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Cataract surgery in Keratoconus

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No routine surgery

To perform cataract surgery in eyes with keratoconus (or in any eye) surgeons need to measure the anatomical characteristics of the eye in a process called optical biometry. This enables the surgeons to calculate how much your eye focuses light onto the retina (your “optical power”) and what contribution your lens makes to the focusing. This enables the surgeon to select the intraocular lens (IOL) with the right “power” for your eye.

Cataract surgery in keratoconus is not routine surgery

When talking about cataract surgery in keratoconus, it is worth remembering that around 70% of the focusing of light onto the retina is performed by the cornea, with the rest by the lens. As patients with keratoconus have highly irregular corneas, this means that both planning the surgery and choosing the best intraocular lens can be highly challenging. 

Better biometry: the key to success when performing cataract surgery in keratoconus
Better biometry: the key to success when performing cataract surgery in keratoconus

Hitting the Target

At ELZA, we use advanced ocular biometry equipment to perform comprehensive exams that measure the anatomy and optical power of all patients’ corneas. This benefits everyone, not just those with keratoconus.

Everyone undergoes series of examinations with advanced corneal (and retinal) diagnostic equipment, including corneal topography, corneal wavefront analysis, OCT imaging and ocular aberrometry. These are specialised instruments that regular cataract surgeons do not have – but are particularly important to perform in eyes with irregular corneas.

What makes us unique are the following points:

  • We are the only eye clinic in Switzerland equipped with a combination of some of the most advanced and sophisticated devices to measure corneal biomechanics (CorVis ST), corneal wavefront (Sirius, CSO Italia), ocular aberrometry (Peramis, CSO Italia) and a high-resolution anterior segment OCT, combined with placido-based technology (MS-39, CSO Italia)
  • Having all these devices is like having a Formula 1 car: it cannot show its full potential without an experienced driver. And this is where our experience in the field of keratoconus and cornea comes really shows its value. This experience is essential because the data from the measurements leaves us with a great range of possible lens powers that could be used. We then have to decide, based on our experience, which lens is the right choice.
Anterior-Chamber-Distance-Measurements
Accurate measurements of your ocular anatomy are required to calculate the correct IOL power for your eye

During the procedure

Keratoconic corneas tend to be thinner than normal, but unless they are extremely thin, this should not make a difference to the technical difficulty of the procedure. At ELZA, we can offer the option of femtosecond laser-assisted cataract surgery, where the laser can make super-accurate incisions in the cornea, perform a capsulotomy, and pre-fragment the lens to make the entire procedure as safe and as “light touch” as possible. This approach should be considered in eyes with very thin keratoconus corneas that require cataract surgery.

A femtosecond laser has made a capsulotomy
A femtosecond laser has been used to make a capsulotomy

What to expect after surgery

The intraocular lens will replace your natural lens. So the best this lens can do is to remove the additional blurriness that began with the onset of your cataract.

The new lens can be compared to a fresh pair of glasses. It makes vision better, but neither glasses nor an intraocular lens can correct for the optical errors that have their origins in the irregular keratoconus cornea. Cataract surgery treats the lens, not the cornea. In other words: we return your vision back to the level it was before your cataract started to develop.

At 6 months after your cataract surgery, we can perform additional corneal laser surgery. This approaches the problems of an irregular cornea and can therefore further improve your quality of vision.

ANTERIOR

The Visual Symptoms of Cataracts

ANTERIOR
SEGUINTE

Cataract surgery: Laser or Ultrasound?

SEGUINTE
CXL controversies at ESCRS 2024
  • Farhad Hafezi, Poder do pódio, Popular press, Uncategorized
ELZA covered by CAKE: Innovations and controversies in CXL
The AAO-ESCRS Joint Symposium, held on Day 4 of the 42nd Congress of the European Society of Cataract and Refractive Surgeons (ESCRS 2024) in Barcelona, convened leading ophthalmology experts to explore the latest developments in corneal collagen cross-linking (CXL).
  • por Mark Hillen
  • Setembro 13, 2024
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OCT keratoconus classification featured image ophta
  • Emilio Torres, Scientific article
STEP: An OCT-Based Keratoconus Classification System
The STEP system utilizes two parameters: the minimum overall stromal thickness (ST) and the standard deviation of epithelial thickness (EP). This approach provides a more detailed understanding of keratoconus progression, offering insights that may assist in clinical decisions, especially concerning corneal cross-linking (CXL) protocols.
  • por Mark Hillen
  • Agosto 26, 2024
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  • Farhad Hafezi, Popular press, Uncategorized
Going for Gold! ELZA-PACE customized CXL
ELZA-PACE not only improves corneal biomechanics (just like regular CXL) but by flattening the cone significantly, also enhances patients’ visual quality. The results so far indicate that patients treated with this method have better visual outcomes compared to traditional CXL treatments.
  • por Mark Hillen
  • Agosto 19, 2024
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  • Farhad Hafezi, Scientific article, Uncategorized
Ophthalmologie Nachrichten covers ELZA Slit Lamp CXL method
Ophthalmologie Nachrichten recently featured an article from the ELZA Institute, highlighting advancements in corneal cross-linking (CXL). This new approach allows the procedure to be conducted at the slit lamp, significantly reducing costs and extending access to advanced eye care in underserved regions. The innovative method is especially effective for treating keratoconus and infectious keratitis. By optimizing UV exposure times, ELZA’s researchers have made CXL more efficient and accessible, democratizing high-quality ophthalmic treatments globally.
  • por Mark Hillen
  • Julho 11, 2024
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Nikki Hafezi Featured in The Mag - image of her, Farhad Hafezi and a patient
  • Nikki Hafezi, Popular press, Uncategorized
ELZA CEO, Nikki Hafezi, profiled in The Mag
Nikki Hafezi, a partner of MESCA Foundation, is leading healthcare transformation in Uzbekistan. MESCA, founded in 2021 by Bakhtiyor Fazylov, focuses on medical education, training, and research. It aims to enhance ophthalmological care, particularly addressing keratoconus, a significant cause of preventable blindness in children. MESCA’s initiatives include training local healthcare professionals and collaborating with institutions like the Andijan State Medical Institute to improve medical practice and education.
  • por Mark Hillen
  • Julho 11, 2024
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ELZA rehabiliating keratoconus
  • Emilio Torres, Farhad Hafezi, Popular press, Scientific article, Uncategorized
The ELZA approach to Rehabilitating Keratoconus Corneas
Discover the latest advancements in keratoconus treatment with the ELZA Institute’s innovative techniques: transPRK, PACE, and All Femto-CAIRS, as featured in The Ophthalmologist.
  • por Mark Hillen
  • Maio 24, 2024
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Augeninstitut ELZA
Augeninstitut ELZA
4.8
Como base em 109 críticas
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review us on
mike
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!ler mais
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!ler mais
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!ler mais
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!ler mais
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.ler mais
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 youler mais
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.ler mais
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!ler mais
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.ler mais
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.ler mais
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Augeninstitut ELZA
Augeninstitut ELZA
4.8
Como base em 109 críticas
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