Can Cross-Linking be repeated?

Can you repeat cross-linking? The answer to this is, in principle, “yes”. However, one has to analyze exactly why the operation has to be repeated.

Another question we are asked again and again is can you repeat cross-linking? The answer to this is, in principle, “yes”. However, one has to analyze exactly why the operation has to be repeated:

In a classic epi-off CXL, in 3% to 7% of cases, the therapy does not respond. Here it is possible to repeat cross-linking after six months.
If the cornea deteriorates after epi-on CXL, cross-linking can also be repeated after six months.
If other factors have been added, such as pregnancy or thyroid disease, a case-by-case decision must be taken.

Even if the effect of cross-linking diminishes after a few years, the therapy can be repeated. Our group has made important contributions in recent years to understand what causes repeated cross-linking.

Research

In a lab study, we were able to show that repeated cross-linking within a week does not improve corneal biomechanics. However, we know that in reality there are often months and sometimes years between the first cross-linking and the repeat procedure.

Additive

Clinic

We published the case of a patient who we treated with CXL on both sides. One eye remained stable for years – we performed only regular check-ups. The other eye’s ectasia progressed, so we repeated the CXL. What happened? The twice-treated eye displayed a further marked improvement. In other words, the effects of the two treatments were additive.

First CXL