Democratizing corneal cross-linking

The ELZA Institute has led an initiative that is leading to the “democratization” of corneal cross-linking (CXL), with the aim of making this sight-saving corneal procedure accessible globally, especially in low-to-middle-income countries (LMICs). A recent article on the International Agency for the Prevention of Blindness (IAPB) features an inteview by ELZA’s Dr. Mark Hillen with Prof. Farhad Hafezi e Dr. Emilio Torres-Netto on exactly this topic. In this article, our surgeons explain that CXL has traditionally been a complex procedure performed in hospital settings. However, advancements by ELZA researchers, including , are revolutionizing this by making CXL portable and affordable.

 

Prof. Hafezi explains in the article the importance of CXL: “Traditionally, disorders such as keratoconus and infectious required treatment in a hospital. Keratoconus is the leading cause of preventable blindness among children and adolescents worldwide. What happens in   is that the cornea becomes increasingly weaker. Because the eye is pressurized, the weakened part starts to bulge outward into a cone shape. As the cone grows, people’s vision gets worse. Historically, the only treatment was a corneal transplant, but for the last 20 years, we’ve been able to strengthen the cornea and stop the disease from progressing using a treatment called corneal cross-linking (CXL) – and CXL has dramatically reduced the number of corneal transplant surgeries required to treat keratoconus.”

Dr. Torres-Netto adds, “The problem is that until relatively recently, CXL has mostly been performed in operating theaters inside hospitals. Operating theaters need to be completely sterile, staffed, and booked weeks in advance, as surgeons compete for theater space. This makes the procedure very expensive. Often the problem is that in LMICs, most of the population lives in rural regions, whereas the hospitals are concentrated in one or two cities. In LMICs, it’s not only the cost of the procedure in the hospital that can be prohibitive, it’s also the cost of the time and travel to the hospital that stops people from receiving the procedure. In extreme cases, many cities or villages don’t even have hospitals or surgical centers, and it can often take days to get there. I’ve had this experience several times traveling through riverside towns in the middle of the Amazon rainforest.”

These advancements allow CXL to be performed outside traditional settings, reducing costs and increasing accessibility. The article highlights that innovative portable CXL devices that can be used with slit lamps are now available, and as slit lamps are near-ubiquitous in eye care, or even in the most remote of locations. This technological leap not only makes the procedure more accessible but also significantly reduces costs, making it feasible for LMICs where healthcare resources are often limited.

ELZA’s efforts align with broader goals of global health equity, addressing disparities in eye care access. The development of these portable devices is seen by the interviewees as a game-changer, enabling more patients to receive timely and effective treatment.

 

Dr. Torres-Netto: “The UV light delivered during cross-linking does not care whether it is being delivered from above with the patient lying down or sitting upright at the slit lamp. We’ve done the work to show that the riboflavin in the eye does not settle downwards when the patient is sat upright either. We’ve recently shown that CXL at the slit lamp is as effective and as safe as CXL performed in the OR.”

By making CXL portable and affordable, ELZA is paving the way for broader access to essential eye care services, particularly in resource-limited settings.

Dr. Torres-Netto adds, “The problem is that until relatively recently, CXL has mostly been performed in operating theaters inside hospitals. Operating theaters need to be completely sterile, staffed, and booked weeks in advance, as surgeons compete for theater space. This makes the procedure very expensive. Often the problem is that in LMICs, most of the population lives in rural regions, whereas the hospitals are concentrated in one or two cities. In LMICs, it’s not only the cost of the procedure in the hospital that can be prohibitive, it’s also the cost of the time and travel to the hospital that stops people from receiving the procedure. In extreme cases, many cities or villages don’t even have hospitals or surgical centers, and it can often take days to get there. I’ve had this experience several times traveling through riverside towns in the middle of the Amazon rainforest.”

These advancements allow CXL to be performed outside traditional settings, reducing costs and increasing accessibility. The article highlights that innovative portable CXL devices that can be used with slit lamps are now available, and as slit lamps are near-ubiquitous in eye care, or even in the most remote of locations. This technological leap not only makes the procedure more accessible but also significantly reduces costs, making it feasible for LMICs where healthcare resources are often limited.

ELZA’s efforts align with broader goals of global health equity, addressing disparities in eye care access. The development of these portable devices is seen by the interviewees as a game-changer, enabling more patients to receive timely and effective treatment.

Dr. Torres-Netto: “The UV light delivered during cross-linking does not care whether it is being delivered from above with the patient lying down or sitting upright at the slit lamp. We’ve done the work to show that the riboflavin in the eye does not settle downwards when the patient is sat upright either. We’ve recently shown that CXL at the slit lamp is as effective and as safe as CXL performed in the OR.”

By making CXL portable and affordable, ELZA is paving the way for broader access to essential eye care services, particularly in resource-limited settings.

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Augeninstitut ELZA
4.8
Como base em 109 críticas
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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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