cross-linking-for-wheelchair-users-featured-image-with picutre of man in wheelchair at the slit lamp and a picture of a journal manuscript, side by side

What’s the best way to cross-link the eyes of wheelchair users?

It can be challenging to cross-link the eyes of wheelchair users – for the patient and clinic staff alike. One example of just how challenging this can be is shown in a case report, recently published in the Journal of Refractive Surgery Case Reports (1), where a patient with Duchenne Muscular Dystrophy (DMD) required photoactivated chromophore for infectious keratitis-CXL (PACK-CXL) for the treatment of an infectious corneal ulcer.

People with DMD usually have great problems getting up from sitting or lying down and display Gower’s sign – an inability to get up thanks to weak lower limb muscles. Further, most people with DMD develop cardiomyopathy and respiratory impairment, which can result in reduced lung capacity when patients switch between sitting and supine positions. This is not an ideal situation when performing traditional cross-linking, where the patient would need to be transferred to a reclining chair, and receive up to 30 minutes of UV irradiation while lying on their back.

However, a new approach, cross-linking at the slit lamp, pioneered by Prof. Farhad Hafezi of the ELZA Institute in Zurich, allows CXL and PACK-CXL to be performed with the patient sitting upright at the slit lamp, using a portable, slit lamp-mountable cross-linking device called C-Eye. This approach was used by Dr. Boris Knyazer from Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel, to successfully perform two PACK-CXL procedures over a 5-day period, on the eye of a 39-year-old wheelchair-using patient with DMD to treat infectious corneal keratitis. The procedure was simple: the patient simply maneuvered himself before the slit lamp to receive UV irradiation, avoiding the need to change position or risk compromising the patient’s lung capacity during the period of UV irradiation. This approach: CXL at the slit lamp can make any type of procedure to cross-link the eyes of wheelchair users easier, and potentially safer too.

To read the full text of the article, click here.

CXL-for-wheelchair-users-1

Reference:

1. Knyazer B, Hillen M, Hafezi F. Corneal cross-linking for infectious keratitis at the slit lamp in wheelchair users. Journal of Refractive Surgery Case Reports. 2021;1(3).

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Augeninstitut ELZA
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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
Squitieri Elias
Squitieri Elias
12:43 08 Sep 21
Die Behandlungen waren bei mir erfolgreich, alle waren sehr nett und haben mein Leben vereinfacht.Danke
Eliane Bossart
Eliane Bossart
13:01 05 Sep 21
Vor einem Jahr war ich einer ganz verzweifelten Situation und total im Stich gelassen. Meine Augen wurden aufgrund... eines ausgeprägten Kerakotonus immer schlechter, ich hatte Angst und war alleine mit meinen Problemen. Zudem vertrug ich die Kontaktlinsen nur noch ganz schlecht und hatte jeden Tag Schmerzen.Professor Hafezi hat mir mit zwei Operationen wieder das auf Grund der Situation mögliche an Lebensqualität zurückgebracht. Es war ein starpaziöses Jahr mit vielen Entbehrungen aber es hat sich gelohnt! Herzlichen Dank fuer die Unterstützung.read more
Gabriela Meyer
Gabriela Meyer
18:32 22 Aug 21
Ich wurde von meiner Optikerin auf Prof. Dr. Dr. Hafezi aufmerksam gemacht. Es war mir vorher nicht bewusst, dass meine... Augenkrankheit (Keratokonus) operativ mittels Cross Linking behandelt und so gestoppt werden kann. Die Beratung und Behandlung war sehr kompetent und ich fühlte mich jederzeit wohl. Die Operation verlief gut und das Ergebnis ist einwandfrei.read more
Naomi
Naomi
11:38 11 Aug 21
Ich bin sehr glücklich, dass ich das Elza Institute gefunden habe. Ich wurde von anderen Augenärzten abgewiesen, da... meine Augen zu kompliziert/schwierig zu behandeln waren. Prof. Dr. Dr. Hafezi konnte mir jedoch helfen und ich bin sehr glücklich und zufrieden mit dem Resultat. Vielen Dank!read more
Till B
Till B
08:30 19 Jul 21
Ich habe eine überaus kompetente Beratung und Behandlung erlebt. Die gesamte Betreuung war sehr freundlich und... professionell. Herzlichen Dank!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
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