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Corneal Crosslinking

What is Corneal Crosslinking?

Here at Stahl Eyecare Experts, our goal is to provide our patients with the best possible treatment options. That’s why we offer Corneal cross-linking (CXL) for our patients with keratoconus.

We understand that keratoconus can make life difficult. Many people with keratoconus avoid treatment because they are afraid to have a corneal transplant. What if we told you that CXL significantly decreases your chances of needing a corneal transplant? Well, it’s true!

Keratoconus, a disease that affects 1 in 750 Americans, causes the cornea to become weak and “bulge” into a cone-like shape. Corneal cross-linking is an amazing procedure that helps to actually strengthen your cornea, often stopping the progression of keratoconus altogether.

Frequently Asked Questions:

What is keratoconus?

Keratoconus is a progressive eye disease that causes the cornea to become weak and thin. Because of the progressive thinning in the cornea, the cornea begins to take on a cone-shape. This cone-shaped cornea distorts vision and causes high levels of astigmatism. Patients with keratoconus generally require a corneal transplant when the disease becomes severe.

What is astigmatism?

Astigmatism occurs when the surface of the cornea is irregular in shape. This irregularity causes distortion in the way the cornea reflects light onto the retina. Astigmatism causes blurry vision and glare.

What is CXL?

Normal corneas have crosslinks between its collagen fibers that keep your cornea strong and able to hold its shape. Patients with keratoconus do not have enough of these crosslinks.

Corneal cross-linking works by using a combination of liquid riboflavin (vitamin B-12) and ultraviolet light. Together, these work to strengthen the corneal crosslinks. After treatment, the cornea is more stable, strong and able to hold its shape.

Is CXL for everyone with keratoconus?

Not everyone can safely undergo corneal cross-linking. Those with severe keratoconus may not qualify because of extreme thinness and scarring of the cornea.

Is it effective?

Corneal cross-linking has been proven to be extremely effective in slowing or stopping the progression of keratoconus. Studies have shown corneal cross-linking prevents further vision loss in over 95% of patients and improves vision in 60-81% of patients.

How does the procedure work?

The corneal cross-linking procedure is painless and quick with little to no downtime required. The procedure will occur in our office as an outpatient procedure.

To start, your doctor will administer numbing eye drops and a mild sedative to keep you calm during the procedure. Your doctor will then ask you to look up at a soft blue light. This is the ultraviolet light.

If you are having epithelium-off CXL, your doctor will remove the epithelium (a thin layer of tissue on the cornea.) If you are having epithelium-on CXL, the epithelium will remain intact. Next, riboflavin drops will be used in your eye. While these drops are in your eye, you are asked to look up at the ultraviolet light.

The amount of time the light and drops will be kept on your eye depends on your specific case. Generally, this procedure takes about an hour and a half. Afterwards, you will be able to go home. Be sure to have someone there to drive you!

What happens after the procedure?

Most patients actually experience worse vision directly after the procedure as the epithelium grows back. Positive effects begin at around the 4-8 week mark. Major improvements are achieved at about 3 to 6 months after the procedure.

How soon you are able to return to your daily activities depends on which type of CXL you get. If you had epithelium-off CXL, you can return to daily activities in around a week. With epithelium-on CXL, you are able to return to daily activities the next day.

You may resume wearing contact lenses about 2 to 6 weeks after your CXL procedure. You may need to be examined for a new prescription, as most patients find that their old prescriptions are too strong after the procedure.

If you are interested in corneal cross-linking and would like to see if it’s right for you, contact our staff at Stahl Eyecare Experts. Located conveniently in Garden City, Manhattan, and Hauppauge, our expert doctors are here to help you see clearly! Don’t wait for your keratoconus to worsen, call Stahl today!