Stabilise your keratoconus with cross-linking (CXL) treatment in East Grinstead, Sussex and London

Discover how CXL for keratoconus can significantly strengthen your cornea

Stabilise your keratoconus with cross-linking (CXL) treatment in East Grinstead, Sussex and London

Discover how CXL for keratoconus can significantly strengthen your cornea

Stop keratoconus from getting worse with cross-linking

A great solution if you want to avoid a corneal transplant

Cross-linking is a procedure that uses UV light, and eye drops to strengthen the cornea’s collagen fibres. It is considered the only effective treatment to halt progressive keratoconus.

We will remove the epithelium (the superficial thin layer of the cornea) and apply riboflavin drops to the corneal surface. We then shine a specific type of UVA light onto the cornea. This causes new collagen crosslinks to develop. The cross-links cause the collagen fibrils to shorten and thicken, leading to a stiffer, stronger cornea.

Corneal cross-linking is an outpatient procedure that typically lasts for about an hour.

We recommend corneal cross-linking (CXL) for patients whose corneal scans show evidence of worsening keratoconus or those who might be at especially high risk of worsening keratoconus.

Healthy corneas can retain their shape due to strong bonds (cross-linkage) between collagen fibres.

But when keratoconus occurs, these cross-links, or support beams, break down, weakening the cornea and causing the tissue to bulge outwards.

With corneal cross-linking, we apply riboflavin eye drops and ultraviolet light to the eye to increase the strength of collagen bonds. This strengthens the cornea and prevents further loss of vision.

Advantages
  • Improved vision: Up to 81% of patients who undergo CXL see more clearly after treatment. 1Miamikeratoconus.com. 2021. What is Cross Linking (CXL)?. [online] Available at: <https://www.miamikeratoconus.com/site/what-is-cross-linking-cxl.htm> [Accessed 24 June 2021].
  • Minimally invasive: Compared to a corneal transplant, which requires a surgical procedure, CXL is minimally invasive.
  • Long-lasting results: Studies have concluded that CXL results can last for years and that the strengthening effect may be permanent.
  • Shorter recovery: Recovery following a corneal transplant can often be a lengthy process. In contrast, CXL allows patients to return to normal activities within days.
Disadvantages
  • In general, cross-linking is very safe2Clark Chang, M., 2021. Your Top 12 Crosslinking Questions—Answered!. [online] Reviewofoptometry.com. Available at: <https://www.reviewofoptometry.com/article/your-top-12-crosslinking-questionsanswered#footnotes> [Accessed 24 June 2021]., but you should allow your eye to heal, and problems can occasionally occur.
  • For example, about 3% of patients will experience some loss of vision in the treated eye due to haze, infection, or other complications.3Hull University Teaching Hospitals NHS Trust. 2021. Corneal Collagen Crosslinking (CXL) for Keratoconus | Hull University Teaching Hospitals NHS Trust. [online] Available at: <https://www.hey.nhs.uk/patient-leaflet/corneal-collagen-crosslinking-cxl-for-keratoconus/> [Accessed 24 June 2021].
  • In most cases, we can reverse any visual loss with a corneal transplant.
  • Without cross-linking treatment, at least 20% of all patients with keratoconus will eventually require a corneal transplant.4Hull University Teaching Hospitals NHS Trust. 2021. Corneal Collagen Crosslinking (CXL) for Keratoconus | Hull University Teaching Hospitals NHS Trust. [online] Available at: <https://www.hey.nhs.uk/patient-leaflet/corneal-collagen-crosslinking-cxl-for-keratoconus/> [Accessed 24 June 2021].

Overall, cross-linking is low risk. However, the following risks can occur:

  • Corneal haziness, opacity, dropping of visual acuity and stromal scarring
  • Corneal epithelial defect (disruption of surface cells)
  • Delayed epithelial healing
  • Infection
  • Severe inflammation

Treatment for keratoconus depends on the severity of your condition and how quickly the condition is progressing.

Generally, there are two approaches to treating keratoconus:

  1. Slowing the progression of the disease
  2. Improving your vision.

If your keratoconus is progressing, we may suggest corneal collagen cross-linking treatment to slow or stop the progression. This is a newer treatment that has the potential to prevent you from needing a cornea transplant in the future. However, this treatment does not reverse keratoconus or improve vision.

Improving your vision depends on the severity of keratoconus. Mild to moderate keratoconus can be treated with eyeglasses or contact lenses. However, this will likely be a long-term treatment, especially if your cornea becomes stable with time or from cross-linking.

In some people with keratoconus, the cornea becomes scarred with advanced disease or wearing contact lenses becomes difficult. In these people, cornea transplant surgery might be necessary.

The procedure will take about an hour. You will be awake throughout.
We will numb your eye using anaesthetic drops and can give you mild sedation if you choose.

Patients typically do not experience any discomfort during the procedure.

After the procedure, patients usually experience pain that we can control with pain killers. Other symptoms include increased sensitivity to light, as well as general discomfort in the affected eye. Some patients describe that discomfort as a gritty, burning sensation.

You should avoid rubbing your eyes for up to five days following the procedure.

Cross-linking is currently the only available treatment that appears to stop the worsening of keratoconus.5Cross-linking is currently the only available treatment that appears to stop the worsening of keratoconus.9WebMD. 2021. What Is Corneal Cross-Linking?. [online] Available at: <https://www.webmd.com/eye-health/corneal-cross-linking-for-keratoconus> [Accessed 24 June 2021]. Clinical trials based on outcomes one year after cross-linking show success in the halting of keratoconus in more than 90% of treated eyes, with more than 45% of eyes also gaining an improvement in corneal shape.10 A separate study over five years showed a similar success rate in halting the progress of keratoconus.

Visual improvement after treatment occurs in approximately 50% of cases. However, after treatment, you will still need to wear spectacles or contact lenses.

Clinical trials involving patients who received cross-linking one year previously show that more than 90% of treated eyes had no worsening of keratoconus and 45% of eyes showed an improvement in corneal shape6Aldo Caporossi, Cosimo Mazzotta, Stefano Baiocchi, Tomaso Caporossi, Rosario Denaro, “Age-Related Long-Term Functional Results after Riboflavin UV A Corneal Cross-Linking”, Journal of Ophthalmology, vol. 2011, Article ID 608041, 6 pages, 2011. https://doi.org/10.1155/2011/608041.

A separate study over five years showed a similar success rate in halting the progress of keratoconus7Christopher Kent, S., 2021. Cross-Linking: Asking the Tough Questions. [online] Reviewofophthalmology.com. Available at: <https://www.reviewofophthalmology.com/article/cross-linking-asking-the-tough-questions#:~:text=so%2C%20for%20whom%3F-,Dr.,some%20flattening%20after%20cross%2Dlinking.> [Accessed 24 June 2021]..

In about half of cases, visual improvement occurs, however glasses or contact lenses will still need to be worn after treatment.

Corneal diseases are a leading cause of blindness and vision impairment all over the world

Early diagnosis and treatment is key to preventing further damage and restoring vision. Come see us today for an assessment.

Is poor vision or a worrying eye condition holding you back?

If so, we’re here to help you move forward with your life quickly and conveniently

I have cataracts or my vision is cloudy, yellow and dull

If your vision is hazy or blurred (even with glasses); if colours appear dull or faded; or if you’re having increasing difficulty driving or seeing at night, it’s likely you have a cataract.

Restore your visual clarity (AND remove your need for glasses!) with premium cataract surgery.

My glasses and contacts interfere with my lifestyle

Do glasses or contact lenses get in your way or make you feel uncomfortable? We understand how it feels to be let down by your eyes while everyone else enjoys life with natural vision.

Enjoy ultimate visual freedom free from glasses and contacts with laser eye surgery or lens replacement.

I have a troublesome eye condition

Whether you have keratoconus, dry eye, or another cornea and ocular surface disease, we appreciate the impact this can have on your comfort and quality of life.

Gain relief from your condition and move forward with your life with our range of gold-standard eye treatments.

Affiliations and memberships

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Academic resources on Keratoconus treatment – Cross-Linking CXL

Learn more about Keratoconus treatment – Cross-Linking CXL from authoritative sources

Diagnosable through a routine eye exam, your ophthalmologist will examine your cornea and measure its curvature. This helps analyse a change in the corneal shape. This paper also encompasses Keratoconus treatments and tips. Click here for more information.

This paper covers the first-ever collaboration of 4 supranational cornea societies joining forces in a multistep process to develop the Global Consensus on Keratoconus and Ectatic Diseases. Click here for more information.

Keratoconus is a progressive eye disease that causes a thinning of the clear front surface of the eye (cornea) and distorts the cornea into a cone-like shape. This causes distorted vision that cannot be rectified with spectacles. Click here for more information.

Get relief from your troubling eye condition

Early diagnosis and treatment is key to preventing further damage and restoring vision. Come see us today for an assessment.

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We provide personalised treatment at a time and place that suits you

Mr Mohamed Elalfy

MBBCh, MSc, MD, DRCOphth, FRCS (Ed), FRCS (Glas), FRCOphth, FICO, FEBO
Consultant Ophthalmic Surgeon

Seeking eye treatment for a worrying eye condition can be stressful. Waitlists everywhere are long due to the lockdowns, and leaving the house to attend appointments can be a real inconvenience.

To make your experience as easy and stress-free as possible, we provide assessments in your local area. We also offer online appointments both before and after your treatment, so you don’t have to travel far to get the personalised support you deserve.

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