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Corneal Cross-Linking (CXL) for treating Keratoconus
Corneal cross-linking is a minimally invasive, in-office procedure that is also referred to as corneal collagen cross-linking. It’s designed to strengthen the cornea if it has been weakened, usually by keratoconus.
A healthy cornea has “crosslinks” that connect its collagen fibers, keeping it strong enough to retain its normal shape. Corneal cross-linking increases these crosslinks to help the cornea retain its normal shape and prevent further vision loss.
The corneal cross-linking procedure applies liquid riboflavin (vitamin B2) to the surface of the eye followed by a controlled ultraviolet light. This is to eliminate corneal ectasia, which is mostly associated with keratoconus
Will insurance cover corneal cross-linking?
Insurance companies should cover all aspects of the procedure when performed for keratoconus in place of a corneal transplant. Even with substantial data published in the Peer-Reviewed Medical Literature, some insurers may not recognize the procedure for treating keratoconus. Technology is working to educate insurers, but this may take time. To the best of our abilities, we will obtain authorization from a patient’s insurance company to request reimbursement. However, all fees are ultimately the patient’s responsibility.
The National Keratoconus Foundation is a wonderful resource for keratoconus patients and families. They offer information and support through free, interactive online forums. These forums provide keratoconus patients with a unique opportunity to share their experiences, concerns, and stories with others who can truly understand the challenges of living with this condition
Before the corneal cross-linking procedure:
Before the corneal cross-linking procedure, patients undergo a thorough eye examination. Your examination will include a variety of standard ophthalmic tests for this type of procedure, as well as general medical tests and a review of your specific medical history.
Risks & precautions
As with any surgical procedure, there are some risks with corneal cross-linking, including infection. Some patients experience visual symptoms, including difficulty with night vision, glare, halos, blurry and fluctuating vision. Patients with keratoconus must not have LASIK or PRK laser eye surgery due to an unacceptable risk of a poor outcome. The cornea in keratoconus is unusually thin and weak. For patients with keratoconus, LASIK surgery thins and weakens their corneas further. This can irreversibly destabilize the cornea and accelerate its distortion. Rubbing the eyes may also increase the progression of keratoconus. Eye rubbing can often be very vigorous with patients using excessive force with their knuckles. Corneas already weakened by inflammation may develop thinning and protrusion as a result of rubbing.