What is Corneal Cross-Linking?
 
Cross-linking is a minimally invasive outpatient procedure that combines the use of UVA light and riboflavin eye drops to add stiffness to corneas which have been weakened by disease or refractive surgery. Cross-linking, which has been performed in Europe since 2003, is considered the standard of care around the world for keratoconus and corneal ectasia following refractive surgery.

Keratoconus, often referred to as ‘KC’, is a non-inflammatory eye condition in which the typically round dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and optical irregularity of the cornea. This causes ‘static’ in your vision and can result in significant visual impairment.


Symptoms 
Keratoconus typically first appears in individuals who are in their late teens or early twenties, and may progress for 10-20 years, and then slow or stabilize. Each eye may be affected differently. In the early stages of keratoconus, people might experience:


Slight blurring of vision

Distortion of vision

Increased sensitivity to light

 

The cornea is responsible for focusing most of the light that comes into the eye. Therefore, abnormalities of the cornea, such as keratoconus, can have a major impact on how an individual sees the world, making simple tasks such as driving a car or reading a book very difficult.  Keratoconus can result in significant vision loss; and may lead to corneal transplant in severe cases. 

Is Cross-Linking Right for Me?

Patients over the age of 14 who have been diagnosed with progressive keratoconus or corneal ectasia following refractive surgery should ask their doctor about corneal cross-linking.

 

Our practice is proud to offer patients in our practice the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus. This approval offers an effective treatment for patients who, until recently, had no therapeutic options to limit the progression of this sight-threatening disease.

Cross-Linking for Progressive Keratoconus Video 
Corneal Cross-Linking
Corneal Cross-Linking

What is keratoconus?

Keratoconus, often referred to as “KC”, is a non-inflammatory eye condition in which the typically round dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and optical irregularity of the cornea. This causes “static” in your vision and can result in significant vision impairment.

 

What is cross-linking?

Cross-linking is a minimally invasive, FDA approved, outpatient procedure that combines the use of riboflavin eye drops, Photrexa® Viscous, (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution), and ultra-violet A (UVA) light from the KXL® system for the treatment of progressive keratoconus.

What is riboflavin?

Riboflavin (vitamin B2) is naturally occurring in the body, including the eye. It is a photosensitizer. Riboflavin is non-toxic and is used as an additive in food and pharmaceuticals.

What is ultra-violet A (UVA) light?

UVA is one of the three types of invisible light rays given off by the sun (together with ultra- violet B and ultra-violet C) and is the weakest of the three.

Does corneal cross-linking require removal of the epithelium?

Yes, your doctor will apply topical anesthesia to numb the eye prior to the removal of the eipthelium. This process helps to prepare your eye so that the drug can penetrate the tissue of the cornea to have an effective cross-linking procedure.

Am I awake during the procedure?

Yes, typically you will be awake during the treatment. You’ll be given relaxing medication and numbing anesthetic drops.

 

How long does the treatment take?

The actual procedure takes about an hour, but you will be at the office for approximately two hours to allow sufficient time for preparation and recovery before you return to the comfort of your own home.

 

What can I expect during the procedure?

  • After numbing drops are applied, the epithelium (the thin layer on the surface of the cornea) is gently removed.

  • Photrexa Viscous eye drops will be applied to the cornea for at least 30 min;

  • Depending on the thickness of your cornea, Photrexa drops may also be required.

  • The cornea is then exposed to UV light for 30 minutes while additional Photrexa Viscous drops are applied.

 

What can I expect after the procedure?

  • You should not rub your eyes for the first five days after the procedure.

  • You may notice a sensitivity to light and have a foreign body sensation. You may also experience discomfort in the treated eye and sunglasses may help with light sensitivity.

  • If you experience severe pain in the eye or any sudden decrease in vision, you should contact your physician immediately.

  • If your bandage contact lens from the day of treatment falls out or becomes dislodged, you should not replace it and contact your physician immediately.

 

Does it hurt?

There is some discomfort during immediate recovery but usually not during the treatment. Immediately following treatment, a bandage contact lens is placed on the surface of the eye to protect the newly treated area. After the numbing drops wear off, there is some discomfort, often described as a gritty, burning sensation managed with Tylenol and artificial tears. If pain is severe, oral narcotic medications may be used.

 

Can anyone tell by my appearance that I have had cross-linking?

No. There is no change in the appearance of your eyes following cross-linking.

 

Is cross-linking right for me?

Patients over the age of 14 who have been diagnosed with progressive keratoconus should ask their doctor whether they may be an appropriate candidate for corneal cross-linking.

 

Will I need to be out of my contact lenses for this process?
Yes. Typically, doctors ask their patients to stop wearing contact lenses prior to surgery for up to a period of several weeks. Once treated, patients may not be allowed back into contact lenses for 1 month.

How much does corneal cross-linking cost?

Please contact our practice for specific pricing information.