Corneal cross-linking (CXL) is a treatment for patients with keratoconus which can prevent their condition from getting worse. It is successful in more than 90% of cases. After treatment, you will still need to wear spectacles or contact lenses.
Keratoconus gets worse because the cornea weakens, CXL uses ultraviolet light and vitamin B2 (riboflavin) drops to stiffen the cornea. Used together, they cause fibers within the cornea to cross-link - or bond more tightly. This treatment mimics the normal age-related stiffening of the cornea, which is known as natural cross-linking.
The treatment is recommended only for patients whose corneal shape scans show that their keratoconus is getting worse, or for those who are at particularly high risk of worsening keratoconus. Because of natural cross-linking with age, keratoconus usually stops getting worse by the mid-30’s, so CXL is normally not required for older patients.
Collagen cross-linking is the only treatment currently available that appears to stop keratoconus from getting worse. Evidence from three large clinical trials one year after CXL showed success in halting keratoconus progression in more than 90% of treated eyes, with more than 45% of eyes also gaining an improvement in corneal shape.
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