Corneal Cross-linking (CXL) is a procedure that is used to treat keratoconus (KC). During the procedure, riboflavin (vitamin B2) is applied to the eyes via eye drops. Ultraviolet light is then directed onto the eyes. This strengthens and stabilizes the cornea, allowing it to flatten. CXL can effectively halt the progression of KC and preserve the remaining vision in KC eyes. To determine if a patient is a good candidate for CXL, doctors consider multiple factors.
When deciding if CXL is a good treatment option for a patient, doctors examine several factors, including KC progression, patient age, and corneal thickness. In most cases, in order for a patient to qualify for CXL, they must demonstrate progression of KC. Dr. Randleman, an M.D. at the University of Southern California, states that CXL is often a good choice for those with worsening vision that can no longer be corrected with other treatments such as contact lenses. Younger patients tend to experience rapid a progression of KC, so ideally, they are treated with CXL as soon as possible since CXL halts the progression of KC but does not recover lost vision. Older patients typically do not experience such a rapid progression of KC, but they must also be monitored closely to see if CXL is a good option. Additionally, doctors exam the patient’s eye rubbing history when determining if CXL is a good fit for the patient. Corneal thickness is also considered as a cornea that is too thin will not have much benefit from CXL.
There are certain factors that would make doctors decide against CXL. Doctors typically do not recommend CXL if a patient has undergone a penetrating keratoplasty (PK) or a deep anterior lamellar keratoplasty (DALK). During both of these procedures, the central corneal stroma is removed. This region of the eye must be present in order for CXL to be beneficial. CXL also cannot be performed if the cornea is too thin, specifically 400 microns.
CXL is an effective treatment for stopping the progression of KC. The limitations of CXL generally occur during the later stages of KC, so results are most effective if the procedure is done as soon as possible. The best way to find out if you are a candidate for undergoing CXL is to talk to your eye doctor. CXL is a method that can help reduce the impact of KC on your vision and allow you to enjoy your life fully.