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K-MAP at ESCRS 2018

Farhad Hafezi was interviewed by Eyetube on the K-MAP keratoconus prevalence study at ESCRS 2018.

Transcript

Hi, my name is Prof. Farhad Hafezi, I’m the chief medical director of the ELZA Institute in Dietikon, Zurich as well as a professor of ophthalmology at the University of Geneva, Switzerland and the USC Roski Eye Institute, Los Angeles.

The topic of my talk is The Light For Sight KMAP global prevalence of keratoconus study. Now, this is a long name and let me break down the title. First of all, keratoconus, if you open up a textbook, is a rare disease. If you look at the classification you will see that the prevalence is set to 1 in 2000 people in the normal population. And we believe that the real prevalence of the disease is way higher than that. 

Why does it play a role?

It does play a role because 20 years ago we had no possibility to treat a patient once the disease is detected but now with modern corneal cross-linking technology we can treat young patients with keratoconus. So detecting the disease at an early stage is key and detecting the disease also means knowing how rare or even how not rare the disease is. And this is what we put the focus on. 

Again, you open a textbook and you read 1 in 2000 patients and this all boils down to a 1986 paper published by Kennedy and colleagues in The American Journal stating that keratoconus is rare. The data that has been analyzed for this 1986 paper that we all still cite in the textbooks has been collected in Minnesota between the 1930s and 1980s. So you can imagine the standard of technology that was used at that time and the sensitivity of the methods to detect keratoconus. Today we have much more modern technology and we also know that geographically there are large variations of disease prevalence.

So what we have started is a global study and it all started with a pilot that we did in Riyadh, Saudi Arabia. The pilot was published a few months ago in The British Journal and we had amazing numbers. We screened 1044 eyes and then had all these eyes – it was screened with a Scheimpflug imaging system – and we had all these eyes then evaluated by two independent corneal surgeons. And in all but 9 eyes they had perfect congruence in defining the disease, so stating whether or not this person carries keratoconus or not. And in only 9 cases there was discrepancy.

If you then look at the overall prevalence we published we were at almost 5% of the normal population aged 6-21 years. So the prevalence we found in this particular area of the world was almost 100 times higher than what was reported by Kennedy in 1986. And this stimulated our foundation The Light For Sound Foundation to start a global prevalence study. And with this study we’ll now look at the global prevalence of keratoconus on four continents. 

Torres-BJO-KC-prevalence

The study sites were recruited among The Light For Sight centers. We are represented in 42 countries on 5 continents right now and out of these 42 centers, 11 centers are enrolled in the studies, 5 already have positive IRB approval and will start collecting data in the next months. Our aim is to collect 15 000 to 20 000 eyes to get a better idea about the global distribution of prevalence and also it might shine a light on the difference between environmental factors and genetics.

Just think about the possibilities of looking at a cohort of let’s say Chinese patients in mainland China and the Chinese population in San Francisco. Similar genetic backgrounds totally different environments. So we are very excited to hopefully present new, large data in the next 24 months.

 

The ELZA Institute

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mike
09:02 04 Jan 23
Overall as a 50 year old, who wanted to continue to avoid wearing glasses and/or contact lenses, my goal was 100%... achieved with ELZA and Dr. Hafezi. I greatly appreciated the overall approach by Dr. Hafezi and his friendly and competent team in reviewing my vision at the start and following a comprehensive eye exam- the explanations of my options. For me I chose PRK in one eye for a monovision solution to correct short sightedness which was becoming more prevalent in night driving and sports such as skiing and cycling. PRK heals slowly but the outcome is worth the wait- and the cost- you use your eyes every waking moment- and for me I cannot see any reason not to pursue better vision with the ELZA team! A great quality of life enhancement!read more
Zuzana Fecko
Zuzana Fecko
21:48 31 Oct 22
Thank you so much, Dr. Torres and prof. Hafezi. 26 years I was only “dreaming” about the eye surgery due to possible... complications. I was worried ..Thank you for encouraging me to make a decision and thank you for your professionalism, explanations and great work!I wish you all the best, lots of success and only happy patients!read more
Serena Fazio
Serena Fazio
11:15 06 Mar 22
I have been to the ELZA clinic to have surgery for my miopy, as my eyes were rejecting the contacts and I was tired of... wearing glasses. From the first preliminary visit, to the actual surgery and post-surgery care Dr. Hafezi and all his collaborators have been extremely professional, considerate and helpful. All the steps of the (very short!) surgery were thoroughly explained to me in order to be as calm as possible, together with the medication plan and precautions to be aware of so that my eyes could heal in the best way possible. By following their exact instructions, the healing process has been very successful and smooth, and after about one week I was able to see perfectly. I absolutely recommend this team and their expertise!read more
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
Thunder Shiviah
14:05 23 Nov 21
After some research on local options I decided to go with ELZA since it stood out as the best. The operation and the... post-operation recovery went extremely smooth (something I was worried about with PRK). Now my vision is much better than I had hoped and I have no side effects such as dry eye or night vision problems. Thank you!read more
Thomas S.
Thomas S.
09:37 07 Jul 21
My left eye had to be operated on because of a cataract. As I had an Artiflex lens implanted a few years ago, it had to... be removed first before a modern lens could be implanted to correct the cataract. Prof. Hafezi treated me in an very competent and friendly manner. I am very happy with the result.read more
Selma A. Rahim
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
Steven H.A
Steven H.A
16:13 11 Jan 21
Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
Online Commande
Online Commande
09:19 05 Dec 20
Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
Elena Churilova
Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
Michele Aggiato
Michele Aggiato
18:17 10 Jan 20
The day I had Prof Hafezi checking my keratoconus I knew I was finally in the right place after years of searching for... a good ophthalmologist. Prof Hafezi recommended a surgery due to a drastic degeneration of my cornea. The surgery was performed by himself with the assistance of Dr Rodriguez, one more collaborator of Prof Hafezi’s team who got my full trust.read more
Ashley Faulkes
Ashley Faulkes
15:30 21 Mar 16
Professor Hafezi and the team at the ELZA Institute have done an amazing job of creating a first class eye clinic, with... cutting edge technology and support. I went there for a dry eye issue and other issues with my prescription, and they were easily able to help me and put me on the road to better vision! High recommend them to anyone in the Zurich/Aargau area.read more
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