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There are numerous treatment options available for keratoconus including the use of corneal rings in mild cases or corneal transplants in advanced cases. Corneal cross-linking (CXL) is a treatment for patients with progressive keratoconus which can prevent their condition getting worse. It is successful in more than 90% of cases. 

CXL, also known as C3R, uses ultraviolet light and vitamin B2 (riboflavin) drops to stiffen the cornea. Used together, they cause fibres 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. The procedure is designed to stablise vision but can help improve vision in 40-50% of patients. 

Our Process :

Complete a complementary LASIK/ICL suitability test

Assessment

Detailed measurements of the eyes are taken for safety and accuracy, and your surgeon will discuss your options. If you wear contact lenses, please leave them out and wear glasses for two full days prior to the day of your assessment.

1

Meet your surgeon

Your surgeon will thoroughly examine your eye and discuss your keratoconus treatment options including CXL. Our surgeons have published widely on CXL and its benefits.

2
Surgeon sitting at computer by machine

On the day

You will be at Re:Vision for around two hours. After your procedure which typically takes 30 minutes you will be kept comfortable and can choose from a series of snacks. You will need someone to drive you home.

3

Check

The recovery following CXL typically takes a few days. Your eye will be sore for about 2-3 days after the procedure. You will be reviewed 3-5 days after the procedure to check how your cornea is healing and to remove the bandage contact lens. Although vision is often hazy at first, most patients can return to work after 5-7 days. CXL treatment will take several months to completely stabilise the improved shape of the eye.

5

Saving money

The hidden costs: what could you save?

What could that money have done?

The $40,000 you'd potentially spend on glasses and contact lenses over the next 30 years could have given you 15 luxurious holidays.

Est- 15 Holidays

Est - 15 Holidays

Average holiday cost: $2600
Calculation: 40,000 / $2600 = 15

Saving time

The hidden cost of wearing glasses or contact lenses.

Did you know?

The time you'd spend handling glasses and contact lenses over the next 30 years is enough to have could have taken you around our planet over 30 times!

Est - 526 hours

Est- 526 hours

Cleaning: 3 minutes/day
Finding misplaced glasses: 2 minutes/day
Repair, shopping: 2 hours/year
Total: 526 hours (over 30 years)

Est- 526 hours

Inserting and Removing: 3 minutes/day
Cleaning: 2 minutes/day
Renewing & Check-ups: 2 hours/year
Total: 1,012 hours (over 30 years)

Saving planet

Reducing our carbon footprint

The environmental perspective

Over 30 years, using glasses and contact lenses contributes to 876lb of CO2 emissions. Opt for vision correction and take a stand for our planet!

Est - 876.6lb C02 emissions

Est- 876.6 CO2 emissions

Combined plastic waste:

0.525 kg (glasses)+65.7 kg (contact lenses)=66.225 kilograms over three decades.

Total: 66.225 kilograms of plastic×6=397.35 kilograms = 876Lb of CO2 emissions(over 30 years)

CXL benefits

Safe

We use tried at tested crosslinking technology to provide unequalled safety and care.

Fast

With accelerated CXL your treatment will typically be completed in a matter of minutes.

Proven

CXL has been around for over 20 years, with numerous studies proving its effectiveness. Our doctors have also published on the safety and efficacy of CXL.

Our Technology:

Sirius Tomographer

Combines Placido disk topography with Scheimpflug tomography of the front of the eye to allow the surgeon to perform the safest version of laser vision correction customised to your eyes. The device provides highly accurate measurements of corneal thickness, curvature, power as well as pupil size measurements and is commonly used for refractive surgery planning and follow-up.

Detailed Corneal Analysis

Custom Built Surgical Facility

Re:Vision Laser & Cataract was specifically designed and created by our surgeons to provide maximum safety for patients in need of eye surgery. We are fully accredited by the Designated Auditing Agency (DAA) with an excellent scoring.

Custom Built Facility

SCHWIND CXL-365 Vario Corneal Crosslinking System

The CXL-365 vario extension is integrated into the workflow of the SCHWIND AMARIS laser, so that additional adjustment and space are not required.

The CXL-365 vario has three power levels, 3-18 mW/cm2, allowing accelerated treatments of 5 minutes.   

The UV beam diameter is adjustable between  7-11 mm. This protects the limbal stem cells and allows for safe crosslinking. 

Advanced CXL System

Triton Swept Source OCT‍

This Swept Source OCT provides a significant improvement over conventional OCT. Due to the optimized long wavelength scanning light (1,050nm), there is better penetration of the deeper layers of the eye. This device takes 100,000 scans per second to provide better accuracy and is able to scan teh entire cornea in a matter of seconds.

3D Corneal Imaging

How much does CXL cost?

CXL costs are usually covered by most insurance companies. Exact costs depend on the type of CXL best suited for you.

By the time I turn 45, I will have spent on contact lenses/glasses :

$
At Re:Vision, all types of laser vision correction
(LASIK or PRK) cost : $3,494/eye

References :

  • Angelo L, Gokul Boptom A, McGhee C, Ziaei M. Corneal Crosslinking: Present and Future. Asia Pac J Ophthalmol (Phila). 2022 Sep 1;11(5):441-452.
  • Ziaei M, Yoon JJ, Vellara HR, Gokul A, Meyer JJ, Thakur SS, McGhee CN, Patel DV. Prospective one year study of corneal biomechanical changes following high intensity, accelerated cornea cross-linking in patients with keratoconus using a non-contact tonometer. Eur J Ophthalmol. 2021 Dec
  • Angelo L, Gokul A, Wadhwa H, McGhee CNJ, Ziaei M. Assessment of Barriers to Accessing a First Specialist Assessment and Follow-up Keratoconus and Crosslinking Service at a Tertiary Referral Centre to Address Health Disparities. Cornea. 2023 Apr 25
  • Wadhwa H, Gokul A, Li Y, Cheung I, Angelo L, McGhee CNJ, Ziaei M. Repeatability of Scheimpflug based corneal tomography parameters in advanced keratoconus with thin corneas. Eye (Lond). 2023 Apr 19.
  • Al-Mahrouqi H, Cheung IMY, Angelo L, Yu TY, Gokul A, Ziaei M. Therapeutic non-ectasia applications of cornea cross-linking. Clin Exp Optom. 2023 Jan 23:1-11.
  • Ashena Z, Doherty S, Gokul A, McGhee CNH, Ziaei M, Nanavaty MA. Flattening of Central, Paracentral, and Peripheral Cones After Non-accelerated and Accelerated Epithelium-off CXL in Keratoconus: A Multicenter Study. J Refract Surg. 2022 May;38(5):310-316. 
  • Ziaei M, Yoon JJ, Vellara HR, Gokul A, Meyer JJ, Thakur SS, McGhee CN, Patel DV. Prospective one year study of corneal biomechanical changes following high intensity, accelerated cornea cross-linking in patients with keratoconus using a non-contact tonometer. Eur J Ophthalmol. 2021 Dec
  • Chen X, Zhao J, Iselin KC, Borroni D, Romano D, Gokul A, McGhee CNJ, Zhao Y, Sedaghat MR, Momeni-Moghaddam H, Ziaei M, Kaye S, Romano V, Zheng Y. Keratoconus detection of changes using deep learning of colour-coded maps. BMJ Open Ophthalmol. 2021 Jul 13;6(1)
  • Li Y, Gokul A, McGhee C, Ziaei M. Repeatability of corneal and epithelial thickness measurements with anterior segment optical coherence tomography in keratoconus. PLoS One. 2021 Jun 18;16(6):e0248350. doi: 10.1371/journal.pone.0248350. PMID: 34143790; PMCID: PMC8213071.
  • Li Y, Gokul A, McGhee C, Ziaei M. Repeatability and agreement of biometric measurements using spectral domain anterior segment optical coherence tomography and Scheimpflug tomography in keratoconus. PLoS One. 2021 May 21;16(5)
  • Li Y, Lu LM, Gokul A, Ziaei M. Case Report: Successful Corneal Crosslinking in a Patient with Corneal Ectasia Associated with Stevens-Johnson Syndrome. Optom Vis Sci. 2021 Jan 1;98(1):13-17. 
  • Ziaei M, Gokul A, Vellara H, Patel DV, McGhee CNJ. Measurement of refractive, wavefront, topographic, and keratometric changes attributable to epithelial removal in keratoconus. Can J Ophthalmol. 2020 
  • Goh YW, Gokul A, Yadegarfar ME, Vellara H, Shew W, Patel D, McGhee CNJ, Ziaei M. Prospective Clinical Study of Keratoconus Progression in Patients Awaiting Corneal Cross-linking. Cornea. 2020 Oct;39(10):1256-1260
  • Ziaei M, Gokul A, Vellara H, Patel D, McGhee CN. Peripheral Cornea Crosslinking Before Deep Anterior Lamellar Keratoplasty. Medical Hypothesis, Discovery & Innovation in Ophthalmology, 9(2), 127-134. 2020
  • Ziaei M, Gokul A, Vellara H, Lu LM, Patel DV, McGhee CNJ. Measurement of In Vivo Biomechanical Changes Attributable to Epithelial Removal in Keratoconus Using a Noncontact Tonometer. Cornea 2020
  • Ziaei M, Gokul A, Vellara H, Patel D, McGhee CNJ. Prospective two year study of changes in corneal density following transepithelial pulsed, epithelium-off continuous and epithelium-off pulsed, corneal crosslinking for keratoconus. Cont Lens Anterior Eye. 2020.
  • Ziaei M, Vellara HR, Gokul A, Ali NQ, McGhee CNJ, Patel DV. Comparison of corneal biomechanical properties following penetrating keratoplasty and deep anterior lamellar keratoplasty for keratoconus. Clin Exp Ophthalmol. 2019.
  • Ziaei M, Vellara H, Gokul A, Patel D, McGhee CN. Two-Year Outcomes of Accelerated Pulsed Transepithelial Corneal Collagen Cross-Linking for Keratoconus: A Prospective Study. Eye 2019. 
  • Ziaei M, Gokul A, Vellara H, Meyer J, Patel D, McGhee CN. Prospective two-year study of clinical outcomes following epithelium-off pulsed versus continuous accelerated corneal crosslinking for keratoconus. Clin Exp Ophthalmol 2019.
  • Ziaei M, Meyer J, Gokul A, Vellara H, McGhee CNJ. Direct measurement of anterior corneal curvature changes attributable to epithelial removal in keratoconus. J Cataract Refract Surg 2018; 44: 71-77
  • Ziaei M, Barsam A, Donnenfeld E, Collagen Crosslinking for Keratoconus, Cornea (4th edition), Mannis & Holland, Elsevier, 2016 Nov.
  • Ziaei M, Barsam A, Shamie N, Vroman D, Kim T, Donnenfeld ED, Holland EJ, Kanellopoulos J, Mah FS, Randleman JB, Daya S, Güell J; ASCRS Cornea Clinical Committee. A review of reshaping procedures for the surgical management of corneal ectasia. J Cataract Refract Surg. 2015. 41(4):842-872.