At the ESCRS Winter Meeting 2025 in Athens, Prof. Farhad Hafezi and Dr. Emilio Torres-Netto, both from the ELZA Institute, presented new findings on corneal cross-linking (CXL) and its applications in keratoconus and corneal biomechanics.

Ultra High-Fluence CXL and Corneal Allogenic Implants at the ESCRS Winter Meeting 2025

In the Corneal Ectasia and Ocular Surface session, Prof. Hafezi discussed ultra high-fluence CXL for extracorporeal optimization of corneal allogenic intrastromal ring segments (ECO-CAIRS). His findings suggest that high-fluence CXL can enhance the biomechanical properties of allogenic ring segments before implantation, potentially improving their long-term stability.

Corneal Remodeling Without Tissue Removal

In a session on keratoconus management, Prof. Hafezi presented data on corneal remodeling techniques that do not require tissue removal, including ELZA-PACE, Femto-CAIRS, and SLAK. These approaches aim to provide alternatives for patients with progressive keratoconus who may not be candidates for traditional interventions.

Biomechanical and Structural Analysis in Keratoconus and CXL

Dr. Emilio Torres-Netto contributed findings from several studies on CXL biomechanics:

  • High-fluence accelerated epithelium-off CXL was shown to achieve comparable clinical and biomechanical outcomes to the Dresden protocol at one-year follow-up.
  • A second-generation “ELZA-sub400” protocol was evaluated for use in ultrathin corneas, offering potential treatment options for patients with severe corneal thinning.
  • Customized corneal cross-linking (ELZA-PACE) combined with toric intraocular lens (IOL) implantation was presented as a method for visual rehabilitation in keratoconus.
  • High-resolution OCT elastography was used to assess the biomechanical properties of Femto-CAIRS.

Corneal Biomechanics in Refractive Surgery

In the Diagnosis for Corneal Refractive Surgery session, Prof. Hafezi examined corneal biomechanics and its role in preoperative decision-making. Understanding corneal stability is essential for optimizing outcomes in refractive procedures.

The presentations by Prof. Hafezi and Dr. Torres-Netto reflect ongoing efforts to refine CXL protocols, corneal biomechanics assessment, and keratoconus management. Their findings contribute to the development of safer and more effective treatment strategies for corneal diseases.

Finally, ELZA consultant surgeon Dr. Lamis Baydoun, MD, PhD, served as a co-moderator for the Keratoconus session, guiding discussions on the latest advancements in surgical and non-surgical management strategies for keratoconus.