Corneal Cross-Linking

Cross-linking is surgery to treat a weakened or warped cornea. Disease or sometimes surgery can harm collagen-an important substance that holds the cornea together. “Cross-linking” new collagen fibers together strengthens and reinforces the cornea.

Cross-linking is approved for use in people with:

  • Keratoconus: With keratoconus, the cornea thins and changes shape over time. The cornea-normally rounded-bulges outward until it’s shaped like a cone. This causes blurry vision. At times corneal cross-linking is recommended.
  • Corneal bulging (ectasia) after LASIK surgery: LASIK removes corneal tissue to correct blurry vision. Rarely, the removal of tissue weakens the cornea, and it bulges forward, like keratoconus.

Procedure

  • Cross linking is an outpatient procedure. Here is what to expect:
    • Drops will be inserted in your eyes to numb them.
    • A thin outer layer of the cornea will be removed so that the medication can reach deeper into the cornea. With the numbing drops pain will not be felt.
    • Vitamin B (riboflavin) eye drop medicine is applied to the cornea for about 30 minutes.
    • A special device shines a focused beam of UV light rays at your cornea for close to 30 minutes. The light activates the riboflavin in the cornea which helps form new bonds between the collagen fibers in the cornea.
    • A bandage contact lens is placed over the eye(s) to help the cornea heal. The bandage lens is left in place for a week.
  • During the first week as eyes are healing do not:
    • Touch or rub eyes.
    •  Get water in eyes.
    • Use eye makeup.
    •  Do heavy exercise.
    • Be in places that are smoky or dusty.
  • Common side effects of cross-linking surgery:
    • Feeling like something is in the eye (called “foreign body sensation”)
    • Being sensitive to light.
    • Having dry eye.
    • Having hazy or blurry vision.
    • Feeling eye discomfort or mild eye pain.
  • More serious side effects include:
    • Worsening of keratoconus
    • Scarring
    • Infection
    • Loss of vision

Recovery Time

Most people can get back to their normal daily activities within 1-2 weeks of cross-linking. Vision from the surgery may not be fully stable for several months. After six to eight weeks, a refit of glasses or hard contact lenses will take place.

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