Cross-linking treatment

Keratoconus CXL Treatment to Firm the Cornea

Corneal crosslinking (CXL) is a treatment to stop the thinning and deformation of the cornea due to keratoconus. This prevents deterioration of visual acuity. Corneal crosslinking of the cornea is performed by a specialized ophthalmologist. The aim of the treatment is to make the cornea firmer.

How does corneal crosslinking work?

The cornea is made up of very fine fibrils (collagen fibres). These fibers form a well-arranged and strong network, which, due to their special structure, gives the cornea clarity and firmness. Keratoconus is a weakened firmness. CXL connects the fibrils together, making the cornea firmer and stopping the cornea from thinning and bulging. Since CXL has been used, the number of corneal transplants in people with keratoconus has decreased significantly.

When a corneal crosslinking treatment?

CXL is performed if keratoconus has progressed within one year. Young people under the age of 30 are especially suitable for this treatment. Keratoconus usually stabilizes on its own after the age of 35. The cornea does need a minimum thickness to be eligible for this treatment. The ophthalmologist will inform you about this.

How does the corneal crosslinking treatment work?

The keratoconus CXL treatment is a day treatment without anesthesia and without injection. Hospitalization is also not necessary. During the treatment, the eye is sterile covered. A small spacer is then placed between the eyelids so that you cannot blink during the treatment. The covering (epithelium) of the cornea is first removed. You won’t feel anything because of the anesthetic drops. Then the eye is instilled with vitamin B2 (Riboflavin) eye drops for half an hour. The eye is then irradiated with UV light for another 30 minutes. The last step is that a bandage contact lens is placed on the eye, which acts like a bandage to protect your eye.

After treatment

It takes a few days for the epithelium to heal. Until then, the cornea is painful. The protective bandage lens, along with pain relievers and artificial tears, helps to relieve the discomfort. Since the cornea is more vulnerable to infection during this time, antibiotic eye drops are also prescribed. After the corneal cross-linking treatment, the cornea is regularly checked.

Still need lenses or glasses after CXL treatment?

Most people still need glasses or contact lenses after a keratoconus CXL treatment. In some cases, making the cornea more firm also goes hand in hand with making the cornea flatter. For some people this may mean that they no longer need glasses or contact lenses.

What are the risks of CXL treatment?

In general, corneal cross-linking treatment is safe with a very small risk of complications. Complications that can occur include infection, sterile inflammation, scarring of the cornea, and damage to the inner layer of the cornea. There may also be problems with the healing of the covering (epithelium) of the cornea. These complications can lead to permanent cloudiness in the cornea that affects visual acuity. In a small proportion of patients, the keratoconus can still get worse, despite a technically well-performed corneal crosslinking treatment.