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.
