Corneal cross-linking is an advanced treatment that offers hope to individuals with progressive corneal conditions, like keratoconus. By helping to stabilize and strengthen the cornea, this procedure can slow the worsening of vision. If you or someone you know has been diagnosed with keratoconus or another corneal ectasia disorder, understanding who is a candidate for this procedure is an important first step in exploring your treatment options.
 

What Is Corneal Cross-Linking?

Corneal cross-linking (CXL) is a procedure that uses a combination of riboflavin (vitamin B2) eye drops and controlled ultraviolet (UV) light to strengthen the collagen fibers in the cornea. The goal is to slow the progression of corneal ectasia, most commonly seen in keratoconus, by increasing the rigidity of the cornea. This helps lessen further thinning and distortion. While every patient’s needs are unique, there are several criteria that ophthalmologists use to determine who will benefit the most from corneal cross-linking.
 

Progressive Keratoconus or Corneal Ectasia

The most common candidates are individuals with progressive keratoconus, a condition where the cornea gradually thins and bulges outward, leading to distorted vision. Patients experiencing worsening vision, increasing astigmatism, or notable changes in their corneal shape may be recommended for CXL. Additionally, patients with post-refractive ectasia (corneal weakening after refractive surgery, such as LASIK or PRK) may also benefit.
 

Corneal Thickness

Candidates typically need to have a corneal thickness of at least 400 microns (µm) to safely undergo the procedure. If the cornea is too thin, there may be increased risk of complications or even worsening of your condition, and your ophthalmologist may discuss additional precautions or alternative approaches.
 

Absence of Severe Corneal Scarring

Corneal cross-linking is most effective before significant scarring develops. Patients with advanced keratoconus and extensive scarring may not experience the same level of benefit and could require other interventions, such as corneal transplant.
 

Who May Not Be a Candidate?

Not every patient with keratoconus or corneal thinning will be eligible for corneal cross-linking. Contraindications may include:
 

•          Extremely thin corneas (below the safe threshold)

•          Severe dry eye or unhealed corneal wounds

•          Advanced scarring or vision loss where cross-linking cannot restore function

•          Allergy to riboflavin or other components used in the procedure

Your ophthalmologist will conduct a thorough eye examination and review your medical history to determine if corneal cross-linking is right for you.
 

Ready to Explore Your Treatment Options?

Corneal cross-linking has become an important option for managing progressive keratoconus and other corneal thinning disorders. Identifying the right candidates and starting treatment early can make a significant difference in preserving long-term vision and eye health.
 

To learn more about corneal cross-linking and find out if it may be right for you, contact North Texas Ophthalmology Associates to schedule a consultation with one of our experienced ophthalmologists. Visit us at www.ntoaeye.com or call us at (940) 240-8400 to book an appointment today.