Corneal Collagen Cross-Linkage (CXL)

CXL is more successful the younger you are and the earlier KCS is detected. The thicker the cornea is (> 400 microns) the more likely treatment is to halt progression although thinner corneas can be treated by modified protocols. Overall CXL is effective in more than 90% of cases. CXL can be repeated although in less than 2% of cases overall.

Risks with treatment are low but include infection whilst the epithelium is healing, discomfort during healing and haze following treatment which can increase light scatter or glare. Risks are higher in thinner, steeper corneas i.e. advanced disease. The risk of losing vision is very low, around 2% but has to be balanced against the risk of losing vision with disease progression. Many patients gain vision following the procedure.

CXL can be performed on one or both eyes at the same sitting and can be combined with intra-corneal ring segment insertion (ICR) or topography driven photorefractive keratectomy (PRK) or phototherapeutic keratectomy (PTK). When the cornea is stable further treatment with implantable collamer lens (ICL) surgery can be undertaken to treat any residual refractive or focusing error.

Following treatment your eye will be red, sore, light sensitive and gritty. We recommend that you return home and rest quietly in a darkened room and sleep if possible, we will provide you with pain-killers and anti-inflammatory treatment to take. Your vision will be blurry but recover as the surface epithelium regrows and forms a waterproof seal over the front surface of the eye. Your vision will fluctuate as healing continues and we recommend taking a week off from college or work. 

We can advise you specifically depending on the type of contact lens that you wear and your personal circumstances. In general we recommend no contact lens wear for a minimum of two weeks following CXL up to one month depending on your post-operative course of treatment. 

As soon as you meet the driving vision standard and you feel safe to do so you may drive. You will need to arrange transport home on the day of your procedure as you should not drive then. 

The bandage contact lens is there for comfort so do not worry if it falls out or is washed out by your eyedrops. If this happens just discard the lens, do not try to replace the lens in your eye even if you are an experienced contact lens wearer. Continue using your eyedrops as instructed and contact us if you are concerned or worried. 

We’d like you to avoid eye make-up for 7 days following CXL treatment as removing it can risk damaging the healing surface setting back recovery, any other face make-up can be worn after 48 hours.