Precise Epithelium Removal for Ectatic Corneas Technique in Corneal Collagen Crosslinking (PERFECT-CXL)…

Cohort studyClinical ophthalmology (Auckland, N.Z.)· 2026

Precise Epithelium Removal for Ectatic Corneas Technique in Corneal Collagen Crosslinking (PERFECT-CXL): Technique Description and Clinical Outcomes.

Jeffrey Desilets, Kanika Agarwal, Kathryn M Hatch

CorneaCohort studyTreatmentQ1IF 2.6

Only 1.3% of eyes progressed and needed retreatment after PERFECT-CXL crosslinking.

Precise Epithelium Removal for Ectatic Corneas Technique in Corneal Collagen Crosslinking (PERFECT-CXL): Technique Description and Clinical Outcomes.

Jeffrey Desilets … Kathryn M Hatch

Clinical ophthalmology (Auckland, N.Z.) · 2026 · Q1 in Ophthalmology

Purpose

To describe clinical outcomes of a hybrid collagen crosslinking technique, Precise Epithelium Removal for Ectatic Corneas Technique Collagen Crosslinking (PERFECT-CXL) using tomography-guided hybrid partial central epithelium removal with peripheral epithelial disruption in keratoconus.

Methods

In this retrospective chart review, 362 eyes underwent PERFECT-CXL, of which 150 were previously untreated non-contact lens wearing keratoconic eyes.

n = 362 eyes

1.3%

Results

1.3%

very few eyes worsened or needed a repeat treatment afterward

n = 362 eyes

More results

At six months, one, two, and three years post-op, best spectacle-corrected visual acuity was stable in 97.5% (n = 120), 95.7% (n = 93), 94.2% (n = 69), and 94.9% (n = 39) of eyes, respectively.

More results

At one, two, and three years post-op, 80.3% (n = 117), 88.2% (n = 93), 84.1% (n = 69), and 84.6% (n = 39) of eyes experienced stabilization in K max , respectively.

There were no instances of treatment-associated complications.

“

Conclusion

Preliminary, retrospective results suggest that PERFECT-CXL can be a safe and effective technique in halting progression of keratoconus and can be utilized in various stages of keratoconus.

Precise Epithelium Removal for Ectatic Corneas Technique in Corneal Collagen Crosslinking (PERFECT-CXL): Technique Description and Clinical Outcomes.

Precise Epithelium Removal for Ectatic Corneas Technique in Corneal Collagen Crosslinking (PERFECT-CXL): Technique Description and Clinical Outcomes.

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