ELZA’s role in Corneal treatments

Members of ELZA have been instrumental in improving current technology used to reshape the human cornea. We are also heavily involved in research on this topic and teach numerous times throughout the year in Europe, Asia, Africa, and the Americas.


The Chapters

Pterygium
Low vision after transplantation
Low vision due to corneal scars
Cornea and thyroid hormone
Cornea and Pregnancy
Terrien marginal degeneration

Posts on Cornea published by ELZA


CXL at the slit lamp

Why perform corneal cross-linking at the slit lamp?

CXL at the slit lamp may provide access to all. Cataract & Refractive Surgery Today Europe April 2017: ELZA member and ... Read more
Journal of Refractive Surgery April 2017 Cross-Linking at the slit lamp

Another step towards cross-linking at the slit lamp

Journal of Refractive Surgery: Cross-Linking at the slit lamp and riboflavin distribution. We are currently developing the technique of slit lamp ... Read more

Video Interview: Global Innovations

Video Interview on a new indication for corneal cross-linking ELZA founder Prof. Farhad Hafezi speaks about treating therapy-resistant corneal infections ... Read more
Veterinary Ophthalmology Journal

New insights on the penetration depth of cross-linking

Penetration depth of Cross-Linking is species-dependent. In this scientific article, we supported the research of our partner group around Prof ... Read more

ELZA speaks at USC Roski Eye Institute Refractive Symposium 2017

USC Roski Eye Institute Refractive Symposium 2017 with ELZA Founder Prof. Hafezi. Farhad Hafezi speaks on treating ultra-thin keratoconus corneas ... Read more

2nd edition of the textbook “Corneal Cross-Linking” available at ASCRS 2017

Our Textbook on Corneal Cross-Linking available at ASCRS Los Angeles May 2017. We are proud to announce that the completely ... Read more

ELZA speaks @ Refractive Surgery Symposium 2017 Los Angeles

February 2017.Refractive Symposium at the USC Roski Eye Institute. The USC Roski Eye Institute is hosting a Refractive Symposium with ... Read more

Chinese translation of the Hafezi/Randleman Cross-Linking textbook

January 2017. University of Wenzhou, China. The textbook "Corneal Cross-Linking" by Farhad Hafezi and J. Bradley Randleman is the oldest ... Read more
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Pterygium – a sunlight-related disease

Pterygium

A pterygium is a degenerative disorder of the conjunctiva. It is directly related to the extent of ultraviolet (UV) irradiation that an eye has seen throughout life. So people that were exposed to lots of sun, or to sun at high altitude, tend to develop a pterygium much more often than others that grew up in countries with less sun exposure.

A pterygium can lead to dry eye, redness, and reduced vision.




Surgical removal

A pterygium can be removed surgically. In a first step, the pterygium is excised under the operating microscope, and the conjunctiva is closed, either directly, or using a conjunctival transplant. A pterygium may have a very high recurrence rate, because even microscopically small portions may lead to regrowth. Therefore, in a second step, the area of excision on the cornea is treated using the excimer laser. This treatment also smoothens the corneal surface and improves the regularity of the surface..

If the pterygium is successfully treated, dryness and redness as well as reduced visual acuity will resolve over time.


Sunglasses – protect your eyes prom pterygium and early cataract



Low vision after corneal transplantation


One main goal of a corneal transplantation is to avoid rejection of the transplant. Nowadays, potent immunosuppressive agents and other medications help minimize the risk of rejection.

The other main goal is to achieve a satisfactory visual acuity. Although perfectly accepted by the host, the transplant often shows a major amount of irregular astigmatism, which cannot be corrected by glasses or contact lenses. Here, customized Femto-LASIK or PRK procedures may help to increase the regularity of the surface, and increase spectacle-corrected visual acuity. These are highly customised surgeries, and should not be confounded with cosmetic procedures (“living without glasses”).


A 34 year-old-patient presented with a clear transplant, but an irregular astigmatism of over 11 diopters, and a visual acuity of 10%.

A Femto-LASIK procedure was performed by an ELZA member, combined with a re-lift after 6 months to correct for the astigmatism in a two-step approach. The final result was highly satisfactory.



Low Vision due to Corneal Scars


Corneal Scars often is a result of bacterial/fungal/viral infection or of trauma. Depending on its location, the scar may greatly reduce visual acuity, due to opacification of the cornea irregular astigmatism.

A number of customized approaches may eliminate the scar, inclusing PTK, wavefront-guided PRK and Femto-LASIK, or lamellar keratoplasty.



Cornea and thyroid hormone


Hypothyroidism (underfunction of the thyroid)  has a major infleunce on the biomechanical stability of the cornea. The exact mechanism of action has not been elöucidated yet, but it involves thyroid receptors in the human cornea. Under certain circumstances, underfunction of the thyroid may influence the clinical outvome of keratoconus, and may also represent a risk when performing refractive laser surgery.


Video Interview on hormonal corneal changes at WOC Tokyo 2014

Interview on the effect of pregnancy and thyroid disease on the cornea at the World Ophthalmology Congress in Tokyo.
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Patients with thyroid-related disease display altered corneal biomechanics

Acta Ophthalmologica. Study describing the effect of Graves' disease of the thyroid on corneal biomechanics. Read the article here.
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The PowerList 2014

The Ophthalmologist. In 2014, the readers of "The Ophthalmologist" voted for the PowerList, the 100 most influential personalities in global
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2014. World Ophthalmology Congress (WOC).

Tokyo, Japan. Farhad Hafezi, Invited speaker. See the program here.
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The cornea in thyroid gland dysfunction

Journal of Refractive Surgery. Our group shows that hypothyroidism and related hormonal changes affect the biomechanical stability of the cornea.
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Pregnancy may be risk factor for late-onset post-LASIK ectasia

Ocular Surgery News Europe Edition. Cases have been reported up to 9 years after refractive surgery, once the patient became
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Cornea and pregnancy


Recent research findings have shown that pregnancy may have a major impact on the cornea. The increase of estrogen levels in the blood and tissues of a pregnant woman has a direct impact on the biomechanical integrity of the cornea. In other words, the cornea becomes loose at the end of pregnancy. This may have a number of conseuqnces.

Keratoconus: Pregnancy may worsen an existing keratoconus.

Ectasia after LASIK: Our group has published on cases of female patients who showed good vision with excellent and stable results after LASIK surgery for years, until they became pregnant. During pregnancy, they developed postoperative ectasia, a condition similar to keratoconus, and a major copmplication after refractive laser surgery. In some cases, the delay between LASIK surgery and occurrence of ectasia was nine years. These cases show that the surgeon’s experience in judging the cornea preoperatively, is of utmost importance. Also, the surgeon must have adetaiuled knowledge on all the factors that may influence corneal biomechanics.


Corneal biomechanics during pregnancy

Journal of Cataract and Refractive Surgery. Research letter discussing the effect of pregnancy and oestrogen on the biomechanical stability of
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Video Interview on hormonal corneal changes at WOC Tokyo 2014

Interview on the effect of pregnancy and thyroid disease on the cornea at the World Ophthalmology Congress in Tokyo.
Read More

The PowerList 2014

The Ophthalmologist. In 2014, the readers of "The Ophthalmologist" voted for the PowerList, the 100 most influential personalities in global
Read More

2014. World Ophthalmology Congress (WOC).

Tokyo, Japan. Farhad Hafezi, Invited speaker. See the program here.
Read More

Keratoconus during pregnancy

Journal of Refractive Surgery. ELZA shows that the cornea of a person suffering from keratoconus may show massive estrogen-related changes
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Pregnancy may be risk factor for late-onset post-LASIK ectasia

Ocular Surgery News Europe Edition. Cases have been reported up to 9 years after refractive surgery, once the patient became
Read More

Pregnancy may be a risk factor after LASIK

Journal of Refractive Surgery. ELZA members show that pregnancy may lead to corneal complications, even years after LASIK, if proper
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Pregnancy exacerbates iatrogenic keratectasia

Journal of Cataract and Refractive Surgery. The very first report on the use of CXL to halt ectasia that was
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Terrien Marginal Degeneration (TMD)


Terrien marginal degeneration (TMD) is a rare, bilateral, progressive corneal melting disease usually occurring in middle to late age.

It may lead to progressive corneal thinning, and even corneal perforation. The management of TMD remains a major challenge, and even corneal transplantation is difficult and often fails. Members of ELZA published on the first successful partial reversal of a TMD using cross-linking technology. Please find more information in our posts below.


New therapy for Terrien’s Marginal Degeneration

Ocular Surgery News Europe Edition and U.S. edition “We only treated two eyes, but it was the first time a
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Cross-Linking for Terrien’s Marginal Degeneration (TMD)

Journal of Refractive Surgery. Scientific article describing the first use of cross-linking to treat TMD. Read here.
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