CROSSLINKING

What is crosslinking?

Crosslinking is a medical procedure used to treat keratoconus, a progressive eye condition that causes the cornea to thin and bulge into a cone-like shape. This distortion of the cornea can lead to vision problems, including astigmatism and blurred vision. Crosslinking is one of the primary treatments for keratoconus and is aimed at stabilizing and strengthening the cornea to prevent further progression of the condition.

Tissue Crosslinking: In medicine, tissue crosslinking is used to strengthen and stabilize biological tissues. For example, corneal collagen crosslinking is a procedure used to treat keratoconus, a progressive eye condition. It involves the application of riboflavin (vitamin B2) and ultraviolet (UV) light to crosslink the collagen fibers in the cornea, making it more rigid and preventing further deformation.

Here's how crosslinking for keratoconus works:

1. Riboflavin Application: The procedure begins with the application of riboflavin (vitamin B2) eye drops to the surface of the cornea. Riboflavin is important because it absorbs ultraviolet (UV) light and helps in the crosslinking process.

2. UV Light Exposure: After riboflavin is applied, the cornea is exposed to ultraviolet A (UVA) light. The combination of riboflavin and UVA light initiates a chemical reaction that forms new crosslinks (covalent bonds) within the collagen fibers of the cornea.

3. Crosslink Formation: The crosslinks created during the procedure increase the cornea's rigidity and strength. This helps to halt or slow down the progression of keratoconus, as it prevents the cornea from further thinning and bulging.

What is the goal of crosslinking?

The goal of corneal crosslinking is to stabilize the cornea and prevent the need for more invasive treatments, such as corneal transplantation. The procedure is typically performed in an outpatient setting and is minimally invasive.

When is the best time to get crosslinking?

Crosslinking is most effective in the early stages of keratoconus when the condition is still progressing. It may not significantly improve vision, but it can help maintain the current level of vision and prevent further deterioration. After the procedure, patients often continue to wear contact lenses or glasses to correct their vision.

It's important to consult with Dr. Bhasin to determine whether corneal crosslinking is an appropriate treatment for your specific case of keratoconus. The eligibility for the procedure may depend on the severity of the condition and other individual factors.

Risks/Side Effects

  • mild eye pain/discomfort

  • hazy or blurry vision

  • light sensitivity

  • dry eye

  • changes in vision

  • changes to your cornea

Rarely crosslinking can cause more serious side effects, including:

  • worsening of keratoconus

  • scarring

  • infection

  • loss of vision

After Surgery

recovery time

During the first week of recovery, you want to refrain from doing any of the following:

  • rubbing/touching your eye

  • wear any eye makeup

  • get water in your eye

  • heavy exercising

  • bending, straining, swimming, hot tubbing

Talk with Dr. Bhasin to determine when it is safe to resume your normal activities. Most people are able to get back to their normal daily activities within 1-2 weeks of crosslinking. Your vision may not be fully stable for several months. This means your “best-corrected” vision (your eyeglass prescription) will likely change during this time. After 6-8 weeks Dr. Bhasin will refit your glasses or hard contact lenses. You will receive an antibiotic eye drop and a steroid eye drop to help your eye heal after surgery.

Arpita Bhasin