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Corneal cross-linking (also known as CXL, KXL, or CL) is a minimally invasive procedure. Corneal cross-linking uses unique riboflavin eyedrop medication and ultraviolet light from a special machine to strengthen the collagen fibers in the cornea.

The procedure is used for patients with keratoconus or post-refractive ectasia, a condition in which the cornea grows thin and weak. It is the only treatment available that can actually stop the progression of keratoconus and post-refractive ectasia. Corneal cross-linking has helped many patients avoid corneal transplant surgery.

Huffman & Huffman, P.S.C. is the only cornea practice in the state to offer the FDA-approved treatment.

What is Keratoconus?

The cornea is a clear, dome-shaped window at the front of the eye that focuses light into the eye. Keratoconus is a disorder in which the cornea thins and bulges out like a cone. This causes light rays to be out of focus.
Keratoconus is a progressive disease. The changes in the shape of the cornea can progress quickly or slowly over several years.
The bulging of the cornea can result in blurred vision, glare, and halos at night and a sensation of streaking lights. Daily tasks such as reading or driving become increasingly difficult. Sometimes the cornea can swell rapidly and cause corneal scarring.

Why is the Procedure called Cross-Linking?

Corneal cross-linking adds bonds between the corneal fibers to strengthen them. The procedure helps to flatten or stiffen the cornea.
This decreases the bulging that causes visual distortion. This does not reverse or cure keratoconus, but generally is successful in stopping its progression.

Is it Safe?

Yes. After being performed successfully in Europe for over ten years, corneal cross-linking with the Avedro system was approved by the F.D.A. as a new treatment for progressive keratoconus in 2016.

What Does the Procedure Involve?

  • Corneal cross-linking is a procedure that can be performed in your doctor’s office and usually takes about an hour.
  • You will be awake during the procedure, but you should not experience pain or discomfort.Your doctor will apply numbing anesthetic eye drops to your eye and may give you a medication to help you relax.
  • Your doctor will then gently remove the epithelium (the thin layer on the surface of the cornea.
  • Riboflavin (B2) eye drops are then applied to the cornea and need to be absorbed to promote cross-linking.
  • Another riboflavin ophthalmic solution is applied while the cornea is exposed to the UV light from the KXL system for about 30 minutes.
  • A bandage contact lens is placed on the surface of the eye immediately after the procedure.

What Can I Expect After the Procedure?

  • You may experience some discomfort that feels like burning or a gritty feeling in the eye. This can usually be easily managed with Tylenol and artificial tears.
  • There may be sensitivity to light for a few days. Sunglasses will usually help.
  • It is very important that you not rub your eyes for at least 5 days after the procedure.
  • You may need a new prescription for glasses or contacts after your cornea recovers from the procedure.

Am I a Candidate for CXL?

The treatment is not recommended for patients with very thin corneas. This would be a corneal thickness of fewer than 400 microns.
Your doctor at Huffman & Huffman, PSC will do a thorough eye examination. They will then discuss whether you are a good candidate for corneal cross-linking.

What Are the Risks?

Corneal cross-linking usually has a low rate of complications. But there are risks to every surgical procedure.
You should discuss the risks and benefits with your ophthalmologist before giving consent to the procedure.
There are risks to removing the corneal epithelium during CXL. These may include epithelial haze, corneal epithelium defect (disruption of surface cells), and delayed epithelial healing.

Other unusual side effects may include:

  • infectious keratitis
  • herpetic keratitis
  • corneal opacity
  • blurred vision
  • stromal scarring
  • ulcerative keratitis
  • severe inflammation of the eye

Does Insurance Cover Corneal Cross-Linking?

Most insurances now pay for corneal cross-linking for keratoconus as it’s considered medically necessary. The pre-operative evaluation, surgery, and post-operative care should be covered.

The office staff at Huffman & Huffman, PSC can tell you whether your insurance covers it, or help you find out.
Looking for more information about if corneal cross-linking could be right for you? Schedule an appointment at Huffman & Huffman, PSC in Lexington, KY to learn more!

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