Collagen Cross-Linking (CXL) for Keratoconus

Keratoconus is a condition where the clear tissue on the front of the eye (cornea) is weakened or thinning causing it to progressively bulge outward. Symptoms typically occur during a person’s teen years and include blurred vision. It is typically not correctable with glasses, requiring specialty contact lenses, or in severe cases if left untreated, a corneal transplant. Collagen Cross Linking is a procedure that should be performed ASAP to stop or slow down the progression of Keratoconus.

If you have keratoconus, your cornea has too few cross-links—or support beams—allowing your cornea to bulge outward into a cone shape.

The cross-linking procedure adds cross-links to your cornea. Once it has been distorted, the cornea cannot regain it’s normal shape. CXL strengthens your cornea, which stops the thinning process and limits further vision loss.

NVISION is one of the leaders in keratoconus care and surgery. Our surgeons will thoroughly analyze your unique condition to develop a personalized treatment approach. Other procedures can be used in conjunction with CXL such as INTACS, EVO ICL, Laser Vision Correction – to reduce your dependence on glasses and contacts.

Early treatment for keratoconus is necessary to prevent it’s progression. While the patients that benefit the most from crosslinking are in their teens or twenties, any patient that demonstrates active disease with progressive thinning can benefit. CXL is a treatment to consider if you are in one of the following categories:

• You have been newly diagnosed with keratoconus. The earlier you have the treatment, the earlier you have the potential of stopping your disease from progressing.
• You have been living with keratoconus—even if you are getting good vision with contacts. Your disease may very well be progressing despite good vision or comfortable contact lens wear. Any progression is irreversible, and CXL is the only procedure that can stop the progression of the disease.

Common symptoms of keratoconus include blurry or distorted vision, increasing astigmatism, frequent changes in your glasses prescription, glare, and sensitivity to light. Keratoconus is a progressive condition in which the cornea becomes thinner and bulges into an irregular, cone-like shape. As it progresses, you may notice your vision getting worse in a way that glasses can’t fully correct.

Keratoconus is diagnosed with a comprehensive eye exam and specialized imaging of the cornea. Tests such as corneal topography and tomography create detailed maps of the cornea’s shape, curvature, and thickness. This technology can detect subtle changes from keratoconus, sometimes before you notice any symptoms.

Keratoconus most often develops in the teenage years or early adulthood, although it can appear at any age. It often progresses faster in younger patients, especially children and teenagers. Early diagnosis and monitoring are important to help protect your long-term vision.

How fast keratoconus progresses varies a lot from person to person. Some people have rapid changes over a few months, while others have fairly stable vision for years. Younger patients generally have a higher risk of rapid progression, which makes regular monitoring and early treatment especially important.

Corneal topography is a noninvasive imaging test that creates a detailed map of the curve and shape of your cornea. It helps detect irregular astigmatism, diagnose keratoconus, and track changes over time. The test is painless, takes only a few seconds, and provides valuable information for planning treatment.

Corneal cross-linking is generally recommended for patients with keratoconus or certain other conditions that weaken the cornea, when the condition is getting worse or at high risk of getting worse. The treatment uses riboflavin (vitamin B2) and ultraviolet light to strengthen the cornea and help prevent further damage. Your surgeon will evaluate your corneal thickness, imaging, age, and signs of progression to determine whether you are a good candidate.

Yes! The main goal of corneal cross-linking is to preserve the vision you have now by stopping keratoconus from progressing, not to improve vision that has already declined. If your keratoconus is progressing, early treatment may help prevent permanent distortion and scarring of the cornea, as well as the need for more invasive procedures such as a corneal transplant.

Yes! Cross-linking can be especially important for children and teenagers because keratoconus often progresses faster at younger ages. Early treatment can help stabilize the cornea and protect vision during these critical years. FDA-approved cross-linking is available for eligible patients as young as 13, and younger children may be considered after careful evaluation by a specialist.

Yes. If keratoconus affects both eyes and treatment is needed, cross-linking can be done in each eye. The treatments are usually scheduled separately so the first eye can heal before the second is treated. Your surgeon will decide on the timing based on how severe your keratoconus is, how quickly it is progressing, and how you recover.