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What to Expect During Your Corneal Cross-Linking (CXL) Procedure

Keratoconus surprises most people because it begins between your teens and early 20s, an age that seems way too young for serious eye problems.

Once this problem with your cornea begins, it continues to get progressively worse over the next decade or two. Early treatment with corneal cross-linking makes the difference between protecting your vision and potentially severe vision loss.

Corneal cross-linking is the gold standard for treating keratoconus. At Atlanta Vision Cataract & Laser Center, we protect your vision by specializing in the most advanced cross-linking options. Read on to learn about the procedure and how it stops keratoconus in its tracks.

Corneal cross-linking halts progressive cornea damage

Your cornea is made up of several layers of tissues, one of which consists of collagen fibers. These fibers support the cornea’s structure, maintaining its natural dome-like shape. 

Strong collagen is essential because the shape of your cornea plays a vital role in focusing light for normal vision. When the collagen fibers start to weaken, the cornea thins, starts to bulge outward, and takes on a cone-like shape. That’s when you have keratoconus.

Without treatment, the condition progresses, and you can end up with blurred vision, irregular astigmatism, and severe vision loss. But early treatment with corneal cross-linking strengthens the cornea and stops progressive changes.

About corneal cross-linking

Cross-linking occurs when bonds (or links) develop between the strands of collagen. This process occurs naturally as you get older, because long-term exposure to sunlight triggers the chemical reactions that create the links.

When used as a treatment, corneal cross-linking uses that same principle to accelerate the production of collagen links. During cross-linking, we apply riboflavin eyedrops and use an artificial light to activate the riboflavin. 

The riboflavin causes bonds to develop between the collagen fibers. As the collagen fibers link together, your cornea gets stronger and thicker. Corneal cross-linking effectively stops the progressive damage of keratoconus.

Here’s what happens during your cross-linking procedure

Before your procedure, we perform a comprehensive eye examination and map your cornea to be sure you’re a good candidate for corneal cross-linking.

When it’s time for your procedure, you lay back in the treatment chair, and we put riboflavin drops in your eye. We add another drop of riboflavin at regular intervals until your eye has absorbed the optimal amount.

For the next step, we aim a soft blue ultraviolet light on the cornea and give it time to activate the riboflavin.

The specifics of corneal cross-linking — the amount of time between drops, the number of drops you need, whether the light stays on constantly or is turned on and off at regular intervals, and the total time for the procedure — depend on the type of eyedrops we use.

After your initial exam, we choose the best type of eyedrops and give you all the details about what to expect.

After your corneal cross-linking procedure

When your corneal cross-linking procedure is finished, we put an antibiotic ointment in your eye and apply a bandage.

You need to apply antibiotic drops several times daily for a short time and come in for follow-up appointments at three and five days after your procedure. 

We also see you again in one month and three months to monitor your progress. Most patients achieve optimal results after a few months.

If you need exceptional treatment for keratoconus or you have any questions about vision problems, we’re here to help. Call us at our Atlanta, Georgia, office or book an appointment using our online tool. We also offer telehealth visits.

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