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CLX allows to reinforce the corneal surface, creating new connections between the collagen fibers that make up the stroma, increasing its mechanical resistance. The technique exploits the action of riboflavin (vitamin B2) which, subjected to the action of ultraviolet rays type A (UVA), makes the cornea itself more rigid, therefore less subject to the process of exhaustion, characteristic of keratoconus.
The Corneal Cross-Linking allows, therefore, to contrast and / or stop the evolution of the disease.
. This degenerative eye disease is characterized by a progressive weakening of the cornea (transparent surface placed in front of the iris) which, over time, leads to its thinning. Over time, keratoconus leads to fatigue: being less resistant, the corneal surface - normally round - protrudes outwards and takes on a characteristic cone shape.
Cross-Linking involves the creation of bonds between the collagen fibers of the stroma. The procedure exploits the combined effect of riboflavin (vitamin B2) and ultraviolet rays, with the aim of increasing the connection between the fibers and their mechanical strength.
Keratoconus: key points
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- What it is: keratoconus is a degenerative disease, often progressive, which causes deformation of the cornea, which thins and begins to vary its curvature towards the outside, taking on a cone-shaped appearance. Usually, the disease process begins during adolescence and adulthood, but tends to stabilize after the age of 40-50. The cone shape assumed by the cornea modifies its refractive power and does not allow the correct passage of the light input towards the internal ocular structures.
- Causes: at the origin of the disease the intervention of a specific genetic alteration was hypothesized, which would result in an imbalance in the layers of the cornea, with effects on its thickness and resistance capacity.
- Symptoms: a direct consequence of corneal exhaustion is astigmatism (in this case, the defect is called irregular, as it cannot be corrected with lenses). Keratoconus can also be associated with myopia and, rarely, with hyperopia. initial symptoms, therefore, are related to these refractive defects. Keratoconus is a disease that typically requires frequent changes in eyeglass prescription. As the condition progresses, vision becomes progressively more blurred and distorted, as well as increasing sensitivity to light ( photophobia) and eye irritation. Sometimes keratoconus causes corneal edema and scarring. The presence of scar tissue on the corneal surface determines the loss of its homogeneity and transparency. As a result, opacity can occur which further reduces vision.
- Diagnosis: Keratoconus is diagnosed with:
- Corneal topography: examination that evaluates the conformation of the cornea, studies its surface and monitors the evolution of the disease;
- Pachymetry: measures the thickness of the cornea;
- Confocal microscopy: allows the observation of all layers of the cornea and identifies any fragility.
- Treatment: keratoconus can be treated with corneal cross-linking, but, in severe cases, corneal transplantation is required (mandatory if perforation occurs).
Terminology and synonyms
Cross-Linking is also known as corneal reticulation or photodynamics.
In medical practice, the intervention is abbreviated with the abbreviation CXL or CCL.
anesthetic. For this reason, the procedure shouldn't be painful.
Corneal Cross-Linking and Contact Lenses
Before Corneal Cross-Linking, the use of contact lenses must be suspended for an appropriate period, established by the ophthalmologist.
and blindfolded.If the corneal epithelium has been removed (epi-off technique), a soft, protective, therapeutic contact lens can be applied for approximately 3-4 days.Corneal Cross-Linking: how long does it last?
Corneal Cross-Linking takes about 30-60 minutes.
After a short period of observation, the patient can be accompanied home by a trusted person on the same day that the treatment is performed.
After Corneal Cross-Linking, driving a car is contraindicated, both for the intense and prolonged use of sight that this activity entails, and for reasons of road safety.
Post-operative care
- After the Corneal Cross-Linking, the patient must observe at least two to three days of rest, preferably in bed, in a dimly lit environment. In addition, in the days following the operation, it is important to avoid reading and watching television, trying to sleep at least 10-12 hours a night.
- In the 2-3 days following the Corneal Cross-Linking with removal of the epithelium (epi-off), intense pain, foreign body sensation and photophobia may occur. Post-operative therapy involves the use of painkillers to reduce these symptoms . In treatments without removal of the epithelium (Corneal Cross-Linking epi-on), however, discomfort is almost completely absent and recovery is faster.
- In the post-operative course of epi-off Corneal Cross-Linking, it is important that the patient undergo periodic checks, on a daily basis, up to the removal of the contact lens.
- In the months following Corneal Cross-Linking, to verify the settlement and healing of the most superficial layers of the cornea, the follow-up includes the following tests: topography and corneal tomography, computed optical tomography (OCT) of the anterior segment and endothelial count.
