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Corneal Collagen Crosslinking

The procedure aims to strengthen the cornea of the eye by application of vitamin B2 (riboflavin), followed by treatment with ultraviolet A (UV-A) light.

It is often recommended when the cornea needs strengthening; especially for the treatment of keratoconus, or where there is an unstable cornea.

It is a non-surgical method utilising a UV-A light source, which is delivered onto the cornea, together with a chemical mix largely made up of riboflavin for strengthening the collagen fibres within the corneal structure. The combination of the UV-A light and the riboflavin creates a joining or bonding of the chemical structures within the cornea.

This comparatively simple procedure has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea and subsequently strengthen the cornea. There are published European studies, to show that this Cross Linking procedure has been proven safe and effective in patients with few side effects reported. Additionally, retreatment is an option at a later date if required.

Cross-linking therapy is being used for a number of diseases of the cornea and is proving a useful treatment in conjunction with other surgical techniques such as Intacs and refractive laser surgery.

However cross linking is not for everybody. The first requirement is to ensure that the thickness of the cornea is adequate for the treatment. Special non-invasive measuring devices are used by your specialist to accurately and quickly take these readings.

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Corneal Collagen Crosslinking

At a glance

Treatment

Frequently asked questions

The Cross Linking procedure takes between 10 and 30 minutes and may be either conducted in an Operating theatre or a special “clean” room.

The eye is anaesthetized with drops. Riboflavin eye drops are applied for the initial 10-30 minute period. After this, application of the ultraviolet light is commenced for between 4-30 minutes, with further application of the Riboflavin eye drops.

At the end of the procedure, the eye is will gently cleaned with a special solution and a protective bandage contact lens is placed for a period of 1-2 weeks.

Corneal cross linking works by increasing the number of bonds between collagen fibres. It can be performed as a staged procedure with wavefront-guided LASEK (surface excimer laser treatment). After cross linking the corneal shape can improve with a significant increase in mechanical stiffness of the cornea.

Mr Jayaswal has an excellent track record for achieving a very low complication rate with his surgery. However all procedures carry some risk.

When performed by a skilled surgeon with modern equipment, corneal cross-linking has a low risk of serious complication. Possible complications include prolonged healing of the corneal epithelium with delayed recovery of vision, corneal stromal scarring or melting and failure of the cross-linking to increase corneal strength and stability. Overall the risk to benefit ratio for cross-linking is generally considered good and cross-linking should be considered where there is weakening of the cornea and progression of warpage.

Lesser but common issues may include some degree of dry eye or blepharitis (irritation of the eyelids) in the healing period.

There is some degree of unpredictability in outcome as with any corneal surgery. You should read all the information given to you about possible complications before undergoing any treatment.

Risks of the procedure (to all structures of the eye) are minimal. The main risks are infection, and inflammation of the cornea after surgery but these risks are extremely low. Rigorous observation of the indications and contraindications has been conducted.

After Cross Linking, patients often experience:

  • Post-operative pain and sensation of foreign body in the eye for 24-48 hours after treatment until re-epithelialisation is complete
    Watering of the eye for 24-72 hours after treatment
    Transient corneal oedema with visual blurring for 30-60 days after treatment
    Corneal haze usually occurs but clears in the first 8 weeks

Price

From £ 1850

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rakesh.jayaswal@laservision.co.uk

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Compass Rd
Portsmouth
PO6 4RP

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