Cooling the cornea… for better cross-linking

EyeWorld’s Jonathan Kahn (JK) interviews Farhad Hafezi (FH) on a new method that might improve the efficacy of corneal cross-linking: cooling the cornea.

Transcript

Jonathan Kahn (JK): Good morning from the ESCRS conference in Vienna, Austria. We’re pleased to be here with Dr. Farhad Hafezi from Switzerland. Thank you so much for being with us today.

Farhad Hafezi (FH): Thank you for having me.

JK: I’d like to speak with you this morning about collagen cross-linking, because this is a really fun topic and an exciting topic about which you and I have spoke over the years. But every time we speak, there’s something new and exciting and interesting that comes out that makes it better or more effective than previously. I understand that now you have some good information for us about how temperature can affect cross-linking. Can you tell us what that means?

FH: Yes absolutely. Cross-linking is an established method, but there is always room for improvement. And one major improvement on our understanding of the technology was when back in 2013 my group identified oxygen as an essential element in cross-linking. We know that oxygen supply is needed to drive the entire process, and there are new attempts to improve the oxygen supply to the cornea by having a stream of oxygen flooding over the cornea. But when looking through the literature, our group found an interesting hint which is: if you lower the temperature of the cornea, oxygen diffusion improves. Which means theoretically, if you cool down the cornea, you might have more oxygen present in the stroma and maybe better cross-linking efficacy. And preliminary ex-vivo data are from our lab seem to suggest that, indeed, if you lower the temperature of the cornea, you might have a cooling effect that increases efficacy.

JK: It’s interesting, because in some types of cornea treatment (for example, in PRK), we cool the cornea after the laser treatment in order to sort of stop the inflammatory effects of the laser, or stop the progressive treatment effects of the laser, whereas now we’re talking about perhaps the opposite, about cooling the cornea prior to treatment.

FH: Exactly.

JK: And that’s it that’s an interesting way to think about it.

FH: Yes, this. It might be that cooling it, prior and during the treatment, might improve efficacy. We need to look more into this.

JK: So do you think that perhaps there may be future studies that may start to compare a cool treatment as compared to a room-temperature treatment to see whether or not there are differences in efficacy?

FH: This might be the end consequence. We try to get more solid data out of the lab, and once we confirm this, for sure, then the next step would be to cool down the patient’s cornea.

FH: Quite right.

JK: Well this has been really a terrific look for us into some of the future technologies and future advances in cross-linking (as always). I’m so glad you’re able to share your expertise thank you.

FH: Thank you.

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!
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!
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!
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
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!
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.
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
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 you
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.
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!
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.
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.
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