Corneal Cross Linking

Slow down or stop your vision from worsening due to the irregular shape of your cornea.

Slow down or stop your vision from worsening due to the irregular shape of your cornea. At Focus Eye Care & Surgery in New York, our board-certified cornea surgeon, Dr. Neelofar Ghaznawi, specializes in providing surgical treatment of keratoconus. She employs the most cutting-edge techniques in corneal surgery, so you are assured you’re in expert hands.

What is Keratoconus?

The clear front surface of the eyes, or the cornea, can be weakened by various factors.

In keratoconus, the cornea distorts and becomes conical in shape. 

In healthy eyes, the cornea is shaped like a round dome. When the collagen support structure in the cornea breaks down, the normally dome-shaped cornea becomes thinner and steeper.

Because much of the light refracting job rests on the cornea, its abnormal shape leads to distorted visual images. The resulting visual impairment could lead to progressive vision loss that may require corneal transplant.

At Focus Eye Care & Surgery, corneal cross-linking performed by our New York cornea expert reduces your need for corneal transplant.

Symptoms of Keratoconus

Because the cornea performs most of the light-bending role, any changes to its shape results in refractive errors, such as astigmatism.

Aside from blurred vision, people with keratoconus find they are more sensitive to light and change eyeglasses more often.

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What To Expect in Corneal Cross-Linking?

The corneal cross-linking (CXL) treatment has been used overseas for over a decade. It was only recently approved by the FDA for use in the treatment of keratoconus within the United States.

People who endure symptoms of keratoconus now have a minimally invasive surgical option to restore their vision. Left untreated, keratoconus could lead to vision loss unless the cornea is surgically replaced.

To treat keratoconus, the procedure involves strengthening the cornea’s support structure made of collagen. This entails gently scraping the epithelium of the cornea (similar to scraping the topmost layer of the skin) in preparation for eyedrops of liquid riboflavin. These eyedrops both prime the cornea to absorb ultraviolet light and protect the rest of the eye from UV-induced damage. (Following the skin analogy, this initial procedure is similar to brushing away dead skin cells so the skin absorbs well moisturizers, lotions, and serums.)

Using various levels of intensity administered at different lengths of time, ultraviolet light is then focused directly to the cornea. This step triggers growth of new collagen cross-links. In turn, the cross-links become shorter and thicker, making the cornea stiffer, stronger, and less likely to go out of shape.

Other treatments skip scraping the corneal epithelium so it remains intact, leading to lower risk of infection, less pain, and a shorter healing period. Other procedures involve using more intense UV light to hasten the cross-linking effect in a shorter span of time.

The CXL treatment is performed in office settings and usually takes one to two hours to complete.


What are some treatment options for keratoconus?

Although keratoconus cannot be cured completely, treatments are available to halt the progression of keratoconus and to provide relief from the symptoms. In early or mild cases of keratoconus, scleral contact lenses can be used to treat astigmatism and nearsightedness. As the disease progresses, a minimally invasive procedure called corneal cross-linking can be used to halt the progression and restore some corneal strength. In keratoconus cases that have progressed to loss of vision, a corneal transplant from a donor may be able to restore vision.

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

During a corneal cross-linking procedure, you will be placed in an inclined position. Firstly, topical analgesic eye drops are used to minimize pain. Then the corneal epithelium is removed, and riboflavin eye drops are placed on the exposed cornea. UVA exposure is done for 30 minutes on the cornea while repeated riboflavin drops are placed every 5 minutes. After the procedure is completed, antibiotic eye drops are instilled and soft bandage contact lenses are used to protect your eyes until your cornea has healed satisfactorily.

Am I awake during the procedure?

Yes, you will be awake during the entire corneal cross-linking procedure. But as analgesic eye drops are used, you will experience minimal discomfort.

How long does the procedure take?

Corneal cross-linking takes about 90 minutes to complete, including the time taken for analgesic instillment, riboflavin absorption, 30 minutes of UVA exposure, post-procedure antibiotic eye drops placement, and eye bandaging. It is best if you set out a plan for a two-hour stay at the hospital including the time required for review of self-care instructions.

Does Corneal Cross-Linking hurt?

No, there is minimal pain and discomfort during a corneal cross-linking procedure. Analgesic eye drops will be placed prior to the procedure to prevent any discomfort to the patient during the procedure.

Do the appearance of my eyes change after the procedure?

No, corneal cross-linking will not change the appearance of your eyes. In corneal cross-linking, only the epithelial layers of your cornea are removed, which usually heals after a week and does not affect the appearance of your eyes.

Does corneal cross-linking give permanent results?

The goal of corneal cross-linking is to strengthen the cornea and to halt further progression of keratoconus. The results achieved after a corneal cross-linking are permanent, but you may need a repeat procedure as corneas completely rebuild themselves every 7 to 8 years.

What activities must be avoided after corneal cross-linking?

You must avoid swimming, rubbing your eyes, and harmful smoke until your cornea has healed completely, which usually takes two weeks after corneal cross-linking. Moderate exercises can be performed, but you must avoid looking at television or mobile screens for at least a few days as they can cause pain and discomfort.

Call us today to find out if you are a good candidate for corneal cross-linking.

Our New York cornea cross-linking specialist will develop a treatment plan with you that lets you enjoy a higher quality of life.
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