Cameo: Democratizing Customized Cross-Linking – One-Year Outcomes In 50 Eyes

To present the clinical outcomes of the CAMEO platform (Customized Adaptive Masked Epi-On cross-linking), a wavefront-guided, platform-agnostic approach designed to regularize corneal optics while preserving stromal tissue.

Eye clinic Svjetlost, tertiary eye center 

Fifty eyes with progressive keratoconus or ectasia underwent CAMEO treatment. The procedure uses total corneal wavefront-guided planning to create a customized epithelial break over the cone and a compensatory zone, employing the epithelium as a biological masking agent. Transepithelial riboflavin was applied, followed by fluence-controlled accelerated UV-A irradiation adapted to stromal thickness. Patients were followed for up to 12 months with serial tomography and clinical evaluation.

At one year, mean K2 flattening was 6.0 diopters, with a mean localized corneal thickness reduction of 39 µm over the cone, consistent with a controlled coupling effect. No significant adverse events were observed. The procedure demonstrated stable biomechanical outcomes with concurrent optical regularization.

CAMEO represents a shift from purely stabilizing cross-linking toward customized, optics-driven corneal remodeling. The platform can be performed in both laser-guided (CAMEO-LFX) and manual (CAMEO-M) formats, enabling broader accessibility and democratization of personalized cross-linking without reliance on proprietary systems.