Corneal Cross-Linking FAQs

What is keratoconus?

Keratoconus, which is often referred to as “KC”, is a non-inflammatory eye condition in which the cornea of your eye becomes thin and begins to distort into an irregular cone-like shape. This will cause your vision to become blurry and poorly focused and can progressively worsen over time.

What is corneal ectasia?

Corneal extasia is a condition where the cornea becomes thin and progressively distorts, leading to blurry and poorly focused vision. Keratoconus is a naturally occuring type of ectasia, but corneal ectasia can also occur occasionally following LASIK.

What is cross-linking?

Cross-linking is a minimally invasive, FDA approved, outpatient procedure that is done in the doctor’s office. The purpose of cross-linking is to stabilize and prevent further worsening of progressive keratoconus or ectasia after LASIK. It combines the use of special vitamin eye drops (riboflavin) and ultraviolet A (UVA) light from the cornea cross-linking technology for the treatment of progressive keratoconus.

What can I expect during the cornea cross-linking procedure?

  • First you will be given eye drops to numb your eye so there will be no pain during the procedure.
  • The epithelium, or thin layer on the surface of the cornea, will be gently removed.
  • Next the vitamin (riboflavin) eye drops will be applied to the cornea for at least 30 minutes.
  • The cornea is then exposed to UV light for 30 minutes while additional riboflavin drops are applied. During this portion, you will have to lie still while looking at the light.
  • Your doctor will place a special contact lens in your eye to protect it, help it to heal and to reduce the pain that is usually present the first few days.

What is ultraviolet A (UVA) light?

UVA is one of three types of invisible light rays that are given off by the sun.

Does corneal cross-linking require removal of the epithelium?

Yes, the corneal cross-linking procedure does require the removal of the epithelium. Your doctor will first apply a topical anesthesia (eye drops) to numb the eye prior to removal. This removal of the epithelium helps to prepare the eye so that the drug can penetrate the tissue of the cornea allowing an effective cross-linking procedure. There are some studies looking at doing the cross-linking without the removal of epithelium, but this option has not been approved by the FDA.

Am I awake during the procedure?

Yes, patients are typically awake during the treatment. This works out very well for patients. Many patients listen to music, podcasts, audiobooks, etc. during the procedure and there is no pain.

How long does the procedure take?

The actual procedure takes 75-90 minutes. We recommend that you and your driver plan to be at our office for approximately two hours to prepare for it as well as for recovery and review of instructions before going home.

What can I expect after the procedure?

  • You should not rub your eyes for the first 1-2 weeks after the procedure.
  • You may notice a sensitivity to light or a foreign body sensation as well as some discomfort in the treated eye. A minority of patients will actually experience significant pain for several days. You may take over the counter pain medications and your doctor may give you a prescription for a few days of prescription pain pills. In general, most patients are relatively comfortable within a few days.
  • Antibiotic and steroid eye drops will be used for about a month. It is critical that the full course of these drops be taken as instructed for proper healing.

Does it hurt?

You should not experience any pain during the procedure. However, you may have some discomfort or even pain in the immediate recovery period. A bandage contact lens is placed to protect your eye and to reduce pain and discomfort. You may be given a prescription for prescription pain pills in case over the counter pain medications are not strong enough.

Will I need to be out of my contact lenses before having the procedure?

Yes. Your doctor will likely have you stop wearing hard contact lenses prior to surgery for several weeks and once treated they will usually not be allowed back in for about 1 month.

Can anyone tell by my appearance that I’ve had cross-linking?

No, there is no change in the appearance of your eyes.

Is corneal cross-linking right for me?

Patients that have been diagnosed with progressive keratoconus or corneal ectasia following refractive surgery and are over the age of 14, should ask their doctor about corneal cross-linking.

To schedule an appointment with a cornea specialist at Ophthalmic Specialists of Michigan, call us at 1-800-237-EYES (3937).