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.