{"id":41284,"date":"2023-10-02T12:01:12","date_gmt":"2023-10-02T12:01:12","guid":{"rendered":"https:\/\/www.elza-institute.com\/?p=41284"},"modified":"2024-07-15T09:16:57","modified_gmt":"2024-07-15T09:16:57","slug":"total-corneal-wavefront-analysis-excimer-laser-surgery","status":"publish","type":"post","link":"https:\/\/www.elza-institute.com\/pt\/total-corneal-wavefront-analysis-excimer-laser-surgery\/","title":{"rendered":"Otimiza\u00e7\u00e3o da cirurgia terap\u00eautica com Excimer Laser com an\u00e1lise total da frente de onda da c\u00f3rnea"},"content":{"rendered":"
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A cirurgia refractiva a laser com o excimer laser revolucionou o campo da corre\u00e7\u00e3o da vis\u00e3o. Embora muitos destes procedimentos se tenham centrado em resultados cosm\u00e9ticos, permitindo que os doentes fiquem sem \u00f3culos, a cirurgia refractiva com excimer laser tamb\u00e9m oferece benef\u00edcios terap\u00eauticos substanciais para indiv\u00edduos com irregularidades da c\u00f3rnea. Este artigo aprofunda o conceito de an\u00e1lise total da frente de onda da c\u00f3rnea e o seu papel fundamental na melhoria dos resultados terap\u00eauticos da cirurgia refractiva com excimer laser, particularmente para os doentes com c\u00f3rneas irregulares.<\/p>\n

Perspetiva hist\u00f3rica<\/strong><\/h3>\n

Tradicionalmente, a nossa abordagem \u00e0 an\u00e1lise da frente de onda da c\u00f3rnea baseava-se em dados de frente de onda da c\u00f3rnea baseados em topografia obtidos a partir de instrumentos como os sistemas Scheimpflug e Placido, que combinam tecnologias para obter imagens da superf\u00edcie da c\u00f3rnea. Al\u00e9m disso, realiz\u00e1mos uma an\u00e1lise da frente de onda ocular total com um sistema de imagem piramidal, avaliando a frente de onda de todo o olho. Ambas as abordagens desempenharam um papel importante no planeamento das cirurgias refractivas (Figura 1). No entanto, esses m\u00e9todos concentraram-se principalmente em dados da c\u00f3rnea anterior ou abrangeram todo o olho, deixando espa\u00e7o para melhorias adicionais.<\/p>\n

An\u00e1lise da frente de onda total da c\u00f3rnea<\/strong><\/h3>\n

A introdu\u00e7\u00e3o da an\u00e1lise da frente de onda total da c\u00f3rnea significa um salto substancial na nossa capacidade de avaliar e planear cirurgias refractivas terap\u00eauticas com excimer laser. Esta abordagem inovadora, poss\u00edvel gra\u00e7as \u00e0 integra\u00e7\u00e3o de v\u00e1rias tecnologias, permite a avalia\u00e7\u00e3o exaustiva de toda a c\u00f3rnea, incluindo as superf\u00edcies anterior e posterior. Combina a topografia corneana de disco Placido e a tomografia do segmento anterior baseada em OCT de alta resolu\u00e7\u00e3o (sistema MS-39) para fornecer uma an\u00e1lise completa da frente de onda corneana total (Figura 1).<\/p>\n

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Figura 1: Sistema de An\u00e1lise de Frente de Onda Total da C\u00f3rnea<\/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
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A import\u00e2ncia da superf\u00edcie posterior da c\u00f3rnea<\/span><\/h3>

Um aspeto cr\u00edtico da an\u00e1lise da frente de onda total da c\u00f3rnea \u00e9 a considera\u00e7\u00e3o da superf\u00edcie posterior da c\u00f3rnea. Este componente \u00e9 frequentemente ignorado na an\u00e1lise tradicional da frente de onda, mas o seu impacto na qualidade \u00f3tica global do olho pode ser profundo. A superf\u00edcie posterior da c\u00f3rnea, em conjunto com a lente e outros factores internos, contribui significativamente para as aberra\u00e7\u00f5es de ordem superior (Figura 2). Ao ter em conta estas aberra\u00e7\u00f5es da c\u00f3rnea posterior, podemos obter perfis de abla\u00e7\u00e3o mais precisos e adaptados em muitos casos.<\/p>

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Figura 2. Impacto da superf\u00edcie posterior da c\u00f3rnea nas aberra\u00e7\u00f5es de alta ordem<\/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
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Aplica\u00e7\u00f5es cl\u00ednicas<\/span><\/h3>

A an\u00e1lise da frente de onda da c\u00f3rnea total revela-se particularmente valiosa em casos que envolvem c\u00f3rneas irregulares, como as que apresentam ceratocone ou irregularidades p\u00f3s-cir\u00fargicas. Para estes doentes, o objetivo principal \u00e9 terap\u00eautico, com o objetivo de melhorar a fun\u00e7\u00e3o visual e aliviar as perturba\u00e7\u00f5es da c\u00f3rnea. A minimiza\u00e7\u00e3o dos perfis de abla\u00e7\u00e3o \u00e9 uma prioridade para evitar a exacerba\u00e7\u00e3o da inflama\u00e7\u00e3o e do potencial nevoeiro. A an\u00e1lise total da frente de onda da c\u00f3rnea fornece os dados necess\u00e1rios para afinar a abla\u00e7\u00e3o, abordando as aberra\u00e7\u00f5es de ordem alta e baixa antes ou depois da cirurgia com excimer laser.<\/p>

Terapias combinadas<\/span><\/h3>

A integra\u00e7\u00e3o da an\u00e1lise da frente de onda total da c\u00f3rnea com esta abordagem oferece uma solu\u00e7\u00e3o terap\u00eautica abrangente para as irregularidades. No entanto, nalguns casos, a cirurgia com excimer laser por si s\u00f3 pode n\u00e3o ser suficiente para as c\u00f3rneas irregulares. Reticula\u00e7\u00e3o PACE (PTK-Assisted Customized Epi-on)<\/a>que achata a c\u00f3rnea sem remo\u00e7\u00e3o de tecido, pode ser um excelente tratamento adjuvante. Os implantes de segmentos de anel intra-estromal alog\u00e9nico da c\u00f3rnea assistidos por femto-segundo (femto-CAIRS) s\u00e3o tamb\u00e9m uma op\u00e7\u00e3o promissora como tratamento adjuvante nestes casos.<\/p>

Conclus\u00e3o<\/span><\/h3>

A an\u00e1lise total da frente de onda da c\u00f3rnea, facilitada pelo sistema MS-39, representa um avan\u00e7o significativo na cirurgia refractiva terap\u00eautica com excimer laser. Permite uma avalia\u00e7\u00e3o e planeamento abrangentes, particularmente em casos de c\u00f3rneas irregulares. Ao considerar as superf\u00edcies anterior e posterior da c\u00f3rnea, podemos adaptar os perfis de abla\u00e7\u00e3o para otimizar os resultados terap\u00eauticos, minimizando a remo\u00e7\u00e3o de tecido. Esta abordagem expande as nossas op\u00e7\u00f5es para a cirurgia terap\u00eautica com excimer, enfatizando a import\u00e2ncia de melhorar tanto a acuidade visual como a qualidade da vis\u00e3o em pacientes com c\u00f3rneas irregulares.<\/p>

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Pode ler a cobertura da palestra sobre este tema pelo cirurgi\u00e3o de c\u00f3rnea da ELZA,\u00a0Dr. Dr. Emilio Torres-Netto<\/a>MD, PhD, FWCRS,\u00a0aqui<\/a>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\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\t\t<\/div>","protected":false},"excerpt":{"rendered":"

A an\u00e1lise total da frente de onda da c\u00f3rnea, facilitada pelo sistema MS39, representa um avan\u00e7o significativo na cirurgia refractiva terap\u00eautica com excimer laser.<\/p>","protected":false},"author":4,"featured_media":41291,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[243,1,96],"tags":[699,694,700,693,703,683,702,698,701,696,283,624,537,695,697],"class_list":["post-41284","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emilio-torres","category-general-news","category-popular-press","tag-clinical-cases","tag-corneal-wavefront-analysis","tag-dr-emilio-torres-netto","tag-excimer-laser-surgery","tag-eye-care","tag-eye-health","tag-high-order-aberrations","tag-irregular-corneas","tag-laser-refractive-procedures","tag-medical-technology","tag-ophthalmology","tag-pace","tag-refractive-surgery","tag-total-corneal-analysis","tag-visual-correction"],"acf":[],"yoast_head":"\nTotal Corneal Wavefront Analysis in Excimer Laser Surgery<\/title>\n<meta name=\"description\" content=\""Elevating Excimer Surgery: Total Corneal Wavefront Analysis's Crucial Role in Precision and Outcomes" with ELZA's Dr. Emilio Torres-Netto.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.elza-institute.com\/pt\/total-corneal-wavefront-analysis-excimer-laser-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How total corneal wavefront analysis is changing the game in laser surgery\" \/>\n<meta property=\"og:description\" content=\"Discover how total corneal wavefront analysis is transforming the world of excimer laser surgery. 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