Farhad Hafezi Discusses Advancing CXL with OSN
January 31, 2023
Prof. Farhad Hafezi, MD, PhD, FARVO is the Medical Director at The ELZA Institute, was recently interviewed by Ocular Surgery News
Can I perform CXL in my office?
What about the infection risk?
Remember that every cross-linking procedure not only improves biomechanics, it also “disinfects” the cornea by directly killing all micro-organisms and by inhibiting cellular replication. This is why a cornea at the end of every CXL and PACK-CXL procedure is “sterile”. And by the way: office-based cataract surgery and office-based intravitreal injections have been performed in many thousands of cases without increased infection risk.
Isn't time too long?
Irradiation time is not too long. Current modern protocols are integrated in the C-eye device and treat in as little as 10 minutes (CXL) and 4 minutes (PACK-CXL). See the published approach here.
Does CXL work in the sitting position?
We need 3 elements for successful cross-linking: UV light, oxygen and riboflavin. Both UV light and oxygen do not “care” whether the patient is laying down or sitting. As for riboflavin, published research shows that riboflavin concentration is stable in the upright position for up to 60 minutes - much longer than we need for a CXL treatment.
Is the patient comfortable?
Offer the patient the comfortable surgeon’s chair with the armrest and take the extra time to ensure that the patient is well-adjusted. Then, the patient is very comfortable.
What about the patient's fixation?
Fixation is no issue. Offer the patient the fixation target that most slit lamps offer (for retinal examination) and the patient will keep a very steady fixation, as you can see here.
Find more answers in our FAQ section.
