Keratoconus is a common eye condition that affects about one in 1,500 people. It causes the central part of the cornea to thin out and bulge into a cone shape. As the disease progresses, it leads to uneven vision, making it harder to see even with glasses or contact lenses.

Various treatments are available for keratoconus, but corneal collagen cross-linking (CXL) is the most effective method to stop the disease’s progression. For patients with mild-to-moderate keratoconus, vision is usually corrected with glasses or contact lenses, and sometimes with intracorneal ring segment implantation. In more advanced cases, corneal surgery, such as deep lamellar keratoplasty or penetrating keratoplasty, is often necessary. However, to slow down or even stop the progression of keratoconus, corneal collagen cross-linking (CXL) is the recommended treatment.

The CXL Procedure:

1. Preparation: For successful cross-linking, the CXL procedure includes removing the corneal epithelium (the outer layer of the cornea) to allow riboflavin (Vitamin B) eye drops to penetrate the deeper corneal tissues, reaching the corneal stroma (the thickest layer of the cornea).
2. Application of Riboflavin: Riboflavin eye drops are applied to the cornea for 30 minutes.
3. UV Light Activation: After riboflavin application, ultraviolet (UV) light is focused on the cornea for an additional 30 minutes. This step activates the riboflavin, leading to oxidative cross-linking of collagen fibers in the corneal stroma.
4. Strengthening the Cornea: The combination of riboflavin and UV light forges new connections between the collagen fibers, strengthening the cornea and halting the progression of keratoconus.

Corneal Cross-Linking is highly effective in stopping the progression of keratoconus, with a success rate of over 95%. The primary goal of CXL is to slow the disease and prevent future vision problems. In some cases, it may even improve eyesight over time. It is a groundbreaking treatment for keratoconus patients because it significantly reduces the need for corneal transplants. Before the advent of CXL surgery, corneal transplants were the only treatment option for severe cases of keratoconus. Now that corneal cross-linking is a standard treatment, the necessity for corneal transplants has dramatically decreased.

By stabilizing the cornea and preventing further deformation, CXL effectively halts the progression of keratoconus, offering patients a less invasive alternative to corneal transplants and improving their overall quality of life.