Corneal Collagen Cross Linking Surgery in San Diego

Corneal cross-linking is a medical procedure that uses ultraviolet (UV) light and riboflavin (vitamin B2) to create new bonds between collagen fibers in the cornea. This process helps to reinforce and stabilize the cornea’s structure.

• Commonly used for progressive keratoconus crosslinking.
• Approved in several countries as a standard of care.
• Delays or halts further deterioration of the cornea.

This technique is not intended to restore perfect vision but to stop worsening and preserve current visual function.

The procedure involves saturating the cornea with riboflavin eye drops, followed by exposure to UV light. The riboflavin reacts with the UV rays to form new molecular bonds within the corneal structure.

• Strengthens weakened corneal tissue.
• Slows or stops disease progression.
• One-time, in-office outpatient treatment.

The biological changes typically lead to a more regular corneal surface, which may improve visual function and increase tolerance to contact lenses.

There are two main types of corneal cross-linking techniques:

Epi-off Technique:

This traditional method involves the removal of the epithelium (the outer layer of the cornea) to allow better penetration of riboflavin.

• Provides deeper riboflavin absorption.

• More widely studied with a higher corneal cross-linking success rate.

• Recovery may take a bit longer compared to other methods.

This is often recommended for more advanced cases due to its proven long-term effectiveness.

Epi-on Technique:

Also known as transepithelial cross-linking, this method keeps the epithelium intact.

• Less invasive and faster healing.
• Reduced post-procedure discomfort.
• It may be better for mild cases or patients with thin corneas.

This technique has a shorter CXL recovery time, but may offer slightly less stiffening effect than Epi-off.

Indications for corneal cross-linking typically include:

• Individuals with progressive keratoconus.

• Patients diagnosed with corneal ectasia post-LASIK or PRK.

• Adolescents or young adults showing signs of worsening vision due to corneal thinning.

Ideal candidates are those who still have enough corneal thickness to safely undergo the procedure. Early diagnosis significantly improves treatment outcomes.

Proper preparation helps ensure a safe and effective outcome:

• Discontinue wearing contact lenses 3–10 days prior (depending on lens type).
• Arranging transportation as vision will be blurry post-procedure.
• Follow the preoperative instructions provided by your doctor.

A comprehensive eye exam will determine eligibility, including corneal mapping, thickness analysis, and visual acuity testing.

The corneal cross-linking procedure is typically painless and takes about 30–60 minutes.

• Local anesthetic drops are applied.
• Riboflavin drops are instilled over 30 minutes.
• UV light exposure follows for another 30 minutes.

No incisions are made, and the eye is protected during the entire procedure. Most patients rest briefly after the procedure before going home.

Proper post-procedure care ensures smooth healing and optimal results.

• Use antibiotic and anti-inflammatory eye drops as prescribed.
• Avoid rubbing your eyes.
• Wear protective eye shields while sleeping for a few nights.

Corneal cross-linking after surgery may involve light sensitivity, tearing, and blurred vision for a few days. Most people return to normal activities within 1–2 weeks, depending on the technique used.

Visual recovery is gradual. Here's what patients typically experience:

• Vision may initially worsen for 1–2 weeks.
• Improvement generally begins within 1–3 months.
• Final visual results can take 6–12 months.

The goal is to stabilize the cornea. While some patients may notice sharper vision, others may require updated prescriptions or contact lenses post-treatment. This is a common step in keratoconus treatment.

ClearView Eye and Laser Medical Center offers expertly tailored treatment plans for every patient. Led by Dr. Sandy T. Feldman, a nationally recognized ophthalmologist, the center provides cutting-edge eye care with a focus on patient safety and long-term outcomes.

Why patients choose ClearView:

• Over 20 years of corneal and refractive surgery expertise.
• Personalized diagnosis using state-of-the-art imaging.
• Comfortable, efficient care in a professional setting.
• Extensive experience with cross-linking eye surgery.

From your first consultation to post-operative care, ClearView delivers compassionate, comprehensive care with outstanding results.

Q1. Is corneal cross-linking surgery painful?

Ans: No, the procedure itself is not painful due to numbing eye drops. Mild discomfort or irritation may occur after cross-linking eye surgery, especially with the Epi-off method, but it typically resolves within a few days.

Q2. How long does the CXL procedure take?

Ans: The total time for the CXL procedure is approximately 60–90 minutes, including preparation, riboflavin application, and UV light exposure. Treatment of both eyes may extend the duration slightly.

Q3. What are the potential risks of corneal cross-linking?

Ans: Risks include temporary pain, blurred vision, light sensitivity, infection, or corneal haze. Serious complications are rare but possible. Choosing an experienced eye surgeon helps minimize these risks.

Q4. Will I need glasses or contacts after CXL?

Ans: Yes, most patients still require glasses or contacts after CXL. However, improved corneal shape often allows for better vision correction, and some patients may qualify for additional procedures in the future.

Q5. How effective is corneal cross-linking surgery?

Ans: CXL has a high success rate. Clinical studies report a corneal cross linking success rate of over 95% in halting disease progression, with vision improvement observed in up to 70% of cases.

Q6. Can CXL be performed on both eyes at once?

Ans: Yes, in many cases, both eyes can be treated during the same visit, depending on corneal thickness and patient comfort. Some surgeons prefer treating one eye at a time for recovery monitoring.

Q7. How long does it take to see results after CXL?

Ans: Most patients notice stabilization or early improvement within 2–3 months. Significant visual gains may take up to 6–12 months. The full benefits are typically long-lasting, reducing the need for transplant.

Q8. What happens if I have advanced keratoconus?

Ans: If the condition has progressed significantly, keratoconus treatment options may include CXL combined with other procedures like corneal rings or even transplant. CXL may still help slow further deterioration.