Yes, your doctor will apply topical anesthesia to numb the eye prior to the removal of the Epithelium. This process helps to prepare your eye so that the drug can penetrate the tissue of the cornea to have an effective cross-linking procedure. Photrexa Viscous eye drops will be applied to the cornea for at least 30 minutes.

Yes, typically you will be awake during the treatment. You will be administered numbing anesthetic drops for your comfort while you are in the office.

The actual procedure takes about an hour, but you will be in the office for approximately two hours to allow sufficient time for preparation and recovery before you return to the comfort of your own home.

There is some discomfort during immediate recovery but usually not during the treatment. Immediately following treatment, a bandage contact lens is placed on the surface of the eye to protect the newly treated area. After the numbing drops wear off, there is some discomfort, often described as a gritty, burning sensation managed with Tylenol and artificial tears.

• You should not rub your eyes for the first five days after the procedure.
• You may notice a sensitivity to light and have a foreign body sensation. You may also experience discomfort in the treated eye and sunglasses may help with light sensitivity.
• If you experience severe pain in the eye or any sudden decrease in vision, you should contact your physician immediately.
• If the bandage contact lens from the day of treatment falls out or becomes dislodged, you should not replace it and contact your physician immediately.

Yes. Typically, patients are asked by their doctor to stop wearing hard contact lenses prior to surgery for a period of several weeks. Once treated, patients will not be allowed back into contact lenses for a minimum of 1 month.

In clinical trials, progressive keratoconus patients had an average Kmax2 reduction of up to 1.4 diopters in Study 1 and 1.7 diopters in Study 2 (which is flattening) at 12-months post-procedure, while the control group had an average increase of up to 0.6 diopters at 12-months (which is steepening). Individual results may vary. Many research studies have shown that CXL prevents further vision loss in over 95% of patients and improves vision in 60-81% of patients treated.

No. There is no change in the appearance of your eyes following cross-linking.

FDA approved cross-linking is widely covered by insurance.

For additional information on insurance coverage, and to view the latest list of insurers that are known to have policies that cover cross- linking, visit the Insurance Information page on LivingwithKeratoconus.com.

Based on study results over more than a decade, the beneficial effects of corneal cross liking appear to last for many years and there is evidence that this strengthening effect may be permanent. 

The vast majority of patients respond to a single treatment and do not need to have the procedure repeated. For the occasional patient in whom this treatment is not successful, cross-linking can often be repeated.