corneal cross-linking

Corneal Cross-Linking (CXL) Procedural ImageTechnology marches ahead everyday with the singular purpose of making lives better. If you ask most Cornea surgeons about the one technology that they’ve been waiting for over the past couple of years, they’re likely to tell you about Corneal Collagen Cross-linking, also referred to as corneal cross-linking or CXL.  The wait is now over. Milan Eye Center is proud to adopt and implement this life changing procedure. Patients suffering from progressive keratoconus and corneal ectasia following refractive surgery can now receive a therapeutic treatment that has been rigorously tested and FDA approved.

What is Corneal Cross-linking (CXL)?

Corneal cross-linking is a simple procedure that uses Vitamin B2 (Riboflavin) and UV light to strengthen corneas. Corneas can become weak, progressively thin, and bow forward causing irregular astigmatism and loss of vision in some patients. This process is called ‘ectasia’. The most common cause of ectasia is keratoconus. Rarely, patients with a history of LASIK or photorefractive keratectomy (PRK) can also develop ectasia.

Traditionally, these patients had to wear hard contact lenses and bear with deteriorating vision. Surgeons were forced to watch as the disease progressed in many of their patients until they required a corneal transplant. The goal of CXL is to stabilize and even reverse ectatic corneas and prevent progression of the disease.

Corneal cross-linking is performed in an office setting and takes approximately 2 hours total for prep time, treatment time, and proper recovery time. The most wonderful thing about this procedure is that it is minimally invasive and involves only eye drops, UV light and a painless brushing off of the surface cells of the cornea. Recovery generally takes a few days, after which, vision recovers slowly over the next few weeks. This technology is a game changer and we are proud to offer it to our patients!

Other Frequently Asked Questions

Does CXL require removal of the epithelium?

Yes, your doctor will apply topical anesthesia to numb the eye prior to the removal of the epithelium. This process helps to prepare your eye so that the drug can penetrate the tissue of the cornea to have an effective cross-linking procedure.

Am I awake during the corneal cross-linking procedure?

Yes, typically you will be awake during the treatment. You’ll be given medication and numbing anesthetic drops.

Does the CXL procedure hurt?

There can be some discomfort during immediate recovery, but usually not during the treatment. Immediately following treatment, a bandage contact lens is placed on the surface of the eye to protect it. After the numbing drops wear off, there could be some discomfort, managed with Tylenol and artificial tears. If pain is severe, oral narcotics may be used.

What can I expect after the CXL procedure?

You may notice a sensitivity to light and have a foreign body sensation. Sunglasses may help with the light sensitivity. You may also experience discomfort in the treated eye. You should not rub your eyes for the first five days after the procedure.

If you experience severe pain in the eye or any sudden decrease in vision, you should contact your physician immediately. If your bandage contact lens from the day of treatment falls out or becomes dislodged, you should not replace it and also contact your physician immediately.

What are the side effects of corneal cross-linking?

The most common ocular adverse reactions were haze (corneal opacity), inflammation (punctate keratitis), fine white lines (corneal striae), disruption of surface cells (corneal epithelium defect), eye pain, reduced sharpness of vision (visual acuity), and blurred vision.

The side effected noted above are not a comprehensive list. Please contact your physician to discuss these in further detail.

Is corneal cross-linking right for me?

Patients over the age of 14 who have been diagnosed with progressive keratoconus or corneal ectasia following refractive surgery should ask their doctor about corneal cross-linking. We’re happy to be able to offer an effective treatment for patients who, until recently, had no therapeutic options to limit the progression of this sight-threatening disease.

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“Seeing Dr. Sajja was very easy and efficient. He was very thorough and professional. He was also very honest in what he felt needed to be done. He also had a very good bedside manner and was caring, nothing was painful at all. The surgery was a quick procedure and I was in excellent care. I was amazed that Dr. Sajja himself called me two days after surgery to check-up on me!”

“Dr. Milan Patel is an excellent, caring physician. From the initial exam through cataract surgery he was very patient with explaining the surgery and recovery process. I had both eyes replaced with new lenses and felt extremely comfortable through both procedures. I highly, highly recommend him!”

“I was scared of having my cataracts removed, but the doctor and all of the staff made me most comfortable. There was no pain & the recovery was short. I would recommend Dr. Desai to anyone who needs surgery. And the people who work there are just wonderful”
Deb Hallinyer