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What Is Keratoconus?
Keratoconus is a condition in which the cornea — the clear, dome-shaped front surface of the eye — progressively thins and bulges into a cone-like shape. This distortion scatters light entering the eye, causing blurred or distorted vision that glasses and standard contact lenses may not fully correct. It typically begins in the late teens to early adulthood and can continue to progress over several years if untreated.
Corneal Collagen Cross-Linking
What Is Corneal Collagen Cross-Linking (CXL)?
Corneal cross-linking is an outpatient procedure performed under topical anaesthesia (eye drops) for the treatment of keratoconus. It takes about 30 mins to perform and the down time is about 1 week. The cross-linking procedure is a 2-step process.
Firstly, the corneal epithelium (skin) is removed and then the underlying tissue is soaked with liquid riboflavin (vitamin B2). Following this, UV light is used to treat the eye in a controlled fashion. This procedure causes new bonds to form between the cornea fibres resulting in stabilization and strengthening.A bandage contact lens is placed on the eye to aid in healing and is usually removed after 1-2 weeks.
How Is the CXL Procedure Performed?
Step 1: Preparing the cornea
The outer layer of the cornea (the epithelium) is gently removed, and the underlying tissue is soaked with liquid riboflavin (vitamin B2).
Step 2: UV light treatment
UV light is applied to the eye in a controlled fashion, triggering new bonds to form between the corneal fibres. This strengthens and stabilises the cornea’s structure.
Step 3: Healing
A bandage contact lens is placed on the eye to support healing, and is usually removed after 1-2 weeks.
Combining CXL with Laser Vision Correction
Corneal cross-linking has, in recent years, also been combined with [laser vision correction] techniques, resulting in procedures such as SMILE Xtra and LASIK Xtra. The aim of performing corneal cross-linking alongside laser vision correction is to reduce the risk of corneal ectasia and refractive regression after surgery.
Frequently Asked Questions
What will a cornea specialist do?
A doctor managing corneal conditions will assess the shape, thickness and health of your cornea using specialised imaging, diagnose conditions such as keratoconus, and recommend treatment — from monitoring to procedures like corneal cross-linking.
Is corneal cross-linking painful?
The procedure is performed under topical anaesthesia (numbing eye drops), so discomfort during the procedure itself is minimal. Some irritation is common during the first few days of recovery while the corneal surface heals.
Does corneal cross-linking stop keratoconus from getting worse?
CXL is aimed at halting or slowing further progression of keratoconus by strengthening the cornea; it does not reverse existing distortion. Your eye doctor can advise on realistic expectations based on your specific condition.