Corneal cross-linking is a used in the treatment for an eye conditions such as keratoconus.

(Keratoconus is a condition in which the front part of the eye, called the cornea, becomes progressively thin and weak resulting in cornea to bulging into a cone shape, which can distort vision and make it difficult to see)The term “cross-linking” describes the special bonds formed between the collagen fibers in the cornea during the procedure. These bonds acts as support beams to help stabilize the cornea.


What Happens During the Procedure?

-You will be given medication to make you calm then Anesthetic / numbing drops will be applied to the cornea.

-The corneal epithelium is removed (Epi-off technique)

-Riboflavin (vitamin B2) drops will be applied which will react with the UVA light.

-For the rest of the procedure, you’ll lie on your back and look up at the UVA light. You should not feel any pain because your eyes will be numb.

The entire treatment takes about 30-60 minutes.


Types of Corneal Cross-Linking

There are two types: epi-off and epi-on. “Epi” is short for epithelium, a layer of tissue that covers your cornea.

In the Epi-off technique your doctor removes the epithelium before applying Riboflavin drops. Some experts believe that removing the epithelium allows the eye to better absorb the drops and UVA light. Recovery time is longer and there is more post-op discomfort with the Epi-off technique.

In the Epi-on technique the corneal epithelium is left intact resulting in less post op discomfort and a short recovery.


Who Should Get Corneal Cross-Linking?

Corneal cross-linking works best for patients in the early stages of keratoconus or with a recent diagnoses of the condition. The procedure does not reverse corneal changes that have already happened — it just keeps them from getting worse. Your doctor will help you decide if this treatment is appropriate for you.

How long is the Recovery?

The length of recovery varies with the type of CXL performed.

With the Epi-on procedure you will be able to resume regular activities as early as the following day.


If you had an Epi-off procedure you will be fitted with a soft bandage contact lens immediately and begin the use of  antibiotic and steroid drops for up to 2 weeks. You will experience significant discomfort the first 2 days following the procedure. The bandage contact lens will be removed in approximately 1 week and you should be able to resume routine activities. However, it will take several weeks for the epithelium to heal completely.
Usually, you can resume regular contacts lens wear after 2-4 weeks, however, there may be changes in your vision during the 3-6 months following CXL.