Collagen crosslinking (CXL) is a low-risk, painless, in-office procedure performed for patients with keratoconus or post-LASIK ectasia. The procedure is meant to halt the progression of keratoconus to prevent worsening of vision and astigmatism and delay or even eliminate the need for a corneal transplant in the future.
Our office is proud to offer “epithelial-on” crosslinking. This means that the top layer of the cornea is not removed to perform the procedure, allowing for faster healing and less discomfort compared to the older “epithelial-off” version. The procedure involves placing frequent vitamin eye drops (Riboflavin or B2) and then exposing the cornea to a UVA light to strengthen the corneal tissue. Although “epithelial-on” CXL is not yet FDA approved, it’s safety and success is well supported by evidence in the literature. 95% of patients will have no further vision loss after the procedure. The earlier this condition is treated, the better.
Preparing for the procedure
Patients will have a consultation prior to scheduling CXL in order to determine if the patient is a good candidate and if this is the best procedure for the patient’s condition. Generally, patients who are pregnant or nursing, or patients with advanced keratoconus with very thin corneas are not candidates for CXL. Patients who have had corneal transplants in the past may still be candidates for CXL. For some patients, CXL can be combined with (hyperlink) Intacs® to further improve the vision. The CXL procedure is not usually covered by insurance and our certified coordinators will discuss this with you at the time of your consultation.
What to expect
The procedure itself takes about an hour. Patients will be lying flat for the majority of the procedure. They may bring headphones with music to listen to during the procedure. An eyelid speculum will be placed in the eye to help the patient avoid blinking. Most of the procedure will involve a technician instilling eye drops in the eyes. Then your doctor will check the corneal absorption of the drops prior to the UVA light treatment. After the procedure is completed, a special soft contact lens will be placed in the eyes to facilitate healing. You will receive instructions regarding your post-CXL eye drops at the time of your procedure.
There may be some mild discomfort, light sensitivity or foreign-body sensation for 24-48 hours after CXL while the eyes heal. Patients will see their doctor 3-4 days later, at which time the contact lens will be removed.
If you wear contact lenses for your vision, you will be asked to refrain from wearing them for about a week after the procedure. CXL may improve the vision, so it is possible you may require updated glasses or contacts. Most patients return to their normal activities within 2-3 days of procedure. Though the procedure is highly successful, patients will be followed closely afterwards, either by our doctors or your regular eye doctor, to ensure that the condition is not progressing. Usually only one treatment is required, but if there are signs of progression, the procedure can be repeated.
For more information or to schedule a consultation, please call 561-624-7878 and speak to one of our coordinators today.