Cornea Collagen Cross-Linking

Keratoconus (ker-uh-toe-KOH-nus) occurs when your cornea — the clear, dome-shaped front surface of your eye — thins and gradually bulges outward into a cone shape.

What Is Corneal Cross-Linking?

In this condition, the front part of your eye, called the cornea, thins out and gets weaker over time. This makes it bulge into a cone shape, which can distort your vision and make it hard to see. If the symptoms of keratoconus get severe, you will need a corneal transplant.

In corneal cross-linking, doctors use eyedrop medication and ultraviolet (UV) light from a special machine to make the tissues in your cornea stronger. The goal is to keep the cornea from bulging more.

It’s called “cross-linking” because it adds bonds between the collagen fibers in your eye. They work like support beams to help the cornea stay stable.

Corneal cross-linking is the only treatment that can stop progressive keratoconus from getting worse. And it may help you avoid a corneal transplant, which is major surgery.

What Happens During the Procedure

Your doctor can do the corneal cross-linking procedure in their office.

First, you’ll get drops that numb your eyes and a medicine to calm you if needed.

Then, your doctor will put in specially formulated riboflavin (vitamin B2) eyedrops, which allow your cornea to better absorb light. It takes about 30 minutes for the drops to soak into your cornea.
Then, you’ll lie back in a chair and look up at a light. You shouldn’t feel any pain during the procedure because your eyes will be numb.

The entire treatment takes about 60-90 minutes.

Types of Corneal Cross-Linking

There are two types: epi-off and the experimental epi-on. (“Epi” is short for epithelium, the outer layer of the cornea.)

The epi-off technique means your doctor removes the epithelium before they put the drops in. 

With epi-on, your doctor loosens your epithelium with eyedrops or a sponge before they put the eyedrops in. 

Who Should Get Corneal Cross-Linking?

The procedure doesn’t reverse cornea changes that have already happened — it just keeps them from getting worse. Since it can help slow progression, it’s best to talk to your doctor sooner than later if you have keratoconus.

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