{"id":552544,"date":"2026-06-02T23:17:45","date_gmt":"2026-06-02T23:17:45","guid":{"rendered":"https:\/\/www.elza-institute.com\/?p=552544"},"modified":"2026-06-19T11:13:56","modified_gmt":"2026-06-19T11:13:56","slug":"elza-and-the-second-global-consensus-on-keratoconus-and-ectatic-diseases","status":"publish","type":"post","link":"http:\/\/www.elza-institute.com\/pt\/elza-and-the-second-global-consensus-on-keratoconus-and-ectatic-diseases\/","title":{"rendered":"ELZA e o Segundo Consenso Global sobre Queratocone e Doen\u00e7as Ect\u00e1sicas"},"content":{"rendered":"
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Uma d\u00e9cada depois, o Queratocone tem um novo consenso<\/h3>

Dez anos ap\u00f3s o primeiro esfor\u00e7o global para definir a \u00e1rea, a publica\u00e7\u00e3o do\u00a0Consenso Global sobre Queratocone e Doen\u00e7as Ect\u00e1sicas \u2013 Edi\u00e7\u00e3o 2<\/a><\/em> no di\u00e1rio, C\u00f3rnea<\/a>, marca uma clara mudan\u00e7a na forma como o queratocono \u00e9 compreendido e gerido. N\u00e3o se trata de uma revis\u00e3o cosm\u00e9tica da terminologia. \u00c9 uma reavalia\u00e7\u00e3o mais ampla do diagn\u00f3stico, progress\u00e3o e tratamento num campo que amadureceu substancialmente na \u00faltima d\u00e9cada. O novo documento re\u00fane um painel internacional mais alargado e uma perspetiva cl\u00ednica mais ampla, incluindo cirurgi\u00f5es da c\u00f3rnea e cirurgi\u00f5es refrativos de 12 sociedades de seis continentes. Por \u00faltimo, mas n\u00e3o menos importante, dois membros da equipa ELZA, Prof. Farhad Hafezi<\/a> e Dr. Mark Hillen<\/a> foram coautores.<\/p>

O que emerge \u00e9 uma imagem mais moderna do queratocone. A doen\u00e7a j\u00e1 n\u00e3o \u00e9 enquadrada simplesmente atrav\u00e9s de altera\u00e7\u00f5es na curvatura anterior ou achados topogr\u00e1ficos isolados. Em vez disso, o novo Consenso reflete a realidade da pr\u00e1tica atual: os cl\u00ednicos confiam cada vez mais na avalia\u00e7\u00e3o multimodal, integrando tomografia, mapeamento da espessura epitelial e, onde dispon\u00edvel, avalia\u00e7\u00e3o biomec\u00e2nica para caracterizar a doen\u00e7a e o risco com mais precis\u00e3o. O manuscrito anexo torna esta mudan\u00e7a expl\u00edcita, descrevendo um quadro diagn\u00f3stico que vai al\u00e9m da forma da superf\u00edcie apenas e em dire\u00e7\u00e3o a uma compreens\u00e3o mais completa da suscetibilidade e manifesta\u00e7\u00e3o da ectasia.<\/p>

Para os pacientes, isto \u00e9 importante porque uma dete\u00e7\u00e3o mais precoce e precisa muda o que \u00e9 poss\u00edvel. Na ELZA, a mesma l\u00f3gica sustenta o nosso trabalho em\u00a0investiga\u00e7\u00e3o sobre ceratocone<\/a>\u00a0e a nossa abordagem cl\u00ednica a\u00a0reticula\u00e7\u00e3o da c\u00f3rnea<\/a>.Quanto mais cedo uma c\u00f3rnea em risco for identificada, maior a oportunidade de a estabilizar antes que a vis\u00e3o sofra um decl\u00ednio adicional.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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O Segundo Consenso Global: De par\u00e2metros singulares a julgamento cl\u00ednico<\/span><\/h3>

Um dos temas mais importantes do novo Consenso \u00e9 o afastamento da depend\u00eancia excessiva de \u00edndices \u00fanicos. Em particular, o painel adota uma vis\u00e3o mais cautelosa sobre o Kmax. Embora o Kmax continue a ser amplamente utilizado, o documento reconhece a sua repetibilidade e reprodutibilidade limitadas, especialmente em doen\u00e7as mais avan\u00e7adas. Em seu lugar, o Consenso favorece uma interpreta\u00e7\u00e3o mais ampla e consciente da gravidade das altera\u00e7\u00f5es ao longo do tempo, incorporando curvatura regional, altera\u00e7\u00f5es corneanas posteriores, progress\u00e3o pachim\u00e9trica e fun\u00e7\u00e3o visual. Esta \u00e9 uma abordagem mais exigente, mas tamb\u00e9m mais honesta clinicamente.<\/p>

O editorial que acompanha adota o mesmo tom. N\u00e3o apresenta o novo Consenso como doutrina. Em vez disso, apresenta-o como uma declara\u00e7\u00e3o cuidadosamente elaborada do que pode ser acordado de momento, ao mesmo tempo que reconhece onde a evid\u00eancia permanece incompleta. Essa distin\u00e7\u00e3o \u00e9 importante. Consenso n\u00e3o \u00e9 certeza. \u00c9 uma forma disciplinada de definir o estado atual do campo.<\/p>

O cross-linking continua a ser central, mas o tratamento j\u00e1 n\u00e3o \u00e9 igual para todos.<\/h4>

O novo (segundo) Consenso Global reafirma\u00a0Cross-linking da c\u00f3rnea para queratocone<\/a>\u00a0\u00e9 a pedra angular da estabiliza\u00e7\u00e3o da doen\u00e7a. Ao mesmo tempo, reflete a realidade de que as decis\u00f5es de tratamento se tornaram mais individualizadas. Idade, espessura corneana, padr\u00e3o de progress\u00e3o e contexto cl\u00ednico moldam a gest\u00e3o. Em pacientes mais jovens, especialmente aqueles com maior risco de progress\u00e3o r\u00e1pida, o documento apoia a opini\u00e3o de que esperar por observa\u00e7\u00e3o prolongada pode nem sempre ser apropriado.<\/p>

Essa evolu\u00e7\u00e3o no pensamento tamb\u00e9m cria espa\u00e7o para abordagens mais recentes que visam n\u00e3o apenas estabilizar a c\u00f3rnea, mas tamb\u00e9m melhorar a sua regularidade. Na ELZA, um exemplo \u00e9\u00a0Reticula\u00e7\u00e3o personalizada ELZA-PACE<\/a>, o que reflete a tend\u00eancia geral para um tratamento mais individualizado da c\u00f3rnea. O pr\u00f3prio Consenso tem o cuidado de n\u00e3o exagerar o que as estrat\u00e9gias mais recentes podem reivindicar. Mas a sua dire\u00e7\u00e3o geral \u00e9 inconfund\u00edvel: o tratamento do ceratocone est\u00e1 a tornar-se mais personalizado, mais impulsionado por imagem e mais informado estruturalmente.<\/p>

Para al\u00e9m da estabiliza\u00e7\u00e3o<\/h4>

O campo tamb\u00e9m progrediu para al\u00e9m da ideia de que travar a progress\u00e3o \u00e9 o \u00fanico objetivo significativo. O novo Consenso coloca a reabilita\u00e7\u00e3o visual dentro do mesmo quadro de gest\u00e3o geral, integrando lentes de contacto, procedimentos de remodela\u00e7\u00e3o da c\u00f3rnea, implantes intrastromais, queratoplastia, cirurgia refrativa e planeamento de cataratas num todo mais coerente. Essa amplitude \u00e9 uma das for\u00e7as do documento. O ceratocono j\u00e1 n\u00e3o \u00e9 tratado como um problema corneal restrito. \u00c9 gerido ao longo de toda a vida visual de um paciente.<\/p>

\u00c9 tamb\u00e9m aqui que o documento parece mais contempor\u00e2neo. Reflete um campo que se expandiu desde a identifica\u00e7\u00e3o de doen\u00e7as at\u00e9 \u00e0 estratifica\u00e7\u00e3o de riscos, desde a paragem da progress\u00e3o at\u00e9 ao planeamento da reabilita\u00e7\u00e3o visual, e desde escolhas de procedimentos isolados at\u00e9 \u00e0 tomada de decis\u00f5es a longo prazo.<\/p>

Um Segundo Consenso Global mais amplo, n\u00e3o uma palavra final<\/h4>

O que confere um peso especial ao segundo Consenso Global n\u00e3o \u00e9 apenas o seu conte\u00fado, mas o seu \u00e2mbito. De acordo com o manuscrito, 128 peritos participaram no processo, com representa\u00e7\u00e3o de 12 sociedades internacionais e seis continentes. Essa amplitude n\u00e3o elimina o desacordo, mas fortalece o documento como um ponto de refer\u00eancia cl\u00ednica global, em vez de uma declara\u00e7\u00e3o local ou de subespecialidade.<\/p>

Como todo trabalho baseado em Delphi, no entanto, continua a ser um instant\u00e2neo no tempo. O editorial est\u00e1 certo ao salientar que o seu valor reside n\u00e3o em reivindicar perman\u00eancia, mas em definir o que \u00e9 suficientemente suportado para orientar a pr\u00e1tica hoje. \u00c9 isso que torna o Consenso de 2026 importante. N\u00e3o encerra o debate sobre o ceratocone. Eleva o n\u00edvel em que o debate agora ocorre.<\/p>

Cita\u00e7\u00e3o<\/b>:<\/p>

Gomes JAP, Hafezi F, Ambr\u00f3sio R, et al. Consenso global sobre ceratocone e doen\u00e7as ect\u00e1sicas - edi\u00e7\u00e3o 2. Cornea. Publicado online a 21 de maio de 2026. doi:10.1097\/ICO.0000000000004170<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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O Segundo Consenso Global sobre Queratocono e Doen\u00e7as Ect\u00e1sicas foi publicado hoje, e a ELZA desempenhou um papel fundamental no seu desenvolvimento.<\/p>","protected":false},"author":4,"featured_media":552557,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_angie_page":false,"page_builder":"","footnotes":""},"categories":[214,1109,1,95],"tags":[1320,130,100,379,1321,123,109,101618,1074,1554],"class_list":["post-552544","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-farhad-hafezi","category-mark-hillen","category-general-news","category-scientific-article","tag-consensus","tag-cross-linking","tag-cxl","tag-ectasia","tag-guidelines","tag-keratoconus","tag-pellucid-marginal-degeneration","tag-second","tag-second-global-consensus","tag-second-global-consensus-on-keratoconus"],"acf":[],"yoast_head":"\nELZA and the Second Global Consensus on Keratoconus and Ectatic Diseases - 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