Collagen Cross Linking (CXL)

Collagen Cross-Linking (CXL) is a medical procedure used to treat progressive keratoconus and other corneal ectatic disorders. The procedure strengthens the cornea by increasing the collagen cross-links within the corneal tissue, which stabilizes the cornea and prevents further thinning and bulging. This treatment can halt the progression of keratoconus, a condition where the cornea becomes thin and cone-shaped, leading to distorted vision.

How Collagen Cross-Linking Works:
  • Preparation: The eye is numbed using anesthetic drops to ensure patient comfort during the procedure. In some cases, the epithelial layer of the cornea is removed (epithelium-off) to allow better penetration of the riboflavin solution. In other cases, the epithelium is left intact (epithelium-on) to reduce discomfort and recovery time.
  • Riboflavin Application: Riboflavin (vitamin B2) eye drops are applied to the cornea for a specific period, usually around 30 minutes. This helps saturate the corneal tissue.
  • Ultraviolet (UV) Light Exposure: After the riboflavin has sufficiently saturated the corneal tissue, the eye is exposed to a controlled amount of UV-A light for another 30 minutes. The UV light activates the riboflavin, which in turn strengthens the collagen fibers by creating additional cross-links between them.
  • Post-Treatment: Antibiotic and anti-inflammatory eye drops are administered to prevent infection and reduce inflammation. A soft contact lens may be placed on the eye to protect it during the initial healing phase, especially if the epithelium was removed.
Benefits of Collagen Cross-Linking:
  • Stabilization of Keratoconus: The primary benefit is halting the progression of keratoconus, preventing further deterioration in vision.
  • Increased Corneal Strength: By strengthening the corneal structure, CXL can prevent or delay the need for more invasive procedures like corneal transplantation.
  • Improved Vision: In some cases, patients experience a slight improvement in vision and corneal shape, although the main goal is to stabilize the condition.
  • Minimally Invasive: CXL is a relatively simple and minimally invasive procedure with a relatively short recovery time.