CORNEAL CROSS-LINKING PROCEDURE (CXL)

It increases the chance for a positive result of qualification for laser vision correction in people who were previously disqualified from the procedure due to keratoconus.

What is keratoconus?

Keratoconus is a corneal disease in which the central or medial part of the cornea undergoes spontaneous, progressive thinning and bulging, taking the shape of a cone. Such reshaping of the cornea causes rays of light to blur, resulting in blurred and distorted vision, making it difficult to carry out everyday activities, such as reading and driving. It contributes to the emergence of irregular astigmatism.

What is the corneal cross-linking procedure (CXL)?

During the procedure, riboflavin is instilled several times on the cornea of the eye, at few-second intervals, and then it is irradiated with a specially designed UV lamp. This leads to tighter cross-links being formed between the collagen fibres, which in turn contributes to the inhibition of the keratoconus progression. The whole procedure is performed under local anaesthesia in the form of eye drops.

The CXL procedure is always preceded by a qualifying examination during which an ophthalmic surgeon checks all the necessary corneal parameters and selects the most suitable procedure method. Our Centre offers two cross-linking methods and the choice depends on how advanced the disease is. The methods we offer are:

• Epi-Off: procedure with the removal (abrasion) of the epithelium
• Epi-On: procedure without removing the epithelium (transepithelial treatment)

Indications for the procedure

• diagnosed keratoconus
• undiagnosed keratoconus in candidates for laser vision correction
• corneal ectasias
• corneal infections

Contraindications to the procedure:

• active inflammations in the body and eye infections (such as conjunctivitis or blepharitis – an eyelid infection)
• untreated or unmonitored chronic diseases (for instance diabetes or rheumatoid arthritis)
• pregnancy and lactation

The convalescence period:

• The first follow-up appointment is scheduled a week after the procedure
• Patients should use topical medications recommended by the ophthalmic surgeon
• Immediately after the procedure, depending on the chosen method, patients may experience:
  - in the case of the Epi-On method: eye redness, the feeling of a foreign body in the eye, temporary photophobia up to 24 hours after the procedure,
  - in the case of the Epi-Off method: pain, discomfort, and temporary photophobia (these symptoms usually wear off within 3-4 days).

Prior to the procedure, patients should stop wearing soft contact lenses at least 7 days before the procedure and hard or toric lenses – 3-4 weeks before the procedure.