Your Cross-Linking Recovery: Here’s What to Expect

Submitted by Atlanta Vision Cataract and Laser Center on March 16, 2021

Corneal cross-linking is the only treatment available today that stops the progression of keratoconus. As keratoconus gets worse, your cornea bulges outward and your vision deteriorates.

At Atlanta Vision Cataract and Laser Center, we stop keratoconus in its tracks with corneal cross-linking. And if anything is better than protecting your vision, it’s knowing that we can do it in about an hour, and your recovery is smooth-sailing and virtually pain-free.

Types of corneal cross-linking

There are two basic types of corneal cross-linking procedures called epi-on and epi-off. Epi refers to the cornea’s epithelium, which is the top or outermost layer of the tissues that make up the cornea.

The corneal epithelium consists of specialized cells that form a protective barrier. The epithelium helps keep your cornea hydrated and stops bacteria from getting into your eye.

Some corneal cross-linking procedures begin by removing the epithelium. That’s an epi-off procedure. Epi-off was the original technique for cross-linking, and it’s still an effective procedure. 

But epi-off cross-linking increases your risk of complications. Removing the epithelium also leads to more pain and a longer recovery time.

The second type of cross-linking is called epi-on because the epithelium remains intact. When the epithelium stays in place, cross-linking is less invasive and takes less time. 

We perform epi-on cross-linking using the advanced Avedro KXL® system. With the epi-on technique, you have less post-procedure pain and a faster recovery.

Epi-on cross-linking procedure

During an epi-on cross-linking procedure, we place riboflavin eyedrops in your eye. We add the drops on a regular basis, typically every few minutes, for about a half hour or until the cornea is saturated. Then we place an ultraviolet light over the treated eye.

While you’re under the light, we keep adding eyedrops at regular intervals. The light activates riboflavin, which in turn triggers reactions that build bonds between the strands of collagen that make up your cornea.

As new bonds develop, your cornea strengthens, preventing keratoconus from getting worse. The entire procedure only takes 30-90 minutes.

Recovery after your cross-linking procedure

Since the epithelium stays in place, most patients have little to no pain after their cross-linking procedure. But each person’s sensitivity varies, so you may have a little discomfort for the first few days. 

One thing is certain, the pain after an epi-on cross-linking procedure is significantly less compared to epi-off procedures.

You may want to stay away from intense exercise the rest of the day, but our patients typically return to their normal routine the day after their epi-on cross-linking procedure.

You also don’t need to worry about problems developing during your recovery. The complications that can occur in patients who have an epi-off procedure — a cloudy cornea, scarring, and infections — have never appeared in epi-on patients.

If you notice symptoms of keratoconus, such as blurry vision and increased sensitivity to light, or you would like to learn more about cross-linking, call us at our Atlanta, Georgia, center or book an appointment online today.