ANDRE AUGUSTO MIRANDA TORRICELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
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bookPart Caso clínico 3(2022) KITA, Carolina Satie; TORRICELLI, André A. M.bookPart Caso clínico 6(2022) MONTECHI, Lucas Nunes; TORRICELLI, André A. M.bookPart Cirurgia lamelar com laser de fentossegundo (Femto-Lasik)(2022) TORRICELLI, André A. M.bookPart Inlay corneanos(2022) TORRICELLI, André A. M.bookPart Índices, algoritmos, receitas pós-operatórias e termo de consentimento(2022) TORRICELLI, André A. M.; GARCIA, Renato; GIGLIO, Verônica BrescianibookPart Caso clínico 5(2022) RICCI, Helena Maria Moraes; TORRICELLI, André A. M.bookPart Caso clínico 10(2022) PIVA, Caroline; TORRICELLI, André A. M.bookPart Complicações específicas do FemtoLasik(2022) TORRICELLI, André A. M.- Intrastromal Corneal Ring Segment Implantation and Cross-Linking: When and How?(2022) MOSCOVICI, B. K.; TORRICELLI, A. A. Miranda; LEORATTI, M. C.The idea of combining both procedures emerged from the principle of preventing disease progression by acting on collagen fibers through corneal cross-linking (CXL) and remodeling the cornea, improving visual quality and ametropia, through corneal intrastromal ring (ICRS) implantation. The studies show that the CXL and ICRS have beneficial effects if combined, according to their appropriate indication (CXL to keratoconus in progression; ICRS for improvement of visual acuity or quality). As the corneal stiffening occurs right after the interaction between riboflavin and UVA, the most logical would be implantation of ICRS and in a second time CXL. Regardless of the sequence, the literature shows good results, but the rationale and the majority of papers lead us to recommend that ICRS must be performed first or simultaneously to CXL for better outcomes. However, the literature shows that the difference is very small, even if this sequence is broken, with some studies showing equal results regardless of the procedure performed first. Depending on each case (difficulty in taking the patient to the operating room, patient’s anxiety, keratoconus progressing rapidly), one can opt for a simultaneous procedure; otherwise, the suggestion is to start with ICRS and after 1–3 months perform CXL. If it is not possible to perform single-stage surgery and the keratoconus is progressing, there is no harm in performing CXL and after some time ICRS. There is a trend to perform accelerated CXL in combined surgeries to decrease surgical time and avoid the possibility of haze and/or progressive flattening. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Preoperative Predictors for Acute Pain After Photorefractive Keratectomy(2022) TOYOTA, Adriana M.; GARCIA, Renato; TORRICELLI, Andre A. M.; SILVA, Valquiria A.; GALHARDONI, Ricardo; TEIXEIRA, Manoel J.; ANDRADE, Daniel C. de; BECHARA, Samir J.Purpose: The aim of this study was to identify preoperative predictors for the occurrence of early severe postoperative pain in patients undergoing photorefractive keratectomy (PRK). The implementation of preoperative screening methods may facilitate more specific or aggressive pain therapies specifically targeted to individuals at a high risk of experiencing severe postoperative pain. Methods: This was exploratory research that included patients who underwent PRK. Before PRK, patients were administered a sociodemographic questionnaire, the Pain Catastrophizing Scale, and the State-Trait Anxiety Inventory and underwent corneal sensitivity and conditioned pain modulation (CPM) tests. Post-PRK pain was assessed using a pain intensity visual analog scale (VAS), and the short-form McGill Pain Questionnaire (SF-MPQ) was completed 21 days before PRK and 1, 24, 48, and 72 hours after PRK. Spearman correlations were calculated for pain scores and preoperative predictors. Results: This research included 34 eyes of 34 patients. Preoperative corneal sensitivity was positively correlated with post-PRK pain scores as assessed by VAS and SF-MPQ (rho = 0.39 and rho = 0.41, respectively, P < 0.05). No correlations were found between Pain Catastrophizing Scale, State-Trait Anxiety Inventory, and CPM scores and post-PRK pain scores (P > 0.05). Conclusions: Abnormal presurgical corneal sensitivity was a protective marker for severe pain after PRK, while scores as assessed by VAS and SF-MPQ and CPM were not related to postoperative pain.