Cross-Linking

A UV light treatment that can stop progressive changes in corneal shape and prevent loss of vision.

What is Cross-Linking?

Corneal collagen cross-linking is a technique which uses UV light and a photosensitizer to strengthen chemical bonds in the cornea. The goal of the treatment is to halt progressive and irregular changes in corneal shape known as ectasia. 

These changes are typically marked by corneal thinning and an increase in the anterior and/or posterior curvatures of the cornea, and often lead to high levels of myopia and astigmatism. The most common form of ectasia is keratoconus.

When is cross-linking used?

The primary purpose of cross-linking is to halt the progression of ectasia. Likewise, the best candidate for this therapy is an individual with keratoconus or post-refractive surgery ectasia who has documented progression of the disease. 

There currently are no definitive criteria for progression, but parameters to consider are changes in refraction (including astigmatism), uncorrected visual acuity, best corrected visual acuity, and corneal shape (topography and tomography).

Contraindications

  • Corneal thickness of less than 400 microns is a contraindication to the standard treatment protocol
  • Prior herpes infection is a contraindication because it may result in viral reactivation
  • Concurrent infection
  • Severe corneal scarring or opacification
  • History of poor epithelial wound healing
  • Severe ocular surface disease (e.g. dry eye)
  • Autoimmune disorders

How does it work?

The primary goal of the first stage of cross-linking therapy is to allow riboflavin (vitamin B2) solution to diffuse into the cornea. While there are several variations on the techniques used to accomplish this, all entail either removing or weakening the epithelial barrier of the cornea. In all instances the patient is first given anesthetic drops. 

After adequate riboflavin absorption, the corneal thickness is checked and more solution is applied until the corneal thickness reaches 400 microns. Then eye is then irradiated with UV light at a small distance (1-5cm) from the corneal apex for 30 minutes. 

Following irradiation, antibiotic drops and steroid drops are instilled are and a bandage contact lens is placed. The patient is given eye drops post operatively for a few days.

The bandage contact lens will be removed 3 days after the procedure. An eye shield is applied to the eye for the first 24 hours. Patients should wear sunglasses for the first 5 days while recovering at home.

Other Treatments

Learn More

Refractive Lens Exchange

Replacing the natural lens of your eye, and inserting a tailor made lens that can help you see from near and far distances without the use of spectacles.

Cataract Extraction

Removing the cloudy lens, and replacing it with a premium lens for a better visual outcome.

Phakic Lens Implantation

Inserting a small lens beneath the surface of the eye for those having high myopia and wanting to get rid of their glasses or contact lenses.

Intracorneal Ring Segments (ICRS) Implantation

Inserting an ophthalmic medical device for reducing or eliminating myopia and astigmatism in patients with keratoconus.

Ready to correct your vision?