{"id":3237,"date":"2022-10-25T10:27:55","date_gmt":"2022-10-25T09:27:55","guid":{"rendered":"https:\/\/profmunteanu.ro\/?p=3237"},"modified":"2024-04-18T10:07:49","modified_gmt":"2024-04-18T09:07:49","slug":"crosslinking-cornean-ce-reprezinta-si-care-sunt-efectele","status":"publish","type":"post","link":"https:\/\/profmunteanu.ro\/de\/crosslinking-cornean-ce-reprezinta-si-care-sunt-efectele\/","title":{"rendered":"Crosslinking cornean – ce reprezinta si care sunt efectele"},"content":{"rendered":"
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Crosslinking cornean - ce reprezinta si care sunt
efectele acestei proceduri<\/h1>\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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Crosslinking cornean este un procedeu medical inovator utilizat pentru tratarea keratoconusului. Acesta const\u0103 \u00een aplicarea unei substan\u021be fotosensibile pe corneea pacientului, urmat\u0103 de expunerea acesteia la lumin\u0103 ultraviolet\u0103. Crosslinking cornean are ca scop \u00eent\u0103rirea \u021besutului cornean \u0219i \u00eencetinirea progresiei bolii. Indica\u021biile pentru Crosslinking cornean includ pacien\u021bii cu keratoconus stabil, cu sub\u021biere cornean\u0103 semnificativ\u0103 \u0219i modific\u0103ri vizuale. Procedura ofer\u0103 o op\u021biune terapeutic\u0103 promi\u021b\u0103toare \u0219i poate contribui la stabilizarea bolii \u0219i prevenirea avans\u0103rii keratoconusului.<\/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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1. Ce reprezint\u0103 aceast\u0103 procedur\u0103?<\/h2>\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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Crosslinking-ul cornean reprezint\u0103, la ora actual\u0103, cea mai eficient\u0103 metod\u0103 de \u00eencetinire a progresiei keratoconusului, folosit\u0103 \u0219i aprobat\u0103 la nivel mondial. Keratoconusul<\/a> este \u00eencadrat ca fiind o ectazie cornean\u0103, manifestat prin sub\u021bierea progresiv\u0103 a corneei, ce \u00ee\u0219i pierde forma sferic\u0103 , bomb\u00e2ndu-se de regul\u0103 paracentral inferior sub forma unui con. Se dezvolt\u0103 bilateral \u0219i asimetric.<\/p>

Crosslinking-ul este de fapt un proces natural ce are loc \u00een organismal nostru, proces care se intensific\u0103 o dat\u0103 cu \u00eenaintarea \u00een v\u00e2rst\u0103 \u0219i care, la nivel cornean, reprezint\u0103 \u00eent\u0103rirea leg\u0103turilor chimice \u00eentre fibrele de colagen prezente la acest nivel, sub ac\u021biunea direct\u0103 a razelor UV. Acest crosslinking natural \u00eent\u0103re\u0219te teoria stabiliz\u0103rii keratoconusului dup\u0103 v\u00e2rsta de 40 de ani.<\/p>

\u00cen cazurile de keratoconus, acest proces natural este accelerat prin instilarea la nivel cornean a unor substan\u021be catalizatoare ( riboflavina) \u0219i expunerea ulterioar\u0103 la cantit\u0103\u021bi controlate de raze UV, pe o perioad\u0103 bine determinat\u0103 de timp.<\/p>

Aceast\u0103 procedur\u0103 poate fi realizat\u0103 cu sau f\u0103r\u0103 \u00eendep\u0103rtarea epiteliului cornean ( ,,epi-on\u201d sau ,,epi-off\u201d ) . Ini\u021bial metoda cel mai des folosit\u0103 presupunea \u00eendep\u0103rtarea epiteliului cornean chiar dac\u0103 este mult mai dureroas\u0103 \u0219i presupune o vindecare mai greoaie \u0219i cu complica\u021bii relativ mai frecvente. \u00cen timp s-a demonstrat \u00eens\u0103 c\u0103, nu exist\u0103 o diferen\u021b\u0103 semnificativ\u0103 din punct de vedere al eficien\u021bei tratamentului asupra \u00eencetinirii progresiei keratoconusului, opt\u00e2ndu-se astfel mult mai des pentru realizarea crosslinkingului cornean f\u0103r\u0103 \u00eendep\u0103rtarea epiteliului cornean ( ,,epi-on\u201d) , fiind mult mai pu\u021bin traumatizant\u0103 \u0219i mai pu\u021bin riscant\u0103 pentru pacient.<\/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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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Crosslinking\t\t\t\t\t\t\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
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2. Cum se realizeaz\u0103?<\/h2>\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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Crosslinkingul cornean se realizeaz\u0103 \u00eentr-un mediu steril, \u00een sala de opera\u021bii, pacientul fiind anesteziat local cu pic\u0103turi, \u00eentins, acoperit cu un camp steril \u0219i cu un fixator de pleoape montat pentru a expune corneea \u00een mod corect \u0219i uniform pe toat\u0103 durata tratamentului. \u00cen prima parte a tratamentului se instileaz\u0103 pe suprafa\u021ba corneei , pe r\u00e2nd, uniform \u0219i cronometrat conform indica\u021biilor produc\u0103torului, dou\u0103 substan\u021be cu concentra\u021bie diferit\u0103 de riboflavin\u0103 ce va p\u0103trunde \u00een cornee uniform. \u00cen a doua parte a tratamentului, privind fix \u00een lumina aparatului, pacientul va fi expus razelor UV , sub ac\u021biunea c\u0103rora, \u00een prezen\u021ba riboflavinei instalate \u00een prealabil, se va realiza procesul efectiv de crosslinking cornean accelerat. Toate aceste etape se realizeaz\u0103 \u00een aproximativ 15 minute.<\/p>

Aparatul de cross-linking cornean folosit \u00een clinica noastr\u0103 este al companiei Avedro. Procedura de cross-linking este non-invaziv\u0103 \u0219i combin\u0103 utilizarea luminii ultraviolete cu sistemul KXL\u00ae \u0219i formule de riboflavin\u0103 Photrexa.Folosind Photrexa\u00ae Viscous (riboflavin\u0103 5′-fosfat \u00een 20% solu\u021bie oftalmic\u0103 dextran), Photrexa\u00ae (solu\u021bie oftalmic\u0103 5-fosfat riboflavin\u0103) \u0219i Sistemul KXL\u00ae, procedura de cross-linking cornean Avedro este prima \u0219i singura procedur\u0103 terapeutic\u0103 aprobat\u0103 de FDA (Food and Drug Administration \u2013 agen\u021bia federal\u0103 a Departamentului pentru S\u0103n\u0103tate \u0219i Servicii Umane din Statele Unite) pentru pacien\u021bii cu keratoconus progresiv sau ectazie corneean\u0103. Procedura este efectuat\u0103 f\u0103r\u0103 necesitatea \u00eendep\u0103rt\u0103rii epiteliului cornean, astfel c\u0103 vindecarea \u0219i confortul postinterven\u021bional sunt mult mai rapide, comparativ cu variantele clasice de cross-linking, care implic\u0103 \u00eendep\u0103rtarea acestui strat cornean. Aceast\u0103 metod\u0103 se bazeaz\u0103 pe lumina pulsat\u0103, de ultim\u0103 genera\u021bie, a c\u0103rei eficien\u021b\u0103 scade considerabil durata tratamentului \u0219i expunerea \u021besuturilor oculare la radia\u021biile ultraviolete.<\/p>

La sf\u00e2r\u0219itul tratamentului, se va aplica o lentil\u0103 de contact terapeutic\u0103<\/a>, \u00een ciuda faptului c\u0103 nu s-a realizat dezepitelizarea cornean\u0103 \u0219i se vor instila o serie de pic\u0103turi \u0219i unguent. Pacientul nu este nevoit sa mai r\u0103m\u00e2n\u0103 sub supraveghere medical\u0103, el va pleca din clinic\u0103 f\u0103r\u0103 pansament, cu schema de tratament ce se va ini\u021bia chiar din seara aceleia\u0219i zile\u00a0 \u0219i va veni la un control scurt a doua zi de diminea\u021b\u0103. Peste c\u00e2teva zile se va scoate lentila de contact terapeutic\u0103 , se va monitoriza aspectul cornean, iar pacientul va fi nevoit sa continue tratamentul topic \u00eenc\u0103 dou\u0103 s\u0103pt\u0103m\u00e2ni.\u00a0<\/p>

Se descriu \u00een primele zile dup\u0103 interven\u021bie, u\u0219oare simptome precum\u00a0 vederea \u00eence\u021bo\u0219at\u0103, durere, senza\u021bie de corp str\u0103in, care se vor remite cu aplicarea tratamentului recomandat.<\/p>

Cross-linkingul cornean este o procedur\u0103 sigur\u0103, cu complica\u021bii \u0219i rate de e\u0219ec sc\u0103zute, dar \u00een anumite situatii pot ap\u0103rea, de\u0219i foarte rar, anumite complicatii ca de exemplu: infec\u021bii oculare, ulcer cornean, edem cornean, afect\u0103ri ale endoteliului cornean, infiltrate corneene periferice, cicatrici corneene, reactivarea keratiteti herpetice.<\/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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3. Care sunt efectele \u00een timp \u0219i cum le cuantific\u0103m?<\/h2>\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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Dup\u0103 procedur\u0103 , se realizeaz\u0103 o evaluare scurt\u0103 la c\u00e2teva zile \u0219i la o lun\u0103 pentru a exclude anumite complica\u021bii la nivel cornean \u0219i pentru a monitoriza \u00eendeaproape starea corneei. Ulterior, la 3,6 \u0219i 12 luni se va evalua progresia keratoconusului prin evaluarea aspectului clinic, a parametrilor topografici, keratometrie \u00een mod special, acuitate vizual\u0103 \u0219i refrac\u021bie.<\/p>

Studiile efectuate p\u00e2n\u0103 \u00een prezent \u00een acest domeniu, au demonstrat modific\u0103ri semnificative la nivelul indicilor topografici, ai acuit\u0103\u021bii vizuale \u0219i din punct de vedere al astigmatismului \u00een urma realiz\u0103rii acestui tratament. <\/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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Descoperi\u021bi mai multe informa\u021bii valoroase despre oftalmologie \u0219i s\u0103n\u0103tatea ochilor vizion\u00e2nd materialele realizate de exper\u021bi \u00een domeniu de pe canalul nostru de YouTube<\/span><\/a>.<\/em><\/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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\"\"<\/figure>

Conf. Univ. Dr. Alexandra Preda<\/h3>

Medic primar oftalmolog in cadrul Centrului Munteanu din anul 2017, specializata in operatii de cataracta, interventii laser pentru glaucom, retinoaptie diabetica, ochi uscat, injectii intraoculare pentru patologia retiniana. Este Sef de lucrari in cadrul UMF \u201cVictor Babes\u201d din Timisoara, specializarea Oftalmologie si Doctor in Stiinte Medicale. Dr. Preda este medicul de elita cu acreditari europene, in urma cursurilor de specializare in domeniu, in Austria, Bulgaria, Slovenia sau Turcia, pe care ne mandrim sa il avem in echipa noastra de experti dedicati complet oftalmologiei.<\/p><\/div><\/div>\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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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tProgrammierungsberatung<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\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":"

Crosslinking cornean – ce reprezinta si care sunt efectele acestei proceduri Crosslinking cornean este un procedeu medical inovator utilizat pentru tratarea keratoconusului. Acesta const\u0103 \u00een aplicarea unei substan\u021be fotosensibile pe corneea pacientului, urmat\u0103 de expunerea acesteia la lumin\u0103 ultraviolet\u0103. Crosslinking cornean are ca scop \u00eent\u0103rirea \u021besutului cornean \u0219i \u00eencetinirea progresiei bolii. Indica\u021biile pentru Crosslinking cornean […]<\/p>\n","protected":false},"author":1,"featured_media":3950,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-3237","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articole"],"yoast_head":"\nCrosslinking cornean - ce reprezinta si care sunt efectele - Clinica Oftalmologica Dr. Munteanu<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/profmunteanu.ro\/de\/crosslinking-cornean-ce-reprezinta-si-care-sunt-efectele\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Crosslinking cornean - ce reprezinta si care sunt efectele - Clinica Oftalmologica Dr. Munteanu\" \/>\n<meta property=\"og:description\" content=\"Crosslinking cornean – ce reprezinta si care sunt efectele acestei proceduri Crosslinking cornean este un procedeu medical inovator utilizat pentru tratarea keratoconusului. Acesta const\u0103 \u00een aplicarea unei substan\u021be fotosensibile pe corneea pacientului, urmat\u0103 de expunerea acesteia la lumin\u0103 ultraviolet\u0103. Crosslinking cornean are ca scop \u00eent\u0103rirea \u021besutului cornean \u0219i \u00eencetinirea progresiei bolii. 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