Cross-Linking only works when sufficient oxygen is present

Ophthalmology Times.

The success of corneal crosslinking (CXL) for ectatic disease requires oxygen within the tissue, and this dependency likely explains the limited efficiency of high-intensity (rapid) and transepithelial treatment protocols, said Farhad Hafezi, MD, PhD. In a series of studies, Dr. Hafezi and colleagues at Geneva University, Switzerland, demonstrated that the biomechanical effect of CXL is (a) oxygen-dependent, and (b) declines in efficacy when intensity is raised and treatment time reduced, even when the total energy dose (fluence) remains the same.

“By definition, the corneal strengthening effect of treatment with riboflavin and ultraviolet A (UVA) requires oxygen because it arises from crosslinking of collagen and proteoglycans that is mediated by the generation of reactive oxygen species,” said Dr. Hafezi, professor and chairman, Department of Ophthalmology, Geneva University Hospitals, Switzerland, and adjunct clinical professor of ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles. “Previous research has shown that oxygen in the cornea is rapidly depleted during CXL irradiation and at a faster rate using higher intensities, raising concern that high irradiance/short irradiation time protocols or presence of an intact epithelial barrier limit the opportunity for adequate oxygen replenishment through diffusion.

Read the article here.

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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
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Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
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Excellent surgeon
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Steven H.A
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Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
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Online Commande
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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
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