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Do You Know About Corneal Cross-Linking for Keratoconus?

Corneal cross-linking is a procedure that strengthens the tissues in your cornea in order to prevent further deterioration from keratoconus. Learn more about this surgery and to find out if you may be a good candidate for corneal cross-linking.

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What is Corneal Cross-Linking for Keratoconus?

The following article discusses the benefits of corneal cross-linking for people with moderate keratoconus.

Corneal collagen cross-linking is a medical procedure to treat progressive keratoconus, a degenerative eye disease that causes thinning and distortion of the cornea, leading to impaired vision. While usually affecting both eyes, it is not uncommon for one eye to degenerate faster. It involves a treatment of riboflavin eye drops and UV light to prevent further corneal deterioration.

Human corneas are normally spherical in shape. With this condition, the corneas bulge outward becoming more cone-like. As the condition degenerates, complications with vision increase. Fortunately, with proper treatment, there is minimal risk of a total loss of vision. The following section will discuss:

  • the kind of patient that this surgery is appropriate for
  • what to expect during this procedure
  • what to expect after surgery
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Which Keratoconus Patients Are Candidates for Cross-linking?

Cross-linking is suited for those patients where corneal alterations are minimal. If vision losses are severe or the cornea has drastically changed shape from advanced keratoconus, this intervention may cease to be an option. The purpose is to slow the progression of keratoconus. Your doctor will first have to assess overall eye health and measure corneal thickness to determine if you are a candidate. Topography of the cornea is a form of mapping to determine if the procedure is suitable.

Treatment of Keratoconus: What Happens During Surgery?

Treatment of Keratoconus: What Happens During Surgery?

The surgery should take approximately 1 hour to complete and is usually performed with mild sedative and numbing eye drops. In cases where both eyes require the procedure, the standard practice is to work on one eye and then continue with the other eye when the patient recovers. 

The process involves a treatment where the patient's eye is saturated with riboflavin solution eye drops and treated with UV light to strengthen collagen fibers in the eye. The purpose of corneal cross-linking is to prevent further changes to the shape of the cornea and to slow down additional vision loss. An added advantage is that clinical studies show that it may prevent the need for corneal transplantation.

What Can I Expect Post Surgery?

What Can I Expect Post Surgery?

Common post-surgery symptoms for patients include:

  • irritation to light
  • dry eyes
  • Minor discomfort or pain
  • a gritty feeling

Contact your eye doctor if you experience severe pain or other symptoms that suggest infection or other complications after the surgery. Speak to your doctor about the available post-operation options to treat pain and discomfort. Always remember to refrain from rubbing your eyes or touching the area in general.

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Common Questions

Although it varies, many keratoconus patients report that the procedure is not painful. Complaints about pain following surgery are more common. Contact your doctor right away if the pain is severe.
Cross-linking is an outpatient procedure and it does not involve surgical incisions. It is designed to slow down the progression of keratoconus using a combination of UV light and riboflavin, provided that the patient retains adequate corneal thickness. It is regarded as minimally invasive and low risk. Corneal transplant surgery is a proper medical operation, with the possibility of corneal rejection as with any medical transplant.
Riboflavin is a water soluble vitamin also known as Vitamin B2. It has two benefits: Absorbing most of the UV radiation and acting as a photosensitizer.
Always speak with your medical provider for all questions involving protocols and policy.
Yes, you can wear glasses after CXL. While CXL aims to stabilize the cornea, it does not typically correct vision, so glasses or contact lenses may still be necessary. An eye doctor will conduct a contact lens exam or vision assessment to determine the right prescription post-procedure.
Watching TV after crosslinking is generally fine, but it might be uncomfortable due to increased sensitivity and blurry vision immediately after the procedure. It's best to follow the recommendations of your optometrist for post-operative care and comfort.
After crosslinking, it's important to avoid rubbing the eyes, exposing them to dusty or dirty environments, swimming, or wearing contact lenses for a period as advised by the eye doctor. Using prescribed eye drops and attending follow-up appointments is vital to ensure proper healing and to monitor progress.
Blurry vision after CXL can last anywhere from a few days to several weeks, depending on individual healing rates and the specific technique used. Regular follow-ups with a keratoconus specialist will help monitor recovery, and a comprehensive contact lens exam may be required to update vision correction as the eye heals.
Do You Know About Corneal Cross-Linking for Keratoconus?
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Summary

Corneal collagen cross-linking is a unique intervention for moderate cases of progressive keratoconus where the cornea retains requisite thickness for the surgery. It is only effective for a patient who has not sustained significant vision loss or significant corneal alterations. With advanced keratoconus, this may no longer be a viable option. It is not a cure or a procedure to fix the condition. It prevents the condition from degrading.

Cross-linking involves a unique treatment where riboflavin eye drops and Ultraviolet light are utilized to prevent further deterioration of the cornea and to slow down visual deficits. Speak with your eye doctor if you have keratoconus and would like to find out more about this procedure. 

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