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Cross Linking

Corneal Crosslinking for Keratoconus

Corneal collagen crosslinking (CXL) was developed in 1998 by Theo Seiler, MD, and has been shown in numerous clinical trials to strengthen the eye’s clear surface (cornea) through the application of riboflavin, a form of vitamin-B2, followed by treatment with ultraviolet A (UV-A) light.

Crosslinking with riboflavin and UV-A light has proven to be a first-line treatment for people with eye conditions such as keratoconus, pellucid marginal degeneration and corneal weakness (ectasia).

While crosslinking is used in virtually every country around the world, it is still in the FDA approval process in the United States. Both Avedro and Topcon are working to get their brands of riboflavin drops and UV light sources approved by the FDA. As well, many other single-center and multicenter clinical trials are evaluating CXL in the U.S.

The aim of corneal crosslinking is to strengthen the cornea by increasing the number of “anchors” that bond collagen fibers together. Corneal crosslinking can also be used in combination with other technologies, with the goal of improving the visual results more rapidly. Tiny plastic inserts known as Intacs, which are surgically implanted within the cornea, have been shown to work well with crosslinking. Surface laser vision correction guided by corneal topography has also proven to be a useful technology.