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How long does cross-linking last?

This is mainly related to how old the patients were when they first underwent cross-linking. In simple terms, the younger the patient is at the first cross-linking, the higher the likelihood that they will need a second treatment after 7−8 years.

The cornea is completely rebuilt every 7−8 years – a fact that has only recently come to light. What this means is that no original cross-links are left after this time. If the patients were still very young at the time of the first cross-linking, they are still young enough after 7−8 years for keratoconus to re-emerge.

The following video explains the connections.

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Can Cross-Linking be Repeated?

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Cross-Linking in Children

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How long does cross-linking last?
See this video interview with Farhad Hafezi from the ELZA Institute

 

Background
Fifteen years into the clinical application of corneal cross-linking, we are collecting a growing number of long-term results from patients of all age groups, including children and adolescents. The question is whether or not it will become necessary to retreat some of these patients because the cross-linking effect might fade over time.

What is the turnover rate of collagen in the cornea?
We know nowadays that the collagen turnover rate is 6 to 7 years. In other words, after this timespan, the original stiffening effect of the CXL procedure has worn off, and the only factor protecting the cornea is the natural stiffening related to the patient’s age.

Young people more at risk
The turnover rate of collagen explains why patients who were extremely young at the age of the CXL procedure (i.e. 11 years old) are at a greater risk once the CXL effect has worn off 6 to 7 years later: they will be only 17 to 18 years old, so still at an age where the disease can be very active. In contrast, a patient who is 28 years at the time of the first CXL procedure, will be 35 years once the CXL effect has worn off: an age at which typically the progression of keratoconus will slow down anyway.

Keep young patients in close follow-up
This is why young patients should have annual following-ups and be retreated as soon as first signs of reactivation of keratoconus occur.

The ELZA Institute

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Augeninstitut ELZA
4.8
Based on 109 reviews
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mike
mike
09:02 04 Jan 23
Overall as a 50 year old, who wanted to continue to avoid wearing glasses and/or contact lenses, my goal was 100%... achieved with ELZA and Dr. Hafezi. I greatly appreciated the overall approach by Dr. Hafezi and his friendly and competent team in reviewing my vision at the start and following a comprehensive eye exam- the explanations of my options. For me I chose PRK in one eye for a monovision solution to correct short sightedness which was becoming more prevalent in night driving and sports such as skiing and cycling. PRK heals slowly but the outcome is worth the wait- and the cost- you use your eyes every waking moment- and for me I cannot see any reason not to pursue better vision with the ELZA team! A great quality of life enhancement!read more
Zuzana Fecko
Zuzana Fecko
21:48 31 Oct 22
Thank you so much, Dr. Torres and prof. Hafezi. 26 years I was only “dreaming” about the eye surgery due to possible... complications. I was worried ..Thank you for encouraging me to make a decision and thank you for your professionalism, explanations and great work!I wish you all the best, lots of success and only happy patients!read more
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
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
Michele Aggiato
Michele Aggiato
18:17 10 Jan 20
The day I had Prof Hafezi checking my keratoconus I knew I was finally in the right place after years of searching for... a good ophthalmologist. Prof Hafezi recommended a surgery due to a drastic degeneration of my cornea. The surgery was performed by himself with the assistance of Dr Rodriguez, one more collaborator of Prof Hafezi’s team who got my full trust.read more
Ashley Faulkes
Ashley Faulkes
15:30 21 Mar 16
Professor Hafezi and the team at the ELZA Institute have done an amazing job of creating a first class eye clinic, with... cutting edge technology and support. I went there for a dry eye issue and other issues with my prescription, and they were easily able to help me and put me on the road to better vision! High recommend them to anyone in the Zurich/Aargau area.read more
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Augeninstitut ELZA
4.8
Based on 109 reviews
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