Corneal cross-linking for keratoconus at Spire South Bank Hospital

Keratoconus is a dystrophic disorder where structural changes occur within the cornea causing it to stretch and develop an abnormal thin and cone shape. It is diagnosed in the patient’s adolescent years and presents with blurred vision, ocular irritation and the need for increasingly strong glasses or contact lenses to see correctly.

If present in both eyes, the deterioration in vision can affect the patient’s ability to drive a car or read normal print.

You might experience the following symptoms:

• Distorted vision that cannot be corrected with simple glasses.
• Sensitivity to light or the need to ‘squint’ the eyelids closed to see clear detail.
• Inability to have vision corrected with simple soft contact lenses, in some cases vision can only be corrected with rigid gas permeable contact lenses.
• If present in both eyes, the deterioration in vision can affect the patient’s ability to drive a car or read normal print

Keratoconus can now be treated with a non-surgical procedure called cornea collagen cross-linking. The procedure can be performed under topical anaesthetic and takes approximately 30 minutes per eye.

No overnight stay is required. Once you’re ready to be discharged, you’ll need to arrange a taxi, friend or family member to take you home because you won’t be able to drive. You should also ask them to help with shopping and cleaning for a few days, as your vision may take a while to return to normal.

Keratoconus is a condition that causes the cornea, the transparent front part of the eye to weaken, get thinner and change shape. It affects about one in 2,000 people. The exact cause of the condition is unknown. It's possibly passed down through the family.

Keratoconus is one of the most common reasons for corneal transplantation in younger patients. It doesn’t usually appear until the early teens, but can occur earlier in a few patients. Many cases of keratoconus are mild and can be managed by using contact lenses or glasses. But in some patients it can progress to the point where a corneal transplant is necessary.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. A number of our consultants have international reputations for their research in their specialised field.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the surgeon you want to work with, when you want, and where you want from across our network of 38 hospitals and many clinics across the UK. They’ll be with you every step of the way: from giving advice at your first consultation, through to offering on- going support after your surgery.

All of our surgeons are of the highest calibre and benefit from working in our modern, well equipped hospitals. If you don't have someone in mind, we can help you choose the best consultant for you.

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

This is your formal consultation with the surgeon of your choice. During this time you will be able to explain your medical history and any concerns you might have.

We're here to listen and help you every step of the way to improve your eyesight and give you a fresh view of the world in more ways than one.

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.

Please do not wear contact lenses for one week ahead of your procedure and be sure to remove any makeup and jewellery.

We've tried to make your experience with us as easy and relaxed as possible - from efficient check-in processes to your post-operation aftercare.

Your treatment may be adapted to meet your individual needs, so it’s important to follow your consultant’s advice. It's natural to feel anxious before hospital treatment, but knowing what to expect can help. Please raise any concerns or questions with your consultants or nurse so you feel comfortable and in control.

For more information on parking and all those other important practicalities, please visit our patient and visitor information page.

We're here to help every step of the way.

Keratoconus can be treated with a non-surgical procedure called cornea collagen cross-linking. A solution called riboflavin is soaked in to the cornea of the eye after delicately removing the surface layer of cells, this solution is then activated by illumination with ultra violet light from a laser.

The riboflavin absorbs the UV energy and creates free radicals and oxidative stress that leads to the formation of chemical cross-links between the structural collagen fibres of the cornea.

These cross-links increase the strength of the cornea and prevent it from stretching anymore thereby halting the progression of keratoconus.

The procedure can be performed under topical anaesthetic and takes approximately 30 minutes.

Corneal collagen cross-linking (CXL) is currently the best available treatment for keratoconus. This technique uses ultraviolet (UV) light and a photosensitizer (riboflavin) to strengthen chemical bonds in the cornea. It was first developed in Germany in 1998 and clinical trials have been in course since then.

You will be given a pre-operative preparation in the form of oral sedation and analgesia and in some cases you may require an eye drop to constrict the pupil.

Once in theatre your surgeon will give anaesthetic drops to numb the outer surface of the eye.

Your vision will be blurred for the first 4 days, after which time the bandage contact lens will be removed. Moderate discomfort should be expected for the first 24-72 hours, which can be controlled by pain relief.

You may also suffer from red and watering eyes and light sensitivity.

You will be given a large amount of eye drops to take home which will aid your recovery.

You will be able to go home on the same day as your treatment: however you'll need someone to accompany you as your vision will be impaired. The surgeon will have inserted a bandage contact lens for comfort and your eye will be covered by a protective shield.

You will be given several drops to take home which will start on the same day as procedure. These will help the eye to heal and prevent infection and for pain relief.

Pain relief

You may experience moderate discomfort the first 24-72 hours following the procedure. You will be given eye drops and oral analgesia to help with this.

Your nurse will show you how to put these in and give you an advice about caring for your eye. You may find it helpful to wear sunglasses when you leave the hospital as your eyes will be sensitive to the sunlight.

Recovery time

Before leaving the hospital you will be given a date for a follow up appointment with your surgeon to remove the bandage contact lens. Try not to touch or rub your eye. Expect to have blurred vision for a few days – this will start to improve once the bondage contact lens is removed.

How soon you can go back to work depends on the nature of the job. Your surgeon will give you advice about when you can resume driving if you have no other eye condition.

After you leave hospital

Corneal cross-linking for keratoconus (CXL) is current the best available treatment for the keratoconus, however as with all operations it carries risks. Your consultant will talk to you about the possible risks and complications of having this procedure and how the apply to you.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.