Corneal collagen crosslinking (CXL) is a technique that uses ultraviolet (UV) light and a photosensitizer called riboflavin (vitamin B2) to strengthen the cornea and attempts to reduce the progression of Keratoconus (KCN).
Crosslinking of collagen refers to the ability of collagen fibers to form strong bonds with adjacent fibers. In the cornea, collagen cross-linking occurs naturally with aging, which may be one reason why KCN progression is thought to slow with age. This process appears to be sped up through the application of ultraviolet light and riboflavin to the cornea.
During the crosslinking procedure, the patient is first given numbing drops. A lid separator is placed to hold the eyelids open. Depending on the patient, at times the epithelial surface cells may be removed. Riboflavin (vitamin B2) drops are used to moisten the cornea and deliver the riboflavin into the cornea until the riboflavin can be seen throughout the cornea and into the fluid behind the cornea. This usually takes 15 to 30 minutes.
After the riboflavin is present throughout the cornea, the UV light is positioned in front of the cornea and delivered to the cornea. This typically takes about 30 minutes. Various drops and a contact lens are then used to aid in the healing, and the patient is seen over the next few months to monitor the healing response. It is typically 4-6 weeks before a contact lens is used again after the treatment.
Currently, CXL is not FDA approved in the United States. Minnesota Eye Consultants is part of the CXLUSA study group. This is a group of eye surgeon specialists working to improve the treatment of patients with keratoconus, post- LASIK ectasia and similar eye problems. For more information, please contact the Research Department at 612-813-3607.