publicado em 26/08/2009 às 12h00:00
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Technique makes cuts laser refractive surgery

Method of vision makes operations safer and reduces recovery time. Procedure can also be used in transplantation and implantation of a ring in patients with keratoconus, a corneal problem

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Foto: Divulgação / Today.Uk
Patient is prepared for eye surgery
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Patient is prepared for eye surgery

Brazilian medical centers have begun offering a new technology that makes it safer as the refractive eye surgery to correct myopia, hyperopia and astigmatism. This is a device that allows you to laser cuts - which makes this surgery a laser procedure completely from beginning to end.

Typically, the cuts are made mechanically with a machine called a microkeratome. With new technology, the laser becomes a layer of corneal tissue into water vapor, which allows the cornea to raise a blade and then make the correction of the degree.

Called Intralase, the method can be still used in corneal transplants and implants intracorneanos rings on who has keratoconus problem in this part of the eye.

"The cut is perfect and precise, much more. Rather, much depended on the ability of the surgeon," says Leon Grupenmacher, coordinator of corneal implants Ophthalmological Hospital in Sorocaba, the first institution to use the technique in Latin America, in September 2006 .

With Intralase, the cut becomes thinner and with a uniform thickness. So more people are now candidates for refractive surgery, with the traditional method, the thickness of the patient's cornea is too thin, depending on the degree to be corrected, he has no indication to operate, because of the thickness.

The chance of error also decreases, which is significant, because most of the complications in refractive surgery stems from the court. According Grupenmacher because of the errors, the patient may have deformities in the cornea and re-use contact lenses, since the degree may even worsen.

"The chance of complications [with the conventional method] is very small, but how it's done a tremendous amount of refractive surgery in the country, it is essential to have more security," he says.

In the case of corneal transplantation, the number of points fall, with the new method, 24 to 32 for 8 to 12. The recovery, which usually can reach one and a half, is now six months. For whoever gets the ring intracorneano, the reduction is from 90 to 30 days.

According to Mauro Campos, professor at Federal University of São Paulo (UNIFESP), with the new method the variability in the cut was reduced from 30% to less than 1%. CERP, which is the clinical associate director, was the second country to offer the Intralase, installed at the end of last year.

He says this is especially important for high risk patients for whom it is necessary that the court has an exact depth. "You can not do it with the handset. And even if those patients who have no such restriction, if the cut is too deep can produce a weakening of the cornea. With the laser is less a chance."

A survey recently completed by Cerpa also shows that the device is easier to use, which reduces the chances of complication during the first surgery performed by a physician. In the case of the handset, the 400 first cases operated on, 20 had a problem. With the laser, there was only one problem with the first 400 patients.

In the case of ring implantation, the first hundred cases, complications occurred in 2%, with the manual technique, the index is 14.5%. "Adaptation of the new medical technique is almost immediate," says Fields.

He notes, however, that this does not mean that the conventional technique is bad. "It is still the predominant world. We have thousands of people operated with excellent results. But the substitution by the laser is a matter of time."


High price

The Intralase device costs around U.S. $ 650 mil-and refractive surgery can cost twice as much with him. For the patient CERP, for example, the cost rises to $ 2,500 per eye to $ 5,000. In the institution, 20% of refractive surgery are now done entirely by laser.

There are more than 1,800 devices worldwide. In the U.S., according to the manufacturer, 25% of refractive surgery are done with this method.

In addition to the existing devices in Sao Paulo, institutions in Curitiba, Brasilia and Rio de Janeiro are acquiring the technology. "There is no turning back. Who does not want to use the conventional technique. It is far superior," says Grupenmacher.

The Albert Einstein hospital has also acquired Intralase, which should work in three weeks. "It's a resource that will greatly improve the quality of refractive surgery. Wins in predictability and accuracy with much less injury to the cornea," says ophthalmologist Lottenberg Claudio, president of the hospital.

   Palavras-chave:   Eye surgery    Myopia    Laser    Microkeratome    Cornea    Leon Grupenmacher    Mauro Campos    UNIFESP   
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eye surgery    myopia    laser    microkeratome    cornea    Leon Grupenmacher    Mauro Campos    UNIFESP   
Tayara Labres
posted on:
16/04/2012 02:00:46
olá,tenho ceratocone e preciso fazer transplante de córnea!Gostaria de saber se o sus oferece o transplante pela técnica de intralase em Curitiba-PR?agradeço desde já e aguardo respostas.
posted on:
21/10/2010 13:12:22
oi tamires, este valor que te passaram no BOS sorocaba de 8.000 por olho já inclui exames e consulta? obrigado ronaldo
posted on:
21/10/2010 13:12:22
como a Tamires tbem gostaria de saber se a cirurgia intralase e possivel fazer pelo sus...
Tamires Souza
posted on:
21/10/2010 13:12:22
Olá, gostei muito das informacçoes contidas aqui, me ajudaram muito a entender a diferença da cirurgia convêncional para a laser.Eu tenho ceratocone e estava fazendo investigações no BOS, em Sorocaba - SP, o medico me assustou muito em relação a cirurgia convencional, pois ele me falou que dava muitas complicações, quria que eu fizesse a cirurgia a laser, sendo que ficou muito cara os dois olhos 16.000,00 mil reais, daí até hoje eu não fiz, tem três meses, não tenho esse dinheiro.Será que eu consigo fazer esta cirurgia pelo SUS...ME AJUDEM!!!
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