Corneal Collagen Crosslinking

Corneal Collagen Crosslinking for Keratoconus (CXL)

Corneal collagen crosslinking (CXL or C3R) is a technique that has been developed over the past 15 years to strengthen the cornea, which is the clear window at the front of the eye. This is important in progressive keratoconus or corneal ectasia where there is continued deformation of the corneal shape and progressive vision loss.

Crosslinking working by increasing the bonds (cross linking) between the collagen fibres in the cornea. Studies have shown that CXL is successful at stabilising progressive keratoconus in over 90% cases.

The Corneal Collagen Crosslinking Procedure

Crosslinking is a straightforward procedure performed under local anaesthetic drops. “Epithelium off” is the preferred technique as “epithelium on” crosslinking has been shown by studies to be less effective.

The treatment involves applying yellow vitamin B2 eye drops (riboflavin) followed by carefully controlled pulses of ultraviolet A (UV-A) light using the Avedro Mosaic PiXL system.

Overall crosslinking is a safe procedure, but like all surgeries there are some risks. Approximately 3% cases may loose some vision that glasses or contact lens cannot correct due to corneal haze or scarring.

To help put risks into perspective, one in five patients with progressive keratoconus go on to need a corneal transplant, whilst the risk of needing a corneal transplant to restore vision following a serious complication in crosslinking is estimated to be 1/2000. It is important to remember that the main aim of CXL is to stabilise, and not to improve vision.

Corneal Collagen Crosslinking

Arrange a


To arrange a consultation call my team at Moorfields Private Eye Hospital, 9-11 Bath Street, EC1V 9LF, London, or complete the contact form.

020 7100 5468