Corneal collagen crosslinking (CXL) is an FDA-approved, non-invasive treatment for keratoconus and corneal ectasias. Cross-linking is not a cure for keratoconus. It is used to halt the progression of the condition and prevent further deterioration in vision and the need for a cornea transplant.

CXL involves applying a photosensitizing solution consisting of Riboflavin (vitamin B2) to the cornea and exposing it to a low dose of ultra-violet light. The Riboflavin reacts with the ultraviolet light to create new collagen bonds (crosslinks) throughout the cornea. In corneas affected by keratoconus, there are too few collagen bonds to maintain structural integrity. The reduced number of collagen bonds and weakened configuration result in corneal bulging, steepening, and corneal surface irregularity – all of which significantly affect vision. By creating new collagen bonds, CXL strengthens and adds resilience to corneas weakened by keratoconus. If performed early enough, CXL can counteract the progressive nature of keratoconus and allow good vision to be preserved. In advanced cases, CXL can postpone the need for invasive corneal transplants.

How is Treatment Done?

CXL is a straight-forward and painless procedure performed in a treatment room under topical anesthesia. Riboflavin drops are applied to the cornea for 30-60 minutes. Afterward, low-dose ultraviolet light is applied for 30 minutes.

There is some discomfort during the recovery period as the numbing drops begin to wear off, but usually not during the treatment. Discomfort is often described as a gritty, burning sensation, that can be managed with Tylenol and artificial tears. You may notice a sensitivity to light and may want to wear sunglasses. You may also experience the sensation of having a foreign body in the eye. You should not rub your eyes for the first few days after the procedure. If you experience severe pain in the eye(s) or any sudden decrease in vision, contact your ophthalmologist immediately.

Can Ultraviolet Light Hurt My Eyes?

Ultraviolet light used for the CXL treatment was specifically selected to be safe on the cornea, lens, and retina while still being sufficient to induce collagen cross-linking. Clinical studies have demonstrated that the amount of light that reaches the deeper structures in the eye is not strong enough to cause damage. Furthermore, the ultraviolet light is measured and calibrated prior to each treatment to ensure that safe exposure levels are not exceeded.

Is Corneal Collagen Cross-Linking Right For You?

CXL is a treatment for keratoconus and other corneal ectasias, but not all patients with these conditions are suitable for CXL. To find out if you are a good candidate for CXL, or if you need more information about treatment, call Raleigh Ophthalmology at (919) 782-5400, or ask your doctor to schedule a consultation with Dr. Patrick Laber.