Until the introduction of corneal cross-linking (CXL), the only method available for treating keratoconus was corneal transplantation. Usually reserved for advanced cases, corneal transplants tend to improve vision, but the operating is lengthy, the post-operative care regimen is more involved and takes longer for recovery, and the patients can suffer setbacks and still poor eyesight for years after the operation
It is important to know that corneal transplantation does not replace the entire cornea but only a central disc of 8-9 mm. This means that the peripheral cornea is preserved in patients with keratoconus, and it’s from here keratoconus can return to the graft over the years: this happens in 10–15% of all grafts 10 years after transplantation.
The world’s first treatment for corneal graft-restored keratoconus were published in 2010 with ELZA member Prof. Farhad Hafezi as the publication’s first author. Experience with several cases have shown that cross-linking helps to stabilize the cornea when keratoconus returns to the graft.