![\"\"](\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2020\/04\/ESCRS-Winter-Meeting-2020-First-Prize-Refractive-Surgery-Emilio-Torres-reduced-size-1024x683.jpg\")
<\/a><\/p>\nO estudo que apresentou foi uma combina\u00e7\u00e3o dos resultados de v\u00e1rios anos de investiga\u00e7\u00e3o b\u00e1sica e de dados de um estudo cl\u00ednico realizado em Zurique, e centrou-se na melhoria da forma como o laser interage com o tecido, com o objetivo de produzir menos inflama\u00e7\u00e3o durante o procedimento. Isto \u00e9 importante, uma vez que a abla\u00e7\u00e3o a laser do estroma da c\u00f3rnea - especialmente as abla\u00e7\u00f5es profundas, como as que s\u00e3o necess\u00e1rias no tratamento da miopia e do astigmatismo elevados - tem o potencial de causar uma inflama\u00e7\u00e3o significativa da c\u00f3rnea e, como parte da resposta de cicatriza\u00e7\u00e3o da c\u00f3rnea, uma n\u00e9voa corneana, que abranda significativamente o ritmo de recupera\u00e7\u00e3o visual dos doentes.<\/p>\n
Atualmente, os cirurgi\u00f5es refractivos utilizam um f\u00e1rmaco chamado mitomicina C (MMC) para evitar o desenvolvimento de nevoeiro, mas este \u00e9 um f\u00e1rmaco citot\u00f3xico que se intercala com o ADN e impede as c\u00e9lulas de proliferarem, e as consequ\u00eancias a longo prazo da utiliza\u00e7\u00e3o da MMC s\u00e3o atualmente desconhecidas.<\/p>\n
Os nossos investigadores pretendiam saber se a utiliza\u00e7\u00e3o de diferentes algoritmos de abla\u00e7\u00e3o por laser e de perfis de abla\u00e7\u00e3o por laser optimizados poderia alterar os perfis de express\u00e3o gen\u00e9tica da c\u00f3rnea ablacionada, tendo-se concentrado particularmente nos genes que est\u00e3o envolvidos na resposta inflamat\u00f3ria.<\/p>\n
O que descobriram foi que era poss\u00edvel reduzir as respostas inflamat\u00f3rias atrav\u00e9s da otimiza\u00e7\u00e3o dos algoritmos de abla\u00e7\u00e3o do laser e das defini\u00e7\u00f5es de energia, e que a suavidade da c\u00f3rnea no p\u00f3s-operat\u00f3rio parecia ser o fator chave na regula\u00e7\u00e3o desta resposta imunit\u00e1ria. Para tal, realizaram uma ceratectomia fotorrefractiva em c\u00f3rneas de coelho, utilizando uma t\u00e9cnica padr\u00e3o, de alta flu\u00eancia sem otimiza\u00e7\u00e3o da suavidade da c\u00f3rnea (OCS), de baixa flu\u00eancia com OCS e controlos n\u00e3o tratados, e examinaram os perfis de express\u00e3o gen\u00e9tica 48 horas mais tarde, utilizando uma an\u00e1lise de express\u00e3o gen\u00e9tica por microarray para identificar os genes que eram expressos de forma diferente nas c\u00f3rneas tratadas e n\u00e3o tratadas, seguida de uma t\u00e9cnica chamada RT-PCR para validar essas altera\u00e7\u00f5es.<\/p>\n
O que o Dr. Torres-Netto e os seus colegas descobriram foi que v\u00e1rios genes pr\u00f3-inflamat\u00f3rios foram regulados positivamente nas c\u00f3rneas tratadas com laser. De notar que descobriram que a suavidade da c\u00f3rnea no p\u00f3s-operat\u00f3rio era o fator chave na regula\u00e7\u00e3o da inflama\u00e7\u00e3o - quanto mais suave era a c\u00f3rnea, menor era a resposta inflamat\u00f3ria, concluindo que o controlo da suavidade do leito estromal e, por conseguinte, da neblina, pode permitir abla\u00e7\u00f5es mais profundas, mas tamb\u00e9m o desenvolvimento de futuros perfis de abla\u00e7\u00e3o que podem alargar as indica\u00e7\u00f5es de abla\u00e7\u00e3o da superf\u00edcie a profundidades estromais atualmente apenas acess\u00edveis com cirurgias lamelares. O que \u00e9 que isto significa para os doentes? \u00c9 uma mensagem simples: os cirurgi\u00f5es devem ser capazes de corrigir mais miopia utilizando PRK que deixa a c\u00f3rnea mais lisa.<\/p>","protected":false},"excerpt":{"rendered":"
A apresenta\u00e7\u00e3o do poster moderado do Dr. Emilio Torres-Netto \"Stromal bed smoothness after excimer laser surface ablation as a key element for the expression of inflammatory genes\", que ganhou o pr\u00e9mio de melhor poster na ESCRS de inverno, na sec\u00e7\u00e3o de Cirurgia Refractiva.<\/p>","protected":false},"author":4,"featured_media":16628,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[203,243,214,97],"tags":[333,334,129,332,128],"class_list":["post-31049","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-awards","category-emilio-torres","category-farhad-hafezi","category-podium-power","tag-haze","tag-inflammation","tag-prk","tag-smartsurface","tag-trans-prk"],"acf":[],"yoast_head":"\n
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<\/a><\/p>\n