Is Corneal Cross-Linking Right for You? As you age, you might notice that your eyesight was not as good as it once was. You might have trouble seeing small letters, objects in the distance, or in low lighting. One of the most common causes of poor and weakening eyesight is a condition called keratoconus where the cornea thins out and weakens.
As this happens, the cornea bulges into a cone shape which distorts the sight and makes it difficult to see clearly. Weakened eyesight can also be caused by other conditions, such as pellucid marginal degeneration (which is also a thinning of the cornea and can often be confused with keratoconus) and post-LASIK ectasia.
These conditions can be treated using a procedure called corneal crosslinking.
How Does the Procedure Work?
Corneal cross-linking is a non-invasive procedure that is designed to help stop the progressive weakening of the cornea due to keratoconus or similar conditions, and to prevent the need for major surgery such as a corneal transplant.
The goal of corneal cross-linking is to increase the collagen fibers inside the cornea thus helping the cornea to stay in the right shape. Think of it as adding “support beams” to your eyes! The fibers strengthen and stabilize the cornea by adding new links between them.
The basic procedure of corneal cross-linking is simple. First, a doctor applies a mild anesthetic to your eyes. Next, the doctor will soak your eye with liquid riboflavin drops, also known as vitamin B2. The vitamin B2 will help your cornea to better absorb light. The soaking process takes around 30 minutes. Finally, the doctor will expose your eye to a controlled dose of ultraviolet-A light.
The whole procedure will take anywhere from 60 to 90 minutes.
Types of Corneal Cross-Linking
There are two types. The first type is epithelium-off cross-linking, wherein the outer layer of the cornea, or epithelium, is removed so that the vitamin B2 can penetrate the deep corneal tissue.
The second type is epithelium-on cross-linking, where the epithelium is left intact during the whole procedure. The latter procedure is considered to be less invasive and can be completely much faster.
Should I Get this Procedure Done?
If you are considering getting this procedure done, you need to make sure that you are getting it from safe, reputable, and licensed providers. At present, the only FDA-approved corneal cross-linking procedure is the KXL System by Avedro, which also covers the company’s proprietary Photrexa Viscous and Photrexa vitamin B2 solutions.
Corneal cross-linking is most effective if it is applied during the early stages of keratoconus. The procedure will prevent further deterioration of the cornea and improve the overall shape, so the recipient of the procedure can wear contact lenses. If the keratoconus is too severe (i.e., the cornea shape is too irregular or there is already significant loss of vision), corneal cross-linking might not be enough to regain visual acuity.
If you are considering getting LASIK to correct your vision, you might also consider getting corneal cross-linking before going ahead with the LASIK procedure. Getting a corneal cross-linking pre-treatment can strengthen the cornea and prevent post-LASIK cornea-related complications.
In order to know if you are a suitable candidate for corneal cross-linking, you must get examined by a licensed and practiced ophthalmologist. A routine checkup will be performed to determine the thickness and overall health of your corneas, as well as a corneal topography to determine the shape. It is not recommended to get corneal cross-linking before getting your corneas examined to determine if this is a safe and suitable procedure for you.
How Much Does Corneal Cross-Linking Cost?
The cost of corneal cross-linking can vary depending on where you get the procedure. In the United States, it will generally range from between $2500 to $4000 per eye. You can check if your current health policy covers the cost of corneal cross-linking by asking your insurance company. You can also determine how much of the procedure will come out of your own pocket.
What Happens After I Get this Procedure Done?
After you get corneal cross-linking, your doctor will apply a bandage contact lens over your treated eyes to promote healing and reduce discomfort. It will also protect your eyes from light and foreign debris such as dust and dirt. Topical anti-inflammatory and antibiotic drops will also be prescribed.
The healing process can take weeks to months before your eyes will fully recover from the procedure, depending on the type of the process done. If you underwent epithelium-off cross-linking, you can expect minor to significant discomfort in your eyes and a relatively long amount of recovery time. However if you underwent epithelium-on cross-linking, the recovery time can be as quick as one day and you will not typically experience any pain.