Everything You Need to Know About Cross-Linking Eye Surgery

Cross-linking eye surgery is a game-changer for patients with keratoconus. Not long ago, there weren’t any treatments that could stop this corneal disease from getting worse. Now our patients at Atlanta Vision Cataract & Laser Center have another option called corneal cross-linking

With cross-linking eye surgery, you have hope for stopping disease progression and preserving your vision. Here’s what you need to know about cross-linking eye surgery.

Cross-linking stops keratoconus progression

Keratoconus is an eye condition in which the cornea thins out and starts to bulge away from your eye, forming a cone-like shape. These changes in the cornea make your vision increasingly blurry and distorted.

Keratoconus typically starts in your teens and continues to gradually worsen for about 10-20 years. Each patient is different, but the thinning tends to progress most rapidly during adolescence then stabilizes around middle age.

Before the US Food and Drug Administration approved cross-linking in 2016, keratoconus was treated with eyeglasses, contacts, and Intacs®, two semicircular rings that we surgically implanted around the edge of the cornea.

These treatments help correct vision changes — and they’re still good options for patients with mild keratoconus or when used together with corneal cross-linking — but they do not stop the progressive corneal thinning. As a result, patients must wait and see how bad their vision becomes and whether it gets severe enough to need a cornea transplant. 

All that has changed with corneal cross-linking, a simple procedure that’s safe for teens and stops corneal thinning.

Cross-linking explained

Cross-linking occurs naturally in your eyes as you get older. During cross-linking, collagen fibers develop and connect to the layers of connective tissues that make up the cornea. As more collagen fibers create links between multiple layers, they strengthen and thicken the cornea, which stops the progressive thinning of keratoconus.

Details about cross-linking eye surgery

Cross-linking increases as you get older because cumulative exposure to sunlight triggers chemical reactions in your eyes that boost collagen production. During cross-linking eye surgery, we take advantage of the same principle to accelerate the process.

We perform cross-linking surgery on one eye at a time. When you come in for your procedure, we start by applying anesthetic drops so you’re comfortable throughout the procedure. 

Some cross-linking surgeries, called epi-off, begin by gently removing cells from the outer layer of the cornea. Other cross-linking procedures are called epi-on because we leave the outer layer intact and use special eyedrops that go through the barrier.  

Once your eye is prepared, we place drops of riboflavin (vitamin B2) in your eye, applying the eyedrops at specific intervals until a sufficient amount is absorbed by your cornea. Then we aim a soft ultraviolet (UV) light on the cornea for 5-30 minutes, depending on the type of eyedrops and level of UV light. The riboflavin enhances the effect of the UV light, rapidly boosting collagen production.

Healing after cross-linking eye surgery

After the procedure, you may feel a gritty sensation, but this side effect shouldn’t last long. We give you specific care instructions to follow, but one of the most important is to avoid rubbing your eyes for five days.

Most patients can get back to their usual activities the next day. Over the next one to three months, you may experience fluctuations in your vision. After three months, your vision stabilizes.

If you develop blurry vision or have questions about treatment for keratoconus, call us at Atlanta Vision Cataract & Laser Center or use our online booking to schedule an appointment.

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