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Corneal cross-linking, also known as CXL, is a recently released FDA approved treatment for mild to moderate keratoconus. CXL is considered a minimally invasive procedure and has been found to be effective for many patients diagnosed with keratoconus.
Keratoconus is classified as a progressive eye disease. It causes the cornea, which is usually shaped like a dome, to bulge out, into more of a cone shape. Having a cone-shaped cornea means that vision will become blurry and distorted, which requires special contacts and glasses. Those who are looking at corrective vision options like LASIK are typically not considered appropriate candidates, because keratoconus makes the cornea in the eye weaker, leaving it too thin to handle LASIK properly.
When people are first diagnosed with keratoconus, it can be treated using glasses and soft contact lenses. As the disease progresses, a more aggressive treatment regimen becomes necessary. Once keratoconus has progressed beyond a certain point, eyeglasses and contacts are no longer effective treatment options. Instead, many patients find that severe keratoconus is treated by undergoing a corneal transplant. However, for patients who have mild to moderate keratoconus, there is a new treatment option available called Corneal Cross-Linking (CXL).
Corneal cross-linking is a procedure that aims to strengthen the cornea while slowing down the effects of keratoconus. CXL was created to help stall the effects and progression of keratoconus. CXL is performed in two ways: epithelium-off and epithelium-on.
In epithelium-off CXL, the eye doctor will remove the first layer of the cornea, which is known as the epithelium. Removing the epithelium ensures that treatment is most effective. The epithelium removal process is painless and performed very quickly. When the epithelium has been fully removed, your eye doctor will apply liquid riboflavin drops to the eye. When the drops have been absorbed into your eye, they are then activated by using UV light. During the activation step, you will sit with the light in your eye for an extended period, which will be determined by your eye doctor. Next, a special kind of contact lens will be placed on your eye to help with healing.
When performing epithelium-on CXL, your eye doctor will place the liquid riboflavin over the epithelium. The epithelium is not removed, and the UV light is then used on your eye. When having epithelium-on CXL, you must sit under the UV light for a longer amount of time. This ensures that the liquid will fully penetrate the cornea’s surface.
If you suffer from keratoconus and want to learn more about CXL as a treatment option, please book a consultation with one of our highly qualified cornea experts at Boulder Eye Surgeons. If you are suffering from severe keratoconus, you may have progressed too far to be a good candidate for receiving corneal cross-linking. If you have mild to moderate keratoconus, CXL may help you avoid receiving a cornea transplant.
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