Cross-Linking

What is Corneal Cross-Linking?

Corneal cross-linking (CXL) is a treatment for a spectrum of eye diseases called corneal ectasias, the most common of which is called keratoconus.

Cross-linking stiffens the cornea and thus prevents further progression of the ectasia.

The term “ectasia” means the stretching or expansion of a tissue. This occurs as a result of the cornea becoming weakened for some reason. As the eye is pressurized, the weakened region begins to bulge outwards into a cone shape, and this causes vision to deteriorate. Ectasias like keratoconus are often progressive, which means treatment is required to strengthen the cornea and stop the disease from progressing further. The treatment is corneal cross-linking.

In corneal cross-linking, doctors use vitamin B2 eyedrops – riboflavin – and ultraviolet (UV) light from a cross-linking device to strengthen your cornea.

The reason why the technique is called “cross-linking” is because the UV light interacts with the riboflavin to make “reactive oxygen species” in the cornea, which immediately react with the collagen fibers in the cornea, creating chemical bonds between them, so called cross-links. This makes the corneal tissue stronger and more rigid, so that it can better resist the intraocular pressure that was causing the weak parts of the cornea to bulge. The major benefit of this approach is that until the introduction of corneal cross-linking, the only treatment option was corneal transplant surgery. This can now be avoided in all but the most severe cases.

Cross-Linking (CXL)

Play Video

Cross-Linking on Video

Cross-Linking

What Happens During the Procedure?

First, you will receive anaesthetic eyedrops to numb your eyes. If you require an “epi-off” cross-linking, then the doctor will bring you to a slit lamp, then use a cotton swab and a solution to remove the epithelium, the top layer of the cornea. If you are receiving an “epi-on” cross-linking, then this step can be skipped. Then, your surgeon will ask you to lie back in your chair while they apply specially formulated riboflavin eyedrops, which can take between 15 and 30 minutes until it has soaked into your cornea.

Then, you’ll be brought back to the slit lamp, and have your seat adjusted to make you feel comfortable, then you simply look at the light source for what usually takes around 10-15 minutes, in an entirely painless procedure.

Corneal Cross-Linking Types

There are two types: epi-off and the epi-on.

In epi-off corneal cross-linking, your ophthalmologist removes the epithelium before applying the riboflavin drops to your eye.

With epi-on corneal cross-linking, your ophthalmologist loosens your epithelium with eyedrops before they put the riboflavin eyedrops in.

Who Should Get Corneal Cross-Linking?

Anyone with a progressive corneal ectasia – and all children with one. It’s important that corneal cross-linking is performed sooner, rather than later, as cross-linking does not typically reverse the changes to the cornea made by the disease; it simply keeps the disease from getting worse. The earlier you treat, the greater the amount of vision loss is avoided.

How to Prepare

Please note that you will be on sick leave for one week.

Corneal cross-linking is not normally performed with a general anaesthetic, so it is fine to eat a light meal and drink fluids beforehand. However, please don’t wear any eye make-up, mascara, perfume or aftershave on the day of the surgery.

As the procedure will affect your eyesight, you will need to bring someone with you to help you get home afterward. You won’t be allowed to drive a car yourself.

CXL performed with C-Eye Device

What Happens Afterward?

After the procedure, here’s what you need to know to take care of your eyes:

It’s crucial to not rub your eyes and not to let any water come close to your eyes for at least 1 week after the procedure, or as long as the doctor tells you.

You will be given medication and a scheme for how and when to use them. It is important that you follow this exactly, for your comfort but more importantly for the proper and safe healing process.

You will probably experience discomfort, foreign body feeling and light sensitivity for a few days. Your eyes might even itch, burn or also hurt or produce lots of tears.

To make sure that your symptoms are just the normal reaction of your body, your doctor will do regular check-ups after the surgery.

Right after the surgery your doctor will put a contact lens in your eye to protect it and to help it heal. If it falls out, let your doctor know. Do not try to put it back in.

Your Vision After Cross-Linking Surgery

After a cross-linking procedure, your eyesight will be blurry at first. You may notice changes in your vision from time to time to time during the healing process. You may be more sensitive to light and have a poorer vision for about 1-3 months after the surgery.

The goal of corneal cross-linking is to slow your disease and prevent future vision problems, but in some cases, your eyesight may get better over time.

Once you’ve had corneal cross-linking, you might need new glasses or contacts.

Risks

Corneal cross-linking is a safe and effective procedure, but as with all surgical procedures, some small risks are associated with the procedure, and the recovery period afterward.

These include pain, inflammation, infection, and blurred or hazy vision in the period after surgery. However, these risks are all managed with eyedrops taken after surgery, to control pain, haze, and any infection risk.

It’s worth noting that corneal cross-linking sterilizes the cornea (the reactive oxygen species generated by the UV light interacting with the riboflavin kills pathogens), so the risk of infection is mostly concentrated in the first week after surgery, where taking the antimicrobial eyedrops is so important.

The ELZA Institute

EN | DE

Augeninstitut ELZA
4.7
Based on 104 reviews
powered by Google
Serena Fazio
Serena Fazio
11:15 06 Mar 22
I have been to the ELZA clinic to have surgery for my miopy, as my eyes were rejecting the contacts and I was tired of... wearing glasses. From the first preliminary visit, to the actual surgery and post-surgery care Dr. Hafezi and all his collaborators have been extremely professional, considerate and helpful. All the steps of the (very short!) surgery were thoroughly explained to me in order to be as calm as possible, together with the medication plan and precautions to be aware of so that my eyes could heal in the best way possible. By following their exact instructions, the healing process has been very successful and smooth, and after about one week I was able to see perfectly. I absolutely recommend this team and their expertise!read more
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
Thunder Shiviah
14:05 23 Nov 21
After some research on local options I decided to go with ELZA since it stood out as the best. The operation and the... post-operation recovery went extremely smooth (something I was worried about with PRK). Now my vision is much better than I had hoped and I have no side effects such as dry eye or night vision problems. Thank you!read more
Squitieri Elias
Squitieri Elias
12:43 08 Sep 21
Die Behandlungen waren bei mir erfolgreich, alle waren sehr nett und haben mein Leben vereinfacht.Danke
Eliane Bossart
Eliane Bossart
13:01 05 Sep 21
Vor einem Jahr war ich einer ganz verzweifelten Situation und total im Stich gelassen. Meine Augen wurden aufgrund... eines ausgeprägten Kerakotonus immer schlechter, ich hatte Angst und war alleine mit meinen Problemen. Zudem vertrug ich die Kontaktlinsen nur noch ganz schlecht und hatte jeden Tag Schmerzen.Professor Hafezi hat mir mit zwei Operationen wieder das auf Grund der Situation mögliche an Lebensqualität zurückgebracht. Es war ein starpaziöses Jahr mit vielen Entbehrungen aber es hat sich gelohnt! Herzlichen Dank fuer die Unterstützung.read more
Gabriela Meyer
Gabriela Meyer
18:32 22 Aug 21
Ich wurde von meiner Optikerin auf Prof. Dr. Dr. Hafezi aufmerksam gemacht. Es war mir vorher nicht bewusst, dass meine... Augenkrankheit (Keratokonus) operativ mittels Cross Linking behandelt und so gestoppt werden kann. Die Beratung und Behandlung war sehr kompetent und ich fühlte mich jederzeit wohl. Die Operation verlief gut und das Ergebnis ist einwandfrei.read more
Naomi
Naomi
11:38 11 Aug 21
Ich bin sehr glücklich, dass ich das Elza Institute gefunden habe. Ich wurde von anderen Augenärzten abgewiesen, da... meine Augen zu kompliziert/schwierig zu behandeln waren. Prof. Dr. Dr. Hafezi konnte mir jedoch helfen und ich bin sehr glücklich und zufrieden mit dem Resultat. Vielen Dank!read more
Till B
Till B
08:30 19 Jul 21
Ich habe eine überaus kompetente Beratung und Behandlung erlebt. Die gesamte Betreuung war sehr freundlich und... professionell. Herzlichen Dank!read more
Thomas S.
Thomas S.
09:37 07 Jul 21
My left eye had to be operated on because of a cataract. As I had an Artiflex lens implanted a few years ago, it had to... be removed first before a modern lens could be implanted to correct the cataract. Prof. Hafezi treated me in an very competent and friendly manner. I am very happy with the result.read more
Selma A. Rahim
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
Steven H.A
Steven H.A
16:13 11 Jan 21
Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
Online Commande
Online Commande
09:19 05 Dec 20
Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
Elena Churilova
Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
Next Reviews
js_loader
Augeninstitut ELZA
4.7
Based on 104 reviews
powered by Google
js_loader