PACE: Customized Cross-Linking

ELZA has developed a second generation customized cross-linking technique, called PACE.

In standard CXL, we use the same amount of irradiation over the entire cornea. This usually stops the progression of keratoconus – and in some cases, may even lead to a minor beneficial flattening effect in some of the patients after 6 months to one year. 

In PACE (PTK-assisted customized epi-on CXL), we use a greater amount irradiation over the area of the cornea where the keratoconus cone is, and less irradiation over the rest of the cornea. This leads to a gradient that selectively flattens the steepest area of the keratoconus to a great extent, which begins to become apparent after only a few weeks.

We will discuss with you whether or not PACE is an option in your eyes.


Figure 1: “Standard” epi-off CXL before and at 12 month after. No change in topography.


Figure 2: PACE before and 4 weeks after. Note the flattening in the cone region.



Cross-Linking in Children


Cross-Linking Extremely Thin Corneas