Corneal Cross-linking
The treatment that stiffens a thinning cornea in keratoconus and stops progression: who it is for and how it is done.
Cross-linking is a treatment for keratoconus that has come into use in recent years. In keratoconus the cornea (the clear front layer of the eye) is thinner and more cone-shaped than normal. Keratoconus shows itself in adolescence through frequent changes in the spectacle prescription.
Cross-linking stiffens a cornea that is thinner than normal. In this way the steepness of the cornea can be reduced and the progression of the disease stopped or greatly slowed. It is not possible to make the cornea flatter with cross-linking in every patient, but in every treated patient the progression of the disease stops or slows considerably. In about half of patients the cornea flattens somewhat (by 2–3 dioptres).
Which Keratoconus Patients Can Have Cross-linking?
- Those whose corneal thickness is more than 400 microns
How Cross-linking Is Performed
- The eye is numbed with anaesthetic drops.
- The epithelium, the outermost layer of the cornea, is removed.
- Riboflavin (vitamin B2) is dropped into the eye every 2 minutes for 30 minutes.
- After 30 minutes, ultraviolet A light (370 nm) is directed at the eye. While the UVA light is applied, riboflavin continues to be dropped in every 2 minutes.
- After 10 minutes of UVA, a contact lens with no prescription is placed on the eye and the procedure is complete.
Possible Complications of Cross-linking
- Cross-linking should only be applied to corneas thicker than 400 microns. When this rule is followed, no side effects of cross-linking have been reported. The UV level must also be checked with a UVA meter.
Cross-linking at a Glance
- Anaesthesia
- Anaesthetic drops
- Duration
- 40 minutes per eye
- Bandage
- The eyes are not bandaged. A contact lens is placed on the eye.
- After surgery
- There is pain in the eye for the first 3 days.
- Vision
- When the contact lens is removed after 4 days, vision returns to its level before surgery or becomes better.
- Return to work
- After 5 days
- Eye drops
- Until the contact lens is removed, painkilling drops, antibiotic drops and artificial tears; after it is removed, mild steroid drops and artificial tears for as long as your doctor recommends
- Eye check-ups
- The day after surgery, after 4 days, 1 month and 3 months
Have your eyes assessed
Send your prescription history, previous eye reports and any corneal imaging for an individual assessment — in person in İstanbul or over video.
With every surgical or interventional procedure, results vary from person to person. Please obtain a detailed opinion from your doctor before any procedure.
This article is for general information only and does not replace a medical examination or personalised medical advice.