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PACE: Customized CXL ar Winter ESCRS

OSN reports on PACE customized CXL

Emilio Torres-Netto, MD, PhD spoke to Ocular Surgery News about the data he presented at the Winter ESCRS 2023 meeting in Vilamoura, Portugal. He presented the ELZA Institute’s latest data on the second-generation customized corneal cross-linking (CXL) method known as PACE (PTK-assisted epi-on cross-linking). According to Dr. Torres-Netto, PACE could be paving the way for a paradigm shift in corneal ectasia management which could lead to improved visual outcomes as well as halting the disease processes involved in corneal ectasias like keratoconus.

With PACE, a higher amount of irradiation is applied over the area of the cornea where the keratoconus cone is located, and less irradiation is used over the rest of the cornea. This a customized CXL approach that is adapted to each patient’s cornea. The PACE approach creates a gradient that selectively flattens the steepest area of the keratoconus to a significant extent. As Dr. Torres-Netto explains, this results in significant amounts of corneal flattening that appears after just a few weeks.

Dr. Torres-Netto emphasized the advantages of PACE, explaining that it not only regularizes the cornea but also modifies its curvature to enhance vision. “In a case presented here, we obtained a flattening effect of 7 D within a few weeks, which remained stable in the following months,” Torres-Netto told OSN.

The implications of PACE are far-reaching, especially when considering patients with both cataracts and keratoconus. “If we have a patient with cataract and keratoconus, we could first improve the cornea with PACE and then calculate the IOL more precisely and even use a toric IOL,” Torres-Netto explained to OSN. This exciting development could lead to better visual outcomes for patients who previously struggled to find effective solutions.

While more data is needed to fully evaluate the impact of PACE cross-linking, the results showcased at the Winter ESCRS conference have generated immense excitement within the field. PACE customized CXL looks like it is poised to change the landscape of keratoconus treatment and improve the lives of countless patients. Stay tuned for more data to be presented at the main ESCRS meeting later this year in Vienna.

TRANSCRIPT:

Hello, my name is Emilio Torres and I am speaking to you from the Winter ESCRS 2023 conference in Portugal. Today, we are presenting a case of a patient who was able to significantly improve the regularity of their cornea using a new cross-linking technology.

Traditionally, cross-linking has been used to stabilize the cornea, particularly in patients with advanced keratoconus. However, with the second generation of customized cross-linking, known as PACE or PTK-assisted epi-on corneal cross-linking, we can now not only stabilize the cornea but also improve its curvature.

In the case we presented, the patient experienced a flattening effect of up to 7 diopters within a few weeks of treatment, which remained stable after a few months. Although we still need more data to collect, this new technology has the potential to change paradigms in the field.

For example, imagine a patient with cataracts and keratoconus. With PACE cross-linking, we could first improve the cornea and then more accurately calculate and even use a toric intraocular lens.

Overall, we are very enthusiastic about the results of PACE cross-linking and hope to present more data at our main ESCRS meeting this year in Vienna. Thank you.

The ELZA Institute

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Augeninstitut ELZA
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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!read more
Zuzana Fecko
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!read more
Serena Fazio
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!read more
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
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!read more
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
Michele Aggiato
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.read more
Ashley Faulkes
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.read more
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Augeninstitut ELZA
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