Cross Linking

In keratoconus and corneal ectasia Collagen Corneal CrossLinking (CXL) can halt further progression and avoid future needs for corneal transplantation surgery.


How does CXL works?

The human cornea consists of a number of layers  responsible for its strength. these layers are made of millions of collagen fibres in close contact with each other. Cross-linking is a surgical procedure that combines the use of ultra-violet light and Riboflavin eye drops.  During cross-linking vitamin B2 drops are applied  to the cornea and then exposed to ultra-violet light. The UV light light catalyses a chemical reaction which  leads to the formation of bonds between collagen molecules or collagen cross-linking.

The Avedro KXL Accelerated Cross-linking pulsed procedure is performed in 8 minutes, while traditional procedures typically take longer than 30 minutes .Ultraviolet (UVA) light in the presence of vitamin B2 (riboflavin B) induces free radical formation inside the cornea and this causes collagen cross linking. CXL treatment therefore aims to create increased corneal strength and stiffness.

Recently the ophthalmology community has fully accepted  the prominence of corneal collagen cross-linking as a treatment strategy for progressive keratoconus and post-lasik ectasia. This interest has arisen from a body of evidence documenting the biomechanical and cellular changes induced by cross-linking. The findings of this research provide a rationale for its use in keratoconus to retard the progression of this disease.  A rapidly growing number of clinical reports suggest a consistent stabilizing effect of cross-linking along with a variable improvement in corneal shape and visual function in some patients[1].   As a first-line treatment the greatest aim of cross-linking is to reduce and stop keratoconus in the early phase of the condition, and to treat the progressive vision loss that occurs which can lead to corneal transplantation.

[1] Grant R Snibson FRANZCO; Collagen cross-linking: a new treatment paradigm in corneal disease – a review; Clinical and Experimental Ophthalmology 2010; 38: 141–153 doi: 10.1111/j.1442-9071.2010.02228.


FAQ about Cross-linking Treatment

What are the NICE (National Institute Clinical Excellency) guidelines for cross-linking in keratoconus?
What is Vincenzo Maurino's experience with Collagen Corneal Cross Linking at Moorfields Eye Hospital?
Advanced CXL Treatment: PTK and TRANS-PRK at Moorfields Eye Hospital?
What happens during the CXL procedure?
What is the post-operative care for CXL?
Is CXL safe?
What are the potential complications?
What else should I consider before choosing CXL treatment?