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- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: January 9, 2025
Corneal cross-linking (CXL) is a revolutionary treatment that has transformed the management of certain eye conditions, particularly keratoconus. At Blue Fin Vision® Eye Clinic in London, we specialise in this cutting-edge procedure, offering hope to patients struggling with progressive corneal disorders.
Understanding Corneal Cross-Linking
Corneal cross-linking is a minimally invasive procedure designed to strengthen the cornea, the clear front surface of the eye. The primary goal of this treatment is to halt the progression of keratoconus [see image below] and other corneal ectatic disorders, which cause the cornea to thin and bulge into a cone-like shape.
How Does Corneal Cross-Linking Work?
The corneal cross-linking procedure works by creating new bonds between collagen fibres in the cornea. This process is achieved through the combined use of riboflavin (vitamin B2) eye drops and ultraviolet (UV) light. The treatment effectively reinforces the corneal structure, much like adding extra support beams to a weakening framework.
Why Might You Need Corneal Cross-Linking?
The most common reason for undergoing corneal cross-linking is keratoconus, a progressive eye condition that typically begins in adolescence or early adulthood. However, there are other conditions that may benefit from this treatment:
- Keratoconus: A non-inflammatory eye condition causing the cornea to thin and bulge
- Pellucid Marginal Degeneration: A rare corneal disorder like keratoconus
- Post-refractive surgery ectasia: A complication that can occur after procedures like LASIK
Risk Factors for Keratoconus
While the exact cause of keratoconus is not fully understood, several factors may increase the risk:
- Genetics: A family history of keratoconus
- Eye rubbing: Excessive eye rubbing may contribute to the development of the condition
- Certain medical conditions: Such as Down syndrome, Ehlers-Danlos syndrome, and asthma
- Ethnicity: Some studies suggest a higher prevalence in certain ethnic groups
Recognising the Need for Treatment
The symptoms of keratoconus and other conditions that may require corneal cross-linking can vary but often include:
- Blurred or distorted vision
- Increased sensitivity to light and glare
- Frequent changes in eyeglass prescription
- Difficulty driving at night
- Eye strain
- Headaches
- Eye irritation or excessive eye rubbing
It’s crucial to consult an eye specialist if you experience these symptoms, as early detection and treatment can significantly improve outcomes.
The Corneal Cross-Linking Procedure: What to Expect
At Blue Fin Vision® Eye Clinic, we perform corneal cross-linking as an outpatient procedure. Here’s what you can expect during your visit:
- Preparation: Your eye will be numbed with anaesthetic drops, and you’ll be asked to lie back in a treatment chair.
- Epithelium Removal: In most cases, the outer layer of the cornea (epithelium) is gently removed to allow better penetration of the riboflavin drops.
- Riboflavin Application: Special riboflavin eye drops are applied to the cornea at regular intervals for about 30 minutes.
- UV Light Treatment: Once the cornea is saturated with riboflavin, a UV light is directed at the eye for approximately 8-10 minutes.
- Protective Lens Placement: A soft ‘bandage’ contact lens is placed on the eye to promote healing.
The entire corneal cross-linking procedure typically takes about 60-90 minutes per eye.
Types of Corneal Cross-Linking
There are two main types of corneal cross-linking:
- Epithelium-off (epi-off): This is the standard method where the epithelium is removed before treatment.
- Epithelium-on (epi-on): An experimental technique where the epithelium is left intact. This method is not currently approved in the UK.
Recovery and Aftercare
After the corneal cross-linking procedure, you can expect:
- Initial Discomfort: Your eye may feel sore for a few days. We’ll provide pain relief recommendations.
- Vision Changes: Your vision may be blurry at first but should gradually improve over several weeks.
- Follow-up Appointments: Regular check-ups will be scheduled to monitor your progress.
- Eye Drops: You’ll need to use antibiotic and anti-inflammatory eye drops as prescribed.
Most patients can return to work within a week, but it’s essential to avoid rubbing your eyes and to protect them from UV light during the healing process.
Benefits and Success Rates of Corneal Cross-Linking
Corneal cross-linking has shown remarkable success in halting the progression of keratoconus. Studies indicate that the procedure is effective in more than 90% of cases. Benefits include:
- Stabilisation of vision
- Reduced need for corneal transplants
- Improved quality of life
- Potential for combined treatments to enhance visual outcomes
Risks and Considerations
While corneal cross-linking is generally safe, as with any medical procedure, there are potential risks:
- Corneal haze
- Eye infection
- Delayed epithelial healing
- Corneal scarring (rare)
- Vision loss (extremely rare)
Our experienced team at Blue Fin Vision® Eye Clinic will discuss these risks with you in detail and ensure you’re fully informed before proceeding with treatment.
Why Choose Blue Fin Vision® Eye Clinic for Corneal Cross-Linking?
At Blue Fin Vision® Eye Clinic in London, we pride ourselves on offering state-of-the-art corneal cross-linking surgery with a patient-centred approach. Our team of expert ophthalmologists utilises the latest technology and techniques to ensure the best possible outcomes for our patients.
We understand that undergoing any eye procedure can be daunting, which is why we prioritise clear communication and personalised care throughout your treatment journey. From your initial consultation to your final follow-up appointment, you can trust that you’re in capable and caring hands.
Conclusion: Taking the Next Step
Corneal cross-linking has revolutionised the treatment of keratoconus and other corneal ectatic disorders. If you’re experiencing vision changes or have been diagnosed with a corneal condition, don’t hesitate to reach out to Blue Fin Vision® Eye Clinic. Our team is here to provide expert guidance and world-class treatment.
Remember, early intervention is key in managing corneal disorders. By choosing corneal cross-linking, you’re taking a proactive step towards preserving your vision and improving your quality of life.
To learn more about corneal cross-linking or to schedule a consultation, please contact Blue Fin Vision® Eye Clinic. Let us help you see the world more clearly.
