Crosslinking, also known as corneal collagen crosslinking (CXL), is a minimally invasive procedure used to strengthen the cornea and halt the progression of keratoconus, a condition characterized by the thinning and bulging of the cornea. During the procedure, riboflavin (vitamin B2) eye drops are applied to the cornea, followed by exposure to ultraviolet (UV) light. This combination stimulates the formation of additional crosslinks within the corneal tissue, enhancing its strength and stability.


Candidates for crosslinking are typically individuals diagnosed with keratoconus or certain other corneal ectatic disorders, where the cornea has become weak and distorted. The procedure is most effective in patients with progressive keratoconus, where the corneal thinning is actively worsening over time.


Before undergoing crosslinking, patients typically undergo a comprehensive eye examination to assess the severity of keratoconus and ensure they are suitable candidates for the procedure. Contact lenses may need to be discontinued for a period of time prior to the procedure to allow the cornea to stabilize.


During crosslinking, the patient is positioned under a special UV light source, and riboflavin eye drops are applied to the cornea. The riboflavin enhances the absorption of UV light by the corneal tissue, leading to the formation of new chemical bonds (crosslinks) between collagen fibers, strengthening the cornea. The entire procedure typically takes about an hour to complete.


The primary goal of crosslinking is to halt the progression of keratoconus and stabilize the shape of the cornea. While vision improvement may not be immediate, many patients experience a reduction in corneal steepness and improved visual acuity over time. Long-term studies have shown that crosslinking can effectively prevent further deterioration of vision in most patients with keratoconus.


Following crosslinking, patients may experience temporary discomfort, light sensitivity, and blurred vision. These symptoms usually subside within a few days to weeks. It's essential to protect the eyes from excessive UV exposure during the healing process, which may involve wearing sunglasses outdoors and avoiding prolonged exposure to bright sunlight. Patients should adhere to post-operative care instructions provided by their ophthalmologist, which may include using prescribed eye drops, attending follow-up appointments, and avoiding strenuous activities until the cornea has fully healed.

Ivana, Patient Coordinator

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Ivana, ZagrebMed patient coordinator