Cross-Linking in thin corneas: simple, personal and more precise

Keratoconus is the progressive thinning of the cornea, and corneal cross-linking (CXL) can successfully treat it. The application of riboflavin and UV light to the cornea generates highly reactive free radicals that cross-link molecules in the cornea (principally collagen), stiffening and strengthening it and thereby slowing or halting the disease’s progression.

But with CXL, thin corneas – often the corneas in most need of treatment – can cause big headaches. There is a good reason why the standard Dresden protocol for CXL is restricted to corneas with a thickness of >400 µm. Thinner corneas risk UV light penetrating deeper and damaging endothelial cells at the base of the cornea. As these cells cannot regenerate, surgeons performing CXL have had to find ways of making these thin corneas temporarily thicker (e.g. swelling the cornea with hypo-osmolar riboflavin or applying a contact lens to the cornea). These methods certainly complicate the procedure and add an element of uncertainty too. It doesn’t have to be this way.

Our research work has enabled us to build a validated model of how the four main components of the CXL technique (UV energy, UV irradiation time, riboflavin concentration, and oxygen pressure) interact to stiffen the cornea. This allows us to determine not just the stiffening effect of any given combination of the main components of CXL, but how deep the effects of CXL using personalized UV irradiation will be. In other words, a personalized UV illumination profile – helpfully, with a shorter irradiation time – can be used to treat thinner corneas, tailored to each patient’s eye, simplifying and speeding the treatment of thin corneas with CXL.

CRST Individualizing CXL image

The ELZA Institute

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Augeninstitut ELZA
4.7
Based on 80 reviews
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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
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Augeninstitut ELZA
4.7
Based on 80 reviews
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