Keratoconus is a condition in which the front window of the eye (the cornea) becomes more thin and steeply curved.

Collagen Cross-Linking (CXL) is now well accepted as a treatment to slow or stop keratoconus progression in most patients. Some patients also experience an improvement in their vision or in the fit of their contact lenses; these beneficial effects may continue to improve for 12 months after treatment, but it is not expected that the vision will improve enough for you to be free from glasses or contact lenses

CXL is a day procedure that takes around 1 hour in total and it is usually performed in the North Adelaide rooms. Rigid contact lenses need to be removed 2 weeks prior to treatment; soft contacts should be left out for at least 24 hours prior to treatment. When you are seen in the clinic, the procedure will be re-explained and a final set of measurements/corneal scans are taken before the procedure begins. The surface of the eye is numbed with anaesthetic drops prior to the corneal epithelium being removed under microscopic visualisation (painless and takes only around 1 minute). 

Vitamin-A drops (commercially available PESCHKE Isotonic Riboflavin) are then placed onto the cornea until it is completely soaked in the solution. This takes around 20 minutes during which time you will be laying flat on the procedure bed with a sterile drape covering the other eye. At the end of this process, the cornea thickness is remeasured (using a sterile ultrasound probe) to make sure that it is still thick enough for safe cross-linking treatment.

The central 10mm of the cornea is then exposed to intense UV light (9mW/cm2) for 10 minutes, with a soft sponge protecting the rest of the eye from UV exposure.

After UV treatment, antibiotic ointment and a bandage contact lens are placed on the eye to protect it for the following few days. Most patients need analgesia (Panadol; Panadeine Forte or Nurofen should be sufficient) and you will need to come back for review the following day. Recovery takes around 1 week, during which time the vision will be poor and you cannnot use your normal contact lenses. Prescription eye drops are required for around 6 weeks in total.

The procedure is very safe, but the specific risk profile for each person will be discussed as part of the consent.

The cost is between $1500 per eye and only needs to be performed once per eye. If only one eye is demonstrating progressive keratoconus, then only one eye should be treated. Whilst CXL is not urgent, it is important that you don't wait too long because your cornea can become too thin to treat safely.