Corneal Collegen Cross-linking

Cross-linking is a treatment for keratoconus that involves the use of riboflavin (vitamin B2) and ultraviolet light. It strengthens the bonds between collagen fibres in the cornea. A decrease in the strength of these bonds is thought to be the cause for the thinning and protrusion seen in keratoconus.
While it is a relatively new treatment, it stops the progression of keratoconus in most cases. Research has shown that the keratoconus in people who undergo cross-linking treatment remains stable for at least 5-7 years, although longer term results are not yet known. It is not, however, a cure for keratoconus.

Cross-linking is performed as a day procedure under local anaesthetic and takes a little over an hour. The first step involves removing the very surface layer of your cornea (the epithelium). Riboflavin eye drops are then instilled in the eye for 15-30 minutes, followed by ultraviolet light for 10 minutes. Throughout this time, you will be asked to remain lying still with your eyes looking straight ahead.
At the end of the procedure, a contact lens is placed on the eye to help you with the discomfort you will feel over the next week until the surface epithelium grows back. You will also be given antibiotic, anti-inflammatory and artificial tear drops and pain relief tablets to use. As your eye will be quite sore and the vision will be blurry immediately after the procedure, it is recommended that you take one week off from school/ study/ work.

If the cornea becomes too thin during the procedure, the cross-linking will need to be stopped as it will not be safe to continue. Other complications from cross-linking are rare, but include infection and scarring. In severe cases, these complications can permanently affect the vision. It is therefore important that you contact the Emergency Department if you develop any significant decreased vision or increase in pain in the days after your initial follow-up appointment.