{"id":553872,"date":"2026-10-05T14:03:12","date_gmt":"2026-10-05T14:03:12","guid":{"rendered":"https:\/\/www.elza-institute.com\/?p=553872"},"modified":"2026-10-05T14:03:12","modified_gmt":"2026-10-05T14:03:12","slug":"elza-epi-on-protocol-escrs-2026","status":"publish","type":"post","link":"https:\/\/www.elza-institute.com\/pt\/elza-epi-on-protocol-escrs-2026\/","title":{"rendered":"Epi-on com reticula\u00e7\u00e3o sem oxig\u00eanio ou iontoforesis, ELZA na ESCRS 2026"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"553872\" class=\"elementor elementor-553872\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-46aab0ff e-flex e-con-boxed e-con e-parent\" data-id=\"46aab0ff\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-74cdde68 elementor-widget elementor-widget-text-editor\" data-id=\"74cdde68\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Por mais de uma d\u00e9cada, a epirredutagem promete uma forma mais suave de tratar o queratocono. Ela fortalece a c\u00f3rnea sem remover primeiro a sua camada externa, o epit\u00e9lio. O problema \u00e9 que vers\u00f5es anteriores produziam um efeito de endurecimento mais fraco. Ao falar com <em>Healio | Not\u00edcias de Cirurgia Ocular<\/em> no congresso da ESCRS 2026, em Londres, <a href=\"https:\/\/www.elza-institute.com\/pt\/sobre\/farhad-hafezi\/\">Prof. Farhad Hafezi<\/a> Disse que, com o protocolo ELZA epi-on, que n\u00e3o exige ionoforesis nem oxig\u00eanio extra, \u201co epi-on est\u00e1 realmente acontecendo\u201d.\u201d<\/p>\n<p>No curto prazo <a href=\"https:\/\/www.linkedin.com\/feed\/update\/urn:li:ugcPost:7506080786354266115\/\">entrevista em v\u00eddeo<\/a>, o Prof. Hafezi, Diretor M\u00e9dico do Instituto ELZA, e <a href=\"https:\/\/www.elza-institute.com\/pt\/sobre\/nikki-hafezi\/\">Nikki Hafezi<\/a>, O seu Diretor Executivo fez um balan\u00e7o do 44.\u00ba Congresso da ESCRS (11 a 15 de setembro de 2026). Tamb\u00e9m fez um balan\u00e7o do futuro. De acordo com o professor Hafezi, a ELZA esteve representada com 22 contribui\u00e7\u00f5es.<\/p>\n<div class=\"elza-embed\"><iframe src=\"https:\/\/www.linkedin.com\/embed\/feed\/update\/urn:li:ugcPost:7506080786354266115?compact=1\" width=\"504\" height=\"700\" frameborder=\"0\" allowfullscreen=\"\" title=\"Healio | Entrevista em v\u00eddeo com o Prof. Farhad Hafezi e a Nikki Hafezi no ESCRS 2026\"><\/iframe><\/div>\n<h3>Novos artigos sobre reticula\u00e7\u00e3o<\/h3>\n<p><a href=\"https:\/\/www.elza-institute.com\/pt\/cross-linking\/\">Reticula\u00e7\u00e3o da c\u00f3rnea (CXL)<\/a> guloseimas <a href=\"https:\/\/www.elza-institute.com\/pt\/ceratocone\/\">queratocone<\/a>, em que a c\u00f3rnea se espessura, torna-se c\u00f4nica e torna a vis\u00e3o mais difusa. As gotas de riboflavina (vitamina B2) penetram na c\u00f3rnea e s\u00e3o ativadas com luz ultravioleta-A (UV-A). Isso endurece o tecido e interrompe a doen\u00e7a. O professor Hafezi apontou para uma s\u00e9rie de artigos recentes da ELZA.<\/p>\n<ul>\n<li>A <a href=\"https:\/\/www.elza-institute.com\/pt\/sub400-cross-linking-thin-corneas\/\">protocolo ELZA-sub400 de segunda gera\u00e7\u00e3o<\/a> (<em>Jornal Americano de Oftalmologia<\/em>) trata c\u00f3rneas ultra-finas com doses individuais de UV de at\u00e9 10 J\/cm\u00b2. Ap\u00f3s 12 meses, 22 das 29 pupilas (76%) n\u00e3o apresentaram progress\u00e3o e nenhum olho desenvolveu descompensa\u00e7\u00e3o endotelial. Neste grupo gravemente afetado, a vis\u00e3o corrigida com \u00f3culos diminuiu. Essa mudan\u00e7a n\u00e3o foi estatisticamente significativa, mas os autores afirmam que precisa ser confirmada em estudos maiores.<\/li>\n<li>O acompanhamento de cinco anos do protocolo ELZA-sub400 de primeira gera\u00e7\u00e3o foi conduzido pelo Dr. Emilio A. Torres-Netto e publicado na revista <em>Revista de Cirurgia Refractiva<\/em> (JRS). De 39 c\u00f3rneas ultra-finas, 84,6% permaneceram est\u00e1veis ou achatadas, novamente sem descompensa\u00e7\u00e3o endotelial. Desses 39 olhos, 18 conclu\u00edram o per\u00edodo completo de acompanhamento de cinco anos.<\/li>\n<li>Duas pesquisas laboratoriais <a href=\"https:\/\/www.elza-institute.com\/pt\/ceratocone\/femto-cairs-keratoconus\/\">ECO-CAIRS<\/a> apareceu no <em>Jornal de Catarata e Cirurgia Refractiva<\/em>. No ECO-CAIRS, os segmentos de c\u00f3rnea doador s\u00e3o ligados entre si por meio de resinas fora do olho e, em seguida, implantados para nivelar uma c\u00f3rnea queratoc\u00f4nica. Na c\u00f3rnea de porco, a resina de alta intensidade de fluxo (30 ou 60 J\/cm\u00b2) endureceu o tecido em mais de 10 J\/cm\u00b2. Al\u00e9m disso, isso alterou a forma como os segmentos secavam e retomavam a \u00e1gua, o que pode facilitar a manipula\u00e7\u00e3o e o implante.<\/li>\n<li>Os resultados cl\u00ednicos de um ano do protocolo ELZA epi-on, publicados na JRS dias antes do congresso.<\/li>\n<\/ul>\n<h3>O que torna o protocolo ELZA epi-on diferente<\/h3>\n<p>O padr\u00e3o de CXL \u201cepi-off\u201d, o protocolo de Dresden, remove os 8\u20139 mm centrais do epit\u00e9lio. Isso permite que a riboflavina chegue ao stroma, a espessa camada m\u00e9dia da c\u00f3rnea. Remover o epit\u00e9lio pode causar dor, feridas tardias, infec\u00e7\u00e3o e opacidade. Deixar o epit\u00e9lio intacto evita isso, mas os m\u00e9todos anteriores de CXL apresentaram dois problemas. A quantidade de riboflavina n\u00e3o era suficiente na superf\u00edcie intacta. Al\u00e9m disso, a quantidade de oxig\u00eanio n\u00e3o era suficiente no stroma, e o oxig\u00eanio \u00e9 essencial para a rea\u00e7\u00e3o de reticula\u00e7\u00e3o.<\/p>\n<p>Outros grupos abordaram esse problema com a iontoforesis, que transporta a riboflavina com um fluxo el\u00e9trico fraco, ou com oxig\u00eanio extra. Ambos adicionam equipamentos e complexidade. O protocolo ELZA n\u00e3o utiliza nenhum deles. Em vez disso, ele combina tr\u00eas elementos. Uma solu\u00e7\u00e3o modificada para melhorar a penetra\u00e7\u00e3o ajuda a riboflavina a passar pelo epit\u00e9lio. A luz UV-A, pulsada e desligada a cada segundo, permite que o oxig\u00eanio se difunda de volta para o tecido. Finalmente, uma dose de UV mais elevada compensa a luz que o epit\u00e9lio absorve.<\/p>\n<p>\u201c\u00c9 um epifisioterapia sem ionoforesis e sem oxig\u00eanio\u201d, disse o Prof. Hafezi. \u201cAcho que essa \u00e9 a maior mensagem que temos do nosso Instituto.\u201d<\/p>\n<h3>O que os resultados de um ano mostraram<\/h3>\n<p>O estudo tratou 38 olhos de 29 pacientes no Instituto ELZA. A maioria dos olhos (27) recebeu 8,1 J\/cm\u00b2 de UV-A a 18 mW\/cm\u00b2, enquanto pacientes mais antigos receberam 7,0 J\/cm\u00b2. Ap\u00f3s 12 meses, a m\u00e1xima keratometria (Kmax, uma medida da inclina\u00e7\u00e3o do cone) permaneceu inalterada em 56,12 D antes e 56,11 D ap\u00f3s o tratamento. A espessura da c\u00f3rnea e as outras medidas de forma tamb\u00e9m n\u00e3o apresentaram altera\u00e7\u00f5es significativas. Nenhum paciente desenvolveu opacidades, infec\u00e7\u00e3o, defeitos epiteliais ou outras complica\u00e7\u00f5es.<\/p>\n<p>Os autores esclarecem os limites do estudo. O estudo n\u00e3o incluiu um grupo de controle com inje\u00e7\u00e3o de epi e n\u00e3o foi randomizado. Al\u00e9m disso, ele relata apenas a forma da c\u00f3rnea, n\u00e3o a acuidade visual ou os resultados relatados pelos pacientes. Ainda s\u00e3o necess\u00e1rios mais estudos de acompanhamento e compara\u00e7\u00f5es randomizadas com o tratamento com epi-off CXL. Al\u00e9m disso, eles apontam que a maior parte do procedimento, de aproximadamente 54 minutos, consiste na aplica\u00e7\u00e3o de col\u00edrios, algo que os t\u00e9cnicos conseguem realizar. Como resultado, eles veem potencial para o tratamento com epi-on cross-linking realizado no consult\u00f3rio m\u00e9dico.<\/p>\n<h3>Um instituto que est\u00e1 crescendo<\/h3>\n<p>Nikki Hafezi focou-se no desenvolvimento da ELZA como organiza\u00e7\u00e3o. \u201cAgora temos duas cl\u00ednicas e queremos crescer tamb\u00e9m na \u00c1sia Central\u201d, disse ela. Mais de 300 empresas expuseram no ESCRS este ano, desde os Estados Unidos at\u00e9 \u00e0 China. Ela aguarda com expectativa conhecer parceiros da ind\u00fastria, cl\u00ednicos e pesquisadores \u201cpara ver como podemos melhorar o nosso padr\u00e3o de cuidados e os nossos avan\u00e7os tecnol\u00f3gicos na nossa cl\u00ednica\u201d.\u201d<\/p>\n<h3>Saiba mais<\/h3>\n<p>O programa completo do congresso da ELZA est\u00e1 resumido em <a href=\"https:\/\/www.elza-institute.com\/pt\/escrs-2026-highlights-elza-london\/\">Os destaques da ESCRS 2026 em Londres<\/a>. Para mais informa\u00e7\u00f5es sobre o tratamento, consulte as p\u00e1ginas da ELZA. <a href=\"https:\/\/www.elza-institute.com\/pt\/cross-linking\/epi-on-or-epi-off-cross-linking-cxl\/\">Cross-linking do epi-on versus epi-off<\/a> e <a href=\"https:\/\/www.elza-institute.com\/pt\/cross-linking\/cross-linking-cxl-thin-cornea\/\">cross-linking para c\u00f3rneas finas<\/a>. O protocolo ELZA epi-on \u00e9 oferecido aos pacientes no Instituto ELZA. Qualquer pessoa que queira saber se ele \u00e9 adequado para ela pode <a href=\"https:\/\/www.elza-institute.com\/pt\/appointment\/\">reserve uma consulta<\/a>.<\/p>\n<h3>Refer\u00eancias<\/h3>\n<ul>\n<li>Hafezi F, Aydemir ME, Hillen M, et al. Epit\u00e9lio-cross-linking corneano utilizando um agente de penetra\u00e7\u00e3o modificado sem oxig\u00eanio suplementar ou iontoforese. <em>J Refract Surg<\/em>. 2026. doi:10.3928\/1081597X-20260802-01<\/li>\n<li>Torres-Netto EA, Kling S, Akcan RE, et al. Seguimento de cinco anos do protocolo ELZA-sub400. <em>J Refract Surg<\/em>. 2026. doi:10.3928\/1081597X-20260728-01<\/li>\n<li>Aydemir ME, Kollros L, Hillen M, et al. Efeito biomec\u00e2nico de rigidifica\u00e7\u00e3o em segmentos intrastromais de anel de c\u00f3rnea alog\u00eanico extra-corp\u00f3reo com flu\u00eancia ultra-elevada. <em>J Cataract Refract Surg<\/em>. 2026. <a href=\"https:\/\/doi.org\/10.1097\/j.jcrs.0000000000001981\">doi:10.1097\/j.jcrs.0000000000001981<\/a><\/li>\n<li>Kollros L, Aydemir ME, Boote C, et al. Desidrata\u00e7\u00e3o e comportamento de reidrata\u00e7\u00e3o de segmentos intrastromais de c\u00f3rnea alog\u00eanica extracorp\u00f3rea de alta flu\u00eancia (ECO-CAIRS). <em>J Cataract Refract Surg<\/em>. 2026. <a href=\"https:\/\/doi.org\/10.1097\/j.jcrs.0000000000002015\">doi:10.1097\/j.jcrs.0000000000002015<\/a><\/li>\n<li>Hafezi F, Akcan RE, Kling S, et al. Protocolo ELZA-sub400 de segunda gera\u00e7\u00e3o: interliga\u00e7\u00e3o cruzada de alta intensidade individualizada para c\u00f3rneas de queratocono ultra-finas. <em>Am J Ophthalmol<\/em>. 2026;290:318-328. <a href=\"https:\/\/doi.org\/10.1016\/j.ajo.2026.06.034\">doi:10.1016\/j.ajo.2026.06.034<\/a><\/li>\n<\/ul>\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\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Na ESCRS 2026, em Londres, os professores Farhad Hafezi e Nikki Hafezi falaram com a Healio sobre o protocolo ELZA epi-on, os novos dados do ELZA-sub400 e do ECO-CAIRS, e os planos do instituto para crescer.<\/p>","protected":false},"author":4,"featured_media":553877,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"page_builder":"","footnotes":""},"categories":[243,214,223,10],"tags":[],"class_list":["post-553872","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emilio-torres","category-farhad-hafezi","category-nikki-hafezi","category-video-interviews"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ELZA epi-on protocol at ESCRS 2026<\/title>\n<meta name=\"description\" content=\"The ELZA epi-on protocol needs no extra oxygen or iontophoresis, Prof. Farhad Hafezi told Healio at ESCRS 2026.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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