Corneal Cross Linking

Understanding Corneal Ectasia

Corneal ectasia is a condition where the cornea, the clear front surface of the eye, becomes weak and progressively bulges outward, leading to visual impairment. This condition is often associated with keratoconus, a degenerative disorder causing the cornea to assume a conical shape.

When Does Surgery Become Necessary

Corneal Cross Linking (CXL) becomes necessary when corneal ectasia progresses to a point where it significantly affects vision and cannot be adequately corrected with glasses or contact lenses. The goal of CXL is to halt the progression of the disease and prevent further vision loss.

Overview of the Surgical Procedure

Corneal Cross Linking is a surgical technique that strengthens the cornea by creating new links between its collagen fibres. This is achieved by applying a photosensitising solution to the cornea and then activating it with ultraviolet light.

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Causes of the Issues

Corneal ectasia is often caused by keratoconus, a degenerative eye condition. It can also occur as a complication of laser eye surgery.

Conditions Warranting Corneal Cross Linking

Corneal Cross Linking is recommended for patients with progressive keratoconus or post-LASIK ectasia, where the condition continues to worsen despite non-surgical treatments.

Related Concerns

If left untreated, corneal ectasia can lead to significant vision loss and may eventually require a corneal transplant.

Treatment Approaches

Treatment options for corneal ectasia include glasses, contact lenses, intracorneal ring segments, and Corneal Cross Linking. The choice of treatment depends on the severity of the condition and the patient's lifestyle.

Alternatives to Surgery

Non-surgical treatment options include the use of glasses or contact lenses to correct vision. However, these options do not stop the progression of the disease.

Service Overview

Corneal Cross Linking is a minimally invasive procedure that strengthens the cornea and halts the progression of corneal ectasia. It is performed as an outpatient procedure, allowing patients to return home the same day.

Benefits and Risks of Corneal Cross Linking

The primary benefit of CXL is its ability to halt the progression of corneal ectasia, potentially preventing the need for a corneal transplant. However, like all surgical procedures, it carries some risks, including infection, corneal haze, and changes in corneal shape.

Preparation for Surgery

Patients are advised to stop wearing contact lenses several days before the procedure. A thorough eye examination is also performed to ensure the patient is a suitable candidate for the surgery.

Pre-surgery Procedures and Checks

Upon arrival at the hospital, the patient's eye is numbed with anesthetic drops, and the cornea's thickness is measured. The photosensitizing solution is then applied to the cornea.

Step-by-Step Guide to Corneal Cross Linking

1. The eye is numbed with anesthetic drops.
2. A device is used to prevent blinking.
3. The cornea's outer layer (epithelium) is removed.
4. A photosensitizing solution is applied to the cornea.
5. The cornea is exposed to ultraviolet light.
6. A soft contact lens bandage is placed on the eye to aid healing. ### Postoperative Care Patients are given antibiotic and anti-inflammatory eye drops to use at home. They are also advised to avoid rubbing their eyes and to wear sunglasses to protect against UV light. ### Recovery and Rehabilitation Vision may be blurry for the first few weeks after surgery. Most patients can resume their normal activities within 1 to 2 weeks. The final visual outcome may not be apparent for several months. ## References
7. "Corneal Cross-Linking." American Academy of Ophthalmology. https://www.aao.org/eye-health/treatments/corneal-cross-linking-2
8. "Fact Sheet for Coding Corneal Collagen Cross-Linking." American Academy of Ophthalmology. https://www.aao.org/practice-management/news-detail/fact-sheet-coding-corneal-collagen-cross-linking
9. "Corneal Cross-linking consent form." OMIC. https://www.omic.com/corneal-crosslinking-consent-form/

• American Academy of Ophthalmology. https://www.aao.org/eye-health/treatments/corneal-cross-linking-2
• American Academy of Ophthalmology. https://www.aao.org/practice-management/news-detail/fact-sheet-coding-corneal-collagen-cross-linking
• OMIC. https://www.omic.com/corneal-crosslinking-consent-form/