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Corneal Collagen Cross-linking

If you have been diagnosed with keratoconus, post-LASIK ectasia or another condition caused by a weakened stroma (middle layer of your cornea), you may benefit from an advanced procedure called corneal collagen cross-linking (CXL). This procedure works by strengthening collagen bonds in the stroma.

During the procedure, your surgeon applies eye drops with riboflavin (vitamin B2) and projects ultraviolet light onto your cornea to produce new, stronger bonds in the collagen. Corneal collagen cross-linking is sometimes combined with other procedures for enhanced effect, such as implantation of intrastromal corneal rings (e.g., Intacs) or surface laser ablation procedures (e.g., PRK, epi-LASIK).

Corneal collagen cross-linking is still being investigated by the FDA and therefore is not yet available in the U.S. However, it is being performed successfully abroad, and studies have demonstrated that the treatment is very effective.

Benefits of Corneal Collagen Cross-linking

If you have an eye condition caused by a weakened stroma, you are probably anxious to correct the vision problems the condition is causing you. Corneal collagen cross-linking can at least stop the progression of these problems and usually can give you better vision.

Here are some of the benefits of this amazing procedure:

  • Highly effective
  • Eye drops for anesthetic
  • Takes only one hour
  • Prevents further vision loss in almost all patients
  • Three-fourths of patients experience improved vision

Are you a Candidate?

If you are suffering from any of the following conditions, you may be a candidate for corneal collagen cross-linking:

  • Keratoconus
  • Ectasia
  • Pellucid marginal degeneration
  • Corneal ulcers
  • Corneal infections

Also, some surgeons have performed the procedure to stabilize the corneas of patients who previously underwent radial keratotomy (RK).

Corneal collagen cross-linking appears to work best on patients experiencing ongoing fluctuations in vision. In the future, it may even be used to stabilize the corneas of patients who otherwise might not be candidates for LASIK.

Not everyone is a good candidate for CXL. Schedule an appointment with an eye surgeon in your area to learn if you qualify.

Risks & Complications

Corneal collagen cross-linking is safe and effective. However, it usually does not fully correct for nearsightedness, farsightedness or astigmatism. In other words, you will probably need to wear glasses or contact lenses — or have refractive surgery — to achieve best corrected visual acuity (the best vision possible in your case). In fact, it is possible that you will not have 20/20 vision even after CXL and other surgeries.

Most risks associated with CXL are temporary or rare. That being said, potential complications include:

  • Moderate pain
  • Blurry vision (for a few days)
  • Infection
  • Corneal inflammation
  • Dry eye
  • Corneal haze
  • Mild redness
  • Stinging sensation
  • Temporary damage to cornea, retina or lens from overexposure to UV light, leading to temporary vision loss (1-2 days) or need for surgery

How Much Does Corneal Cross Linking Cost?

Because corneal collagen cross-linking is not yet available in the U.S., the exact cost is unknown at this time. However, you can expect the cost to range between $2,500 and $4,000 (per eye). When it does become available it is unlikely to be covered by insurance, unless the treatment is for a medical condition, such as keratoconus or corneal ulcers. However, financing options are available for such procedures. Speak to your eye surgeon to learn more about the cost of CXL.

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