CXL controversies at ESCRS 2024

ELZA covered by CAKE – Innovations and controversies in CXL

AAO-ESCRS Joint Symposium at ESCRS 2024: 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). The symposium, a collaboration between the American Academy of Ophthalmology (AAO) and ESCRS, addressed innovations and ongoing debates in CXL, particularly for keratoconus and infectious keratitis. CAKE magazine reported on the event.

AAO-ESCRS Joint Symposium at ESCRS 2024 Tackles Innovations and Controversies in CXL

Epi-on CXL Revisited

Swiss expert Prof. Farhad Hafezi MD, PhD, FARVO discussed the evolution of epi-on cross-linking (CXL) for keratoconus. Despite the method’s historically challenging reputation, Prof. Hafezi expressed confidence in its future, noting that its simplified, pulsed protocol now eliminates the need for additional oxygen or iontophoresis. He emphasized the importance of optimizing the balance between light, oxygen, and riboflavin, issues that were resolved over time. He pointed out that the technique could significantly improve accessibility and affordability by reducing the need for an operating room.

Balancing the Pros and Cons of CXL

Italian expert Dr. Paolo Vinciguerra examined the strengths and limitations of CXL, noting that the procedure is time-consuming, and recovery can take months. He underscored the role of the corneal epithelium in reshaping the corneal curvature, which influences higher-order aberrations. Dr. Vinciguerra reported long-term stability in corneal flattening, especially in pediatric patients, using high-resolution wavefront-guided systems linked to excimer lasers.

 

CXL for Keratoconus: Protocol Comparisons

Dr. Jose De la Cruz from the U.S. reviewed advancements in CXL for keratoconus and started his presentation with the standard Dresden protocol, which remains the most commonly performed CXL protocol in the U.S. This method involves epithelial removal followed by riboflavin and UVA exposure. Dr. De la Cruz discussed accelerated protocols that reduce treatment time while maintaining safety and effectiveness. Both the standard and accelerated methods yield similar outcomes in terms of topographic and refractive improvements. However, he stressed that patient-specific factors, such as age and family history, must guide treatment decisions.

New Frontiers: CXL for Infectious Keratitis

CAKE reported that in the symposium’s final session, Dr. Jennifer Rose-Nussbaumer (USA) explored the use of CXL in treating infectious keratitis, particularly cases resistant to antibiotics. She presented a case involving pseudomonas keratitis, which was unresponsive to standard treatments and required a therapeutic transplant. Dr. Rose-Nussbaumer highlighted CXL’s antimicrobial effects, its role in reducing inflammation, and its potential to increase corneal resistance. Early research into PACK-CXL cross-linking for bacterial and fungal keratitis showed promise, and ongoing trials are expected to provide further insights.

Jennifer Rose Nussbaum

The symposium showcased how CXL continues to evolve, offering hope for improving both keratoconus management and treatment options for infectious keratitis. The session also underscored the need for individualized approaches and the potential for new frontiers in corneal medicine.

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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!
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!
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!
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!
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.
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 you
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.
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!
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.
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.
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