Advanced treatment to halt the progression of keratoconus
Corneal collagen crosslinking (CXL) is a minimally invasive treatment that strengthens the cornea and halts the progression of keratoconus and other corneal ectasias. By combining riboflavin (vitamin B2) eye drops with targeted ultraviolet light, the procedure creates new chemical bonds between collagen fibres, stiffening the cornea and preventing further thinning.
At Vale Eye Surgeons, collagen crosslinking is performed by a consultant ophthalmologist with specialist fellowship training in corneal disease, ensuring the most appropriate protocol is selected for your individual cornea.
Riboflavin drops are applied to the cornea, saturating the tissue over approximately 10-20 minutes. The cornea is then exposed to a calibrated dose of ultraviolet-A light for around 30 minutes, which activates the riboflavin and creates additional crosslinks between collagen strands. These new bonds make the cornea significantly more rigid and resistant to further deformation.
We offer both epithelium-off (standard) and epithelium-on (transepithelial) protocols, depending on clinical indication and patient suitability.
Detailed corneal imaging including topography, tomography (MS-39 Scheimpflug analysis), and pachymetry to confirm the diagnosis of progressive keratoconus and assess corneal thickness. Not every patient with keratoconus needs crosslinking - it is reserved for eyes showing documented progression.
The procedure is performed under topical anaesthetic as a day case. You will be awake but comfortable. The total treatment time is approximately 30 minutes per eye, following the riboflavin soaking period.
For epithelium-off protocols, a bandage contact lens is placed to aid healing. Expect discomfort, light sensitivity, and blurred vision for three to five days. Full visual recovery typically takes several weeks, and the stabilising effect continues to develop over 12 months.
Crosslinking is indicated for patients with documented progression of keratoconus or post-refractive surgery ectasia. It does not reverse existing corneal distortion, but it can preserve your vision by preventing further deterioration - potentially avoiding the need for a corneal transplant later in life.
Crosslinking is of particular importance in younger patients, where keratoconus tends to progress more rapidly and the window for intervention is critical. Early treatment in this group can protect vision for decades to come.
Crosslinking is of critical importance in younger patients, where keratoconus tends to progress more rapidly. Because the window for intervention is so vital, we often recommend treatment for young patients upon diagnosis, rather than waiting for documented progression.