Corneal Cross Linking Procedure Submitted by Atlanta Vision Cataract and Laser Center on October 27, 2016

Corneal Cross Linking is a procedure performed to treat ocular conditions where the cornea becomes weakened or starts to degenerate. One of the most common issues that Corneal Cross Linking is used to treat is keratoconus, a degenerative disorder that causes structural changes to the shape of the cornea. In a healthy cornea, the epithelial tissue has a natural gradual curve. In an eye affected by keratoconus, however, the cornea becomes thinner and takes on a more pronounced conical shape.

Keratoconus is most often diagnosed during the adolescent years, and in cases where both eyes are affected, visual impairment can be severe enough to impede the ability to drive or read normal-sized print. If keratoconus if identified in its early stages, corrective lenses can be prescribed to allow patients to continue driving and engaging in normal activities. However, once the condition progresses and visual acuity begins to deteriorate further, surgery may be necessary to repair the corneas.  Dr. Achiron and Dr. O’Day along with their team of experts at Atlanta Vision Cataract & Laser Center Center, diagnose and treat patients suffering from a variety of conditions that can lead to impared vision. To Schedule an appointment for an eye examination call (404) 765-2020.

Candidates for Corneal Cross Linking

To determine whether you are a candidate for Corneal Cross Linking, Dr. Achiron or Dr. O’Day will first perform a regular eye exam, as well as measure the thickness of the your cornea. A corneal topography (mapping of the cornea) will also be performed to determine the extent and severity of the condition. Many patients who have received Corneal Cross Linking have enjoyed corneal stability (where their condition did not continue to deteriorate further after the procedure) or actual improvement. The goal is to identify and treat the condition in the early stages, before severe degeneration and visual impairment sets in. Further potential applications for corneal cross linking include:

  • Treatment for corneal ulcers unresponsive to topical antibiotics
  • Corneal infections
  • Corneal instability and vision fluctuation for patients that previously had a radial keratotomy procedure


Early symptoms of keratoconus often mirror those of common refractive eye conditions, like myopia, hyperopia, or astigmatism. Patients suffering from keratoconus often complain of the following symptoms:

  • Distorted vision
  • Multiple images
  • Streaking
  • Sensitivity to light

About the Procedure

This minimally invasive procedure involves applying liquid riboflavin, a form of vitamin B2, onto the surface of the cornea, then treating the eye with ultraviolet light, eliminating cornea ectasia. The procedure is most effective when it can be performed before the cornea(s) become too irregular in shape, or before there is significant vision loss. The Corneal Cross Linking procedure strengthens the cornea, and allows patients suffering from thinning or degenerating corneas (as in cases of keratoconus) to benefit most from the emerging technology.

There are two types of Corneal Cross Linking. Both procedures takes about 60 to 90 minutes after which a protective contact lens may be applied along with topical antibiotics and anti-inflammatory drops. Your doctor will decide before hand which type will be most beneficial to you. At this time, studies show that corneal stability and improvement has occurred in 99 percent of patients.

  • Epithelium Off: In this version, the thin layer of tissue covering the eye is removed to allow for faster and enhanced penetration of the riboflavin treatment.
  • Epithelium On: In the version where the epithelium is not removed, also known as transepithelial Corneal Cross Linking, the riboflavin is applied over the epithelial tissue and requires longer saturation time.

Aftercare and Recovery

After the Cornea Cross Linking procedure, your eyes will be gritty, red and sensitive to light for several days – many patients find sunglasses helpful. Any pain or discomfort can be controlled with over-the-counter medication. Your vision will be quite blurred at first, but will clear gradually within a few weeks. Most patients take 7 – 10 days off of work while the surface healing occurs. Day to day activities such as watching TV or using a computer will not do any damage to your eyes, but you might find it more comfortable to rest with your eyes closed early on.

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