Michael Tappin Consultant Ophthalmologist
Surrey Eye Clinic
Cross Linking Procedure
Cross-linking therapy is being used for a number of diseases of the cornea and is proving a useful treatment in conjunction with other surgical techniques such as Intacs and refractive laser surgery. However Cross linking is not for everybody, the first requirement is to ensure that the thickness of the cornea is adequate for the treatment. Special non-invasive measuring devices are used by your specialist to accurately and quickly take these readings.
The procedure of Cross Linking itself takes just 30 minutes and may be either conducted in an Operating theatre or a special “treatment” room. Some preparation is required which involves anaesthetising the eye to be treated. This is a procedure that takes about 30 minutes prior to the Cross Linking procedure itself. This will involve anaesthetic eye drops applied every five minutes over the 30 minute period. At the end of these 30 minutes, the top layer of protective skin on the eye called the epithelium will be removed, to allow the drops of Riboflavin to penetrate the cornea. Riboflavin is then applied to the eye, with drops at intervals for a short period. This is done prior to the treatment to allow the riboflavin to absorb into the cornea, prior to the application of the ultraviolet light.
During the treatment, the custom-made riboflavin eye drops continue to be applied onto the cornea every few minutes. The patient is asked to look directly at a light to make it easier to keep the eye still during the procedure. At any time in the procedure a rest can be taken and the procedure continued from that point in time Finally, the specialist will wash the corneal surface with a special solution.
Post-operative pain and sensation of foreign body will be experienced in the eye for 24-48 hours after treatment until re-epithelialisation is complete there will be weeping of eye for 24-72 hours after treatment there will be transient corneal oedema with visual blurring for 30-60 days after treatment there will be persistent corneal oedema after second month from treatment corneal haze may occur , this resolves over the following 3 to 6 months. Expert experience with Cross Linking is showing great promise, but cannot exclude the possibility of further treatment or a corneal transplant at this stage
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