayuda de la Biomicroscopia Ultrasónica también son discutidas la fisiopatología de algunas enfermedades del ojo.

El libro demostra de modo simple, pero práctico, nuestra experiencia de más de 15 años trabajando con este método de imagen. Serán mostradas imágenes de muchas enfermedades oculares intentando aclarar su diagnóstico. Con la ayuda de la Biomicroscopia Ultrasónica también será discutida la fisiopatología de algunas enfermedades del ojo.

Objective: This study investigated the influence of early to moderate primary open angle glaucoma on gait, functional mobility and fall risk. Methods: Thirty-three participants in the early and moderate stages of primary open angle glaucoma and 34 asymptomatic controls participated in the study. Spatiotemporal gait data were obtained with the GA...

Objective: to study the efficacy and safety of the use of subconjunctival triamcinolone acetate alone or in combination with mitomycin C as a modulator of trabeculectomy healing in rabbits. Methods: we submitted thirty male, albino, New Zealand rabbits to bilateral trabeculectomy. We divided the animals into four experimental groups with 15 eyes pe...

Objetivo: estudar a eficácia e segurança do uso de acetato de triancinolona subconjuntival isolado ou em associação à mitomicina C como modulador da cicatrização de trabeculectomias em coelhos. Métodos: trinta coelhos machos, albinos, raça Nova Zelândia foram submetidos à trabeculectomia bilateralmente. Os animais foram divididos em quatro grupos...

The adequate IOP evaluation in keratoconic eyes remains a challenge. This study aims to compare IOP measurements obtained by GAT and Tono-Pen AVIA® during daily curve of IOP (DCPo) and to assess relationship between IOP values and Pentacam parameters in keratoconic corneas.

Keratoconic patients underwent a detailed ophthalmologic examination. The diagnosis of keratoconus was made on the basis of the following diagnostic criteria (1 sign or a combination of signs): Munson’s sign (V-shaped conformation of the lower lid on down gaze); biomicroscopic signs: stromal thinning, conical protrusion, Fleischer ring, Vogt striae...

Glaucoma patients with IOP peak at 6:00 am in 24-hour IOP had significant higher rate of global RNFL thickness change compared with those without IOP peak. More patients and longer follow-up are needed to address the degree of this relationship.

This paper demonstrates that an IOP peak at 6:00 am in the 24-hour IOP can cause RNFL thickness changes over time.

A retrospective case series study was done in which data from patients with PCG who underwent trabeculotomy were collected at Hospital São Geraldo/HC-UFMG from 2002 to 2017. All trabeculotomies were performed by the same surgeon. After sedation of children, we measured, before and one month after surgery, the central corneal thickness (CCT), the IO...

Purpose: To assess the visual field (VF) and retinal changes one or more years after an acute primary angle closure (APAC) episode, and to analyze aspects that could impact in the severity of these alterations. Methods: This comparative paired-eye study evaluated affected and fellow eyes of subjects who had APAC crisis at least one year ago. Ophtha...

Purpose: The early diagnosis of glaucoma as well as the detection of its initial progression still remains a great challenge in spite of the technological advances. The purpose of this prospective observational case series study is to determine the relationship between the 24-hour intraocular pressure (DCPo) and the retinal nerve fiber layer thickn...

Purpose: The most common treatment of primary open-angle glaucoma (POAG) is done with daily instillation of eye drops which are effective but may have adverse effects. Polymer systems of extended-release drugs may reduce these effects and improve adherence to treatment. In this paper, we have developed an insert for sustained release of bimatoprost...

Purpose : To determine the optical quality and magnitude of high order aberration (HOA) of three commercial available intraocular lenses (IOL) with three different dioptric power. Methods : Three different IOL designs were analyzed. A spherical and two aspheric lenses were chosen. (Alcon SN60AT®, Bausch and Lomb MX-60® and AMO Tecnis ZCB00®). IOL p...

Purpose: Primary open-angle glaucoma (POAG) is initially treated with daily instillation of eye drops which are effective but may have adverse effects. Polymer systems of extended-release drugs may reduce these effects and improve adherence to treatment. We have developed an insert for sustained release of bimatoprost. After, we assessed in patient...

Purpose : This study investigates the effect of the use of Bevacizumab, Mitomycin C (MMC) and Triamcinolone (isolated and in association) on postoperative scarring after experimental glaucoma filtration surgery (GFS) in rabbits. Methods : Forty-five New Zealand White rabbits underwent bilateral GFS and received different treatments: Saline (group 1...

Purpose : In ocular hypotony, permanent structural and functional damage may occur because of a delayed normalization of intraocular pressure (IOP). Early recognition and appropriate treatment of ocular hypotony is crucial to prevent that damage, however the hypotony duration is not very well established. This study tested the hypothesis that even...

Importance: Visual field variability may impair detection of glaucoma progression over time. Despite the possible overlap between neurocognitive disorders and glaucoma in older individuals, no study has investigated the association between cognitive changes and visual field variability. Objective: To evaluate the association between global neuro...

This ebook presents the following Contents: 1. Concept, Classification and Anamnesis; 2. Clinical Examination; 3. Routines and Management of Primary Open-Angle Glaucoma (POAG); 4. Indications and Interpretation of the 24-Hour Intraocular Pressure (DCPo); 5. Intraocular Pressure Target; 6. Visual Field Defects Scale Using Manual Goldmann Perimetry;...

Purpose : To assess correlation and agreement between sitting and supine intraocular pressure (IOP) measurements in glaucoma patients and suspects as part of 24-hour IOP curve. Methods : Measurements were performed in the sitting position using a Goldmann tonometer and in the supine position using a Perkins tonometer. IOP measurements were obtaine...

Purpose:To evaluate the relationship between the 24-hour intraocular pressure (DCPo) and RNFL thickness assessed by spectral-domain OCT (SD-OCT). Methods:Patients were submitted to an ophthalmic examination including, central corneal thickness (CCT), RNFL imaging (SD-OCT) and standard automated perimetry (SAP). We included glaucoma suspects (GS) an...

Purpose : To investigate correlation and agreement between intraocular pressure (IOP) measurements during a daily curve of intraocular pressure (DCPo) in different periods of the day and the effects of body position and sleeping period. Methods : The DCPo performed in the Glaucoma Division of Hospital Sao Geraldo consisted in measurements obtained...

Purpose : To evaluate the relationship between cognitive decline and variability on visual fields in patients with glaucoma and suspected of having the disease followed over time. Methods : The study involved 189 eyes of 105 patients followed for an average period of 2.6 ± 0.7 years. Eighty-three (79%) patients had a diagnosis of glaucoma and 22 (...

Purpose: To assess correlations between functional and structural changes one or more years after a single episode of APAC in Brazilians. Methods: This is a cross-sectional comparative study. Subjects who had an APAC crisis at least one year ago seen at the Glaucoma Service of São Geraldo Hospital were qualified for the study. These patients were i...

O autor responde a uma pergunta sobre a importância do diagnóstico diferencial entre a papila oblíqua e o glaucoma simples incipiente.

Purpose: To investigate the relationship between measurements of intraocular pressure (IOP) performed at 6 am and at 8 am as part of daily curve of intraocular pressure (DCPo) in glaucoma patients and suspects. Methods: The IOP measurements in DCPo were obtained in the sitting position at 9 am, 11 am, 6 pm, and 10 pm using a Goldmann tonometer. Th...

Objective: Demonstrate the Brimonidine effect over Retinal Spreading Depression (SD). Brimonidine is an alpha-2–adrenergic receptor agonist, used in the management of glaucoma. Alpha2-agonists have been shown to be neuroprotective in various experimental models, however the molecular and cellular targets leading to these actions are still poorly de...