{"id":39757,"date":"2023-03-19T16:24:42","date_gmt":"2023-03-19T16:24:42","guid":{"rendered":"https:\/\/www.elza-institute.com\/?p=39757"},"modified":"2024-07-15T09:19:50","modified_gmt":"2024-07-15T09:19:50","slug":"repairing-failed-smile-procedures-in-the-strongest-way-possible","status":"publish","type":"post","link":"https:\/\/www.elza-institute.com\/pt\/repairing-failed-smile-procedures-in-the-strongest-way-possible\/","title":{"rendered":"Repara\u00e7\u00e3o de procedimentos SMILE falhados da forma mais forte poss\u00edvel"},"content":{"rendered":"
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A Extra\u00e7\u00e3o de Lent\u00edculas de Pequena Incis\u00e3o (SMILE) \u00e9 um tipo de cirurgia refractiva a laser utilizada como alternativa ao LASIK e ao PRK, que envolve a cria\u00e7\u00e3o de uma lent\u00edcula intra-estromal dentro da c\u00f3rnea que, quando removida, remodela a c\u00f3rnea para obter o resultado refrativo desejado. No entanto, podem ocorrer complica\u00e7\u00f5es, particularmente quando o cirurgi\u00e3o n\u00e3o remove completamente a lent\u00edcula, o que pode causar astigmatismo irregular que pode reduzir drasticamente a qualidade de vis\u00e3o dos pacientes. Com mais de cinco milh\u00f5es de procedimentos SMILE efectuados em todo o mundo, corrigir estes problemas<\/a> \u00e9 um desafio devido \u00e0 sua localiza\u00e7\u00e3o intra-estromal. Professor Farhad Hafezi<\/a>Diretor M\u00e9dico do Instituto ELZA, publicou um artigo em Ophta<\/a> analisar as complica\u00e7\u00f5es dos procedimentos SMILE e as estrat\u00e9gias para a sua repara\u00e7\u00e3o.<\/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<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Uma das abordagens poss\u00edveis para a repara\u00e7\u00e3o \u00e9 a chamada \"orienta\u00e7\u00e3o da frente de onda da c\u00f3rnea\".\u00a0queratotomia fotorefractiva transepitelial<\/a>\u00a0(transPRK), que envolve a utiliza\u00e7\u00e3o de dados aberrom\u00e9tricos e mapas epiteliais da c\u00f3rnea para planear uma abla\u00e7\u00e3o a laser que reduza as aberra\u00e7\u00f5es causadas pela remo\u00e7\u00e3o incompleta das lent\u00edculas.<\/p>

Outros m\u00e9todos de repara\u00e7\u00e3o do SMILE incluem o re-SMILE, que envolve o corte de uma segunda lent\u00edcula a partir do fundo do corte original do SMILE, e a abla\u00e7\u00e3o \"Cap to flap\", que envolve a transforma\u00e7\u00e3o da tampa do SMILE num retalho LASIK e a realiza\u00e7\u00e3o de outra abla\u00e7\u00e3o com excimer laser. No entanto, ambas as abordagens enfraquecem mais a c\u00f3rnea do que a abordagem transPRK, e todos estes m\u00e9todos t\u00eam os seus pr\u00f3prios desafios, sendo importante escolher a melhor abordagem para as necessidades de cada paciente.<\/p>

Hafezi salientou que o cross-linking da c\u00f3rnea (CXL) tamb\u00e9m pode ser utilizado para melhorar a biomec\u00e2nica destas c\u00f3rneas - algo que \u00e9 importante quando m\u00faltiplos procedimentos refractivos removem cumulativamente quantidades significativas de tecido estromal da c\u00f3rnea. O CXL envolve a aplica\u00e7\u00e3o de riboflavina (vitamina B2) na c\u00f3rnea para saturar o estroma, a que se segue um per\u00edodo de ilumina\u00e7\u00e3o UV. Este processo provoca uma rea\u00e7\u00e3o fotoqu\u00edmica que liga as mol\u00e9culas do estroma (principalmente colag\u00e9nio e proteoglicanos), aumentando a resist\u00eancia biomec\u00e2nica da c\u00f3rnea. A t\u00e9cnica demonstrou ser eficaz para travar a progress\u00e3o de ectasias da c\u00f3rnea como o ceratocone.<\/p>

O sucesso dos procedimentos SMILE depende n\u00e3o s\u00f3 da per\u00edcia do cirurgi\u00e3o, mas tamb\u00e9m da capacidade de corrigir quaisquer complica\u00e7\u00f5es que possam surgir. O artigo do Prof. Hafezi fornece informa\u00e7\u00f5es sobre as v\u00e1rias abordagens dispon\u00edveis para a repara\u00e7\u00e3o de procedimentos SMILE falhados. A transPRK guiada pela frente de onda da c\u00f3rnea destaca-se como um m\u00e9todo que oferece vantagens significativas em rela\u00e7\u00e3o \u00e0s outras op\u00e7\u00f5es, incluindo a preserva\u00e7\u00e3o de uma maior for\u00e7a biomec\u00e2nica da c\u00f3rnea, o que ajuda a evitar o desenvolvimento de ectasia p\u00f3s-operat\u00f3ria. Com milh\u00f5es de procedimentos SMILE realizados em todo o mundo, \u00e9 importante ter acesso \u00e0s t\u00e9cnicas mais eficazes para reparar quaisquer complica\u00e7\u00f5es que possam surgir.<\/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<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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O laser SCHWIND AMARIS permite o TransPRK e a remodela\u00e7\u00e3o cap-to-flap do leito do estroma.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\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<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

O sucesso dos procedimentos SMILE depende n\u00e3o s\u00f3 da per\u00edcia do cirurgi\u00e3o, mas tamb\u00e9m da capacidade de corrigir quaisquer complica\u00e7\u00f5es que possam surgir. O artigo do Prof. Hafezi fornece informa\u00e7\u00f5es sobre as v\u00e1rias abordagens dispon\u00edveis para a repara\u00e7\u00e3o de procedimentos SMILE falhados. A transPRK guiada por frente de onda da c\u00f3rnea destaca-se como um m\u00e9todo que oferece vantagens significativas, incluindo a melhoria da biomec\u00e2nica da c\u00f3rnea e a preven\u00e7\u00e3o da ectasia p\u00f3s-operat\u00f3ria.<\/p>","protected":false},"author":4,"featured_media":39825,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[214,96],"tags":[100,610,599,242,611,418],"class_list":["post-39757","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-farhad-hafezi","category-popular-press","tag-cxl","tag-fixing-smile","tag-laser-complications","tag-smile","tag-smile-repair","tag-transprk"],"acf":[],"yoast_head":"\nRepairing failed SMILE procedures in the strongest way possible - The ELZA Institute<\/title>\n<meta name=\"description\" content=\"Prof. Farad Hafezi describes how refractive surgeons can go about repairing failed SMILE procedures - 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