Corneal Collagen Crosslinking for Keratoconus (CXL) London

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.

Frequently Asked Questions

Does Corneal Collagen Cross Linking Improve Vision?

Corneal collagen crosslinking is performed to strengthen the cornea, not to change the focus of the eye. Crosslinking typically causes a small degree of corneal flattening and so those with keratoconus will likely notice a small reduction in their glasses or contact lens prescription.

How Long Does It Take To Recover From Corneal Cross Linking?

You should expect to be off work for at least one week whilst the eye(s) heal and you will find the vision takes a few weeks to recover the same clarity as before surgery. Contact lens wear can typically be restarted after two weeks.

How Effective Is Corneal Cross Linking?

Corneal collagen crosslinking is the only treatment available at present to stop keratoconus from worsening. Data from large randomised controlled trials show that corneal collagen crosslinking is effective in preventing further keratoconus progression is over 90% cases with up to 10 years followup.

How Painful Is Corneal Cross Linking?

The actual procedure itself is painless as anaesthetic eye drops are used. The vast majority of the healing process takes 48-72 hours and during this the eye(s) can be quite sore and light sensitive. The sensation is a bit like you’ve been chopping onions.

How Much Does Corneal Cross Linking Cost?

Corneal Collagen Crosslinking Pricing – Click Here

How Is Corneal Cross Linking Performed?

Corneal collagen crosslinking is done under local anesthesia and the total treatment time is about 30 minutes for both eyes. The method of choice is termed accelerated “epithelium off” crosslinking. The duration of pulsed ultraviolet light exposure is 8 minutes.

What Should You Not Do After Cross Linking?

For the first few days after cross linking, you should be at home resting and concentrating on applying the eye drops which are hourly during the daytime to start. You can wash and shower as normal but should avoid getting water in the eyes for the first two days. You should avoid strenuous exercise for a week, and swimming for at least two weeks.

Can I Watch TV After Cross Linking?

Yes, watching TV will not cause any harm or damage to your eyes, but the eyes will be uncomfortable for the first 2-3 days after surgery.

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