Corneal Cross-Linking in Toronto | Keratoconus

What is Corneal Cross-Linking and What Does it Treat?

Corneal cross-linking (or collagen cross-linking) is a minimally invasive therapeutic treatment used to halt the progression of keratoconus. During this procedure, riboflavin (Vitamin B) eye drops are applied to the eye as it is exposed to ultraviolet light.

Corneal cross-linking effectively stiffens the cornea and prevents the progressive ‘coning’ of the cornea. Not only does it prevent worsening of keratoconus, but 50% of people may experience an improvement in the shape of their cornea. Select patients may further benefit from a combined corneal cross-linking procedure with a concurrent laser procedure.

WHAT IS KERATOCONUS?

The cornea is the most important focusing component of the eye.

Typically, it’s the shape of a basketball, allowing you to see clearly. Keratoconus causes a gradual change of the corneal shape from a sphere to a cone. With this ‘coning’ of the eye, the person’s vision gets worse.

In the early stages, keratoconus presents as worsening astigmatism or increased distortion in vision. It can initially be corrected with hard contact lenses.

If left untreated, it can cause permanent vision loss requiring corneal transplantation. Keratoconus typically first appears in individuals who are in their late teens or early 20s.

KERATOCONUS SYMPTOMS

Blurry vision
Eye strain
Increased light sensitivity
Difficulty driving at night – halos
Eye irritation and excessive eye rubbing

What are Treatments for Keratoconus?

At Herzig Eye Institute, we provide full care and follow up for all stages of keratoconus, mild or severe. We use our advanced technology to map the cornea and monitor the progression of the disease. If you require treatment, we can provide full care tailored to the stage of the condition.

Corneal Transplantation

Advanced keratoconus may require an outpatient procedure called a corneal transplant, or keratoplasty, where part of the cornea is replaced with corneal tissue from a donor. A corneal transplant can restore vision, reduce pain, and improve the appearance of a damaged or diseased cornea. Most corneal transplant procedures are successful, but corneal transplants carry a small risk of complications, such as rejection of the donor cornea.

VISIAN ICL & Toric Intraocular Lenses

Patients with moderate keratoconus may benefit from treatments effective for the reduction of astigmatism. Intraocular Collamer Lenses (ICL) such as the Visian ICL or Refractive Lens Exchange (RLE) with a toric intraocular lens may help with astigmatism.

Préparation à la procédure
À QUOI S’ATTENDRE PENDANT LA PROCÉDURE
À QUOI S’ATTENDRE APRÈS LA PROCÉDURE
Examens postopératoires

Pour préparer votre procédure, il peut y avoir quelques considérations préopératoires. Tout cela vous sera communiqué par votre consultant en réfraction et le médecin lors de votre consultation complète. Certaines de ces instructions pourraient inclure :

Passer à des lunettes et éviter de porter des lentilles de contact pendant 1 à 8 semaines (selon le type de verres que vous portez)
Organiser un transport vers et depuis Herzig Eye Institute pour votre journée de procédure

The corneal cross-linking procedure is done one eye at a time and is quick and painless. The epithelium (thin layer on the surface of the cornea) is gently removed and Riboflavin eye drops will be applied to the cornea and is then exposed to UV light.

Once complete, a soft bandage contact lens is placed on the eye to protect it and promote healing. The process is then repeated on the other eye.

Directly following the procedure, you will be examined and given your first set of drops. After your examination, it is recommended you go home and rest as you may be experiencing sensitivity. Discomfort is normal during this time. The drops and medications provided will help minimize this discomfort.

A medicated drop regimen needs to be followed after the procedure. For four to five days after the procedure, the protective contact lens bandage must remain on to help promote the healing of the epithelium.

Other directions will be provided by your Refractive Consultant, the nurses, and the surgeon on the day of your procedure.

It is critical you are seen for all necessary post-operative follow up appointments at Herzig Eye Institute or with your referring optometrist. The typical post-operative follow ups are: 1 day, 4-5 days, 1 month, and 3 months after your procedure. Additional appointments may be recommended.

Corneal Cross-Linking / Keratoconus FAQs

Vitamin B2 (riboflavin) eye drops are applied to the cornea and activated with UV light. This strengthens the cornea’s collagen fibers, helping to halt the progression of keratoconus or corneal thinning disorders.

Cross-linking is best for patients with progressive keratoconus or corneal thinning disorders. It is most effective when performed early, before any significant vision loss occurs.

The main goal is to stabilize the cornea and prevent further vision loss. Some patients may notice improved clarity, but outcomes vary depending on the severity of keratoconus.

Most patients continue using glasses or specialty contact lenses for best vision. Cross-linking helps stabilize the prescription and reduces the likelihood of further worsening.

Cross-linking is designed to permanently strengthen the cornea. Regular follow-up visits are important to monitor long-term stability and results.