In the early stages of Keratoconus, glasses or soft contact lenses may be used to correct vision. However, as the cornea becomes thinner and steeper (more cone-shaped) and develops scarring, patients may then be required to have a cornea transplant
Since the introduction of the relatively new treatment corneal collagen cross-linking (CXL), early detection of Keratoconus has proven more vital as CXL has the ability to stop the disease from progressing and has shown to be effective in 94% of patients.
As Keratoconus continues to advance, the Clinica London Corneal Surgeons, advises Corneal Collagen Cross-linking (CXL) to prevent worsening. They can determine the extent and progression of any keratoconus using eye-scanning technology known as corneal topography, which accurately assesses the shape of the cornea.
What is corneal collagen cross linking? (CXL)?
CXL is an outpatient local anaesthetic treatment to stabilise the progression of Keratoconus. The treatment results in binding and strengthening of the collagen fibres. A small scratch is made on the cornea and riboflavin drops dropped onto the eye for ten minutes to soak into the cornea. The surgeon then applies ultraviolet light using a special machine called a crosslinker. The action of the riboflavin with the UV light and the collagen fibres is to bind them together. This process takes about an hour. The procedure is pain-free, but during the first 24hrs, there is some discomfort; therefore, the patient is the given eye drops to relieve this and often a clear bandage contact lens. It takes about a month for the surface to fully heal and settle.
- CXL prevents progression and need for a corneal transplant.
- CXL treatment gives you the security of not having a corneal transplant always at the back of your mind.
- Corneal Collagen Cross-Linking (CXL) at Clinica London
As this treatment is relatively new, not all clinics have the capability to undertake it.
Clinica London is proud to be one of the few clinics to offer this innovative new treatment requiring specialist skill, training, and equipment, led by one of our Corneal surgeons.
The CXL treatment is a minimally invasive procedure that uses ultraviolet light and eye drops to strengthen the collagen in the cornea.
The CXL procedure
The corneal surgeon at Clinica London carries out the CXL procedure with anaesthetic eye drops. CXL treatment involves removing the fine surface layer of the cornea known as the epithelium. Then Riboflavin (Vitamin B12) drops are applied to the cornea and ultraviolet light is shone on the eye. The eye drops are made of a substance similar to photo enhancing. This enables cross-linking to take place. The procedure allows for new corneal collagen cross-links to develop. Those cross links then cause the collagen fibrils to shorten and thicken, the outcome is then a stiffer, stronger cornea. The first 24 hours of the procedure can often result in pain and irritation from the eye.
Corneal cross-linking normally requires one week for recovery. Some patients face discomfort and pain for up to 5 days.
Potential risks of CXL
The benefits of CXL outweigh the risks in progressive Keratoconus. The rare risks include corneal infection and corneal haze.
We advise patients to take a few days off after the procedure to enable recovery. They can resume contact lens wear once the corneal epithelium heals. We give antibiotic eye drops, anti-inflammatory drops, and lubricant eye drops after the procedure.
How successful is keratoconus treatment?
In early Keratoconus, patients can typically normalise reduced vision with glasses or contact lenses.
CXL aims to stabilise the Keratoconus and is successful in over 94% treatments. It prevents the progression of Keratoconus and hence reduces the need for a corneal transplant.
In advanced Keratoconus, either contact lenses cannot fit the corneal shape, or the cornea becomes scarred and CXL will not be effective. In these situations, vision will be poor and our Corneal Surgeon at Clinica London may offer corneal transplantation to improve vision and enable contact lens wear.