Second-generation customized technique may expand indications for cross-linking
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MILAN — Second-generation customized cross-linking significantly improves vision in patients with keratoconus, according to Emilio Torres, MD, PhD, speaking at the European Society of Cataract and Refractive Surgeons meeting.
“In PACE, which stands for PTK-assisted customized epi-on cross-linking, we use more riboflavin and a greater amount of irradiation over specific areas of the cornea to selectively flatten them and regularize the cornea in a customized fashion,” he said.
The first patients treated so far at the ELZA Institute in Zurich showed good regularization and improved visual acuity and visual quality.
“Indications could go beyond traditional CXL. PACE could be used in patients with thin corneas who are not good candidates for excimer laser surgery and also to enhance the results of cataract surgery,” Torres said.
The best candidates are patients with irregular astigmatism.
“A very asymmetric bow-tie corneal topography pattern becomes a close to normal symmetric bow-tie pattern, and this is without removing any tissue,” he said.
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Torres E. Surgical approach for keratoconus patients: The future of CXL. Presented at: European Society of Cataract and Refractive Surgeons meeting; Sept. 16-20, 2022; Milan.
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