Corneal cross-linking is a procedure used to strengthen corneas. Corneal cross-linking is a minimally invasive procedure that uses ultraviolet light and Riboflavin drops in order to strengthen the collagen fibres in the cornea. The procedure is used for patients with keratoconus, a condition in which the cornea grows thin and weak (and, sometimes, in other conditions that cause a similar weakening of the cornea).

The corneal cross-linking procedure strengthens and stabilizes the cornea by creating new links between collagen fibres within the cornea. The two-step procedure in which the doctor applies speciality formulated riboflavin (vitamin B) eye drops to the surface of the eye immediately followed by controlled exposure of the eye to ultraviolet light for 5 minutes (High Fluence CXL). The riboflavin causes new bonds to form across adjacent collagen strands in the stromal layer of the cornea. The procedure causes new corneal collagen cross-links to develop. Those cross-links cause the collagen fibrils to shorten and thicken, leading to a stiffer, stronger cornea which in turn recovers and preserves some of the cornea’s mechanical strength.

The two basic types of Corneal Cross-Linking are:

• Epithelium-off cross-linking. In this procedure, the thin outer layer (epithelium) of the cornea is removed to allow the liquid riboflavin to more easily penetrate the deeper corneal tissue.
• Epithelium-on cross-linking. In this procedure (also called transepithelial cross-linking), the protective corneal epithelium is left intact, making it a less invasive procedure than cross-linking with epithelium removal.

After epi-off and epi-on cross-linking, a bandage contact lens will be placed on your eye to reduce discomfort and facilitate healing. Topical antibiotics and anti-inflammatory drops will be prescribed.

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

Epi-off cross-linking studies have found that most keratoconus patients will remain stable or achieve improvement in the corneal shape, which is highly significant for people with progressive keratoconus that otherwise might lead to severe vision loss. Epi-on cross-linking is currently under clinical investigation to determine the safety and efficacy of the procedure. Based on this we, at SafeSight, only perform Epi-off cross-linking.

Best candidates for Corneal Cross-Linking

Corneal cross-linking is most effective if it can be performed before the cornea has become too irregular in shape or there is significant vision loss from keratoconus. If applied early, cross-linking typically will stabilize or even improve the shape of the cornea, resulting in better visual acuity and an improved ability to wear contact lenses.

Other potential applications of cross-linking include the treatment of corneal ulcers that are unresponsive to treatment with topical antibiotics.

Corneal Collagen Cross-Linking Costs?

R9 000 per eye. This includes the following:

• Cross-linking procedure,
• surgeons fee,
• Riboflavin drops and all other disposables,
• facility fee,
• 1 Month post-op visits and post-op scans.

Costs Exclude anaesthetic fees in case of general anaesthetic (kids). Excludes post-op medicines (±R800 extra).