Corneal Cross-Linking

What is Corneal Cross-Linking?

Be Eye Wise and know that cross-linking, is a surgical treatment for corneal ectasia such as keratoconus, PMD, and post-LASIK ectasia. It is used to increase the rigidness of the cornea’s surface by inducing additional cross-links between collagen fibers. By using UV-A light, riboflavin and photomediator, cross-linking can help slow, stabilize and perhaps even reverse the progression of corneal ectasia.

Corneal Ectasia

The cornea is the clear, outer layer of your eye. The middle, or stromal layer, is the thickest part of the cornea. It is made up of mostly water and a protein called collagen. Collagen makes the cornea strong and flexible. It also helps the cornea keep its round, regular shape. This healthy cornea focuses light so you can see clearly.

Some diseases change the middle layer of the cornea. The cornea gets thinner and weaker. This thin cornea bulges into an irregular, cone shape. Your vision may be blurry, and your eyes may be bothered by bright lights. The cornea disease may get worse over time. The medical name for this is corneal ectasia, and there are two types.

  • Keratoconus – occurs when the cornea starts to thin out and eventually bulge into a cone-like shape, due to the natural aging and changing of your eyes/cornea.
  • Post-surgery Ectasia – occurs as a result of eye surgery, such as LASIK, resulting in hazy and distorted vision.


Corneal collagen cross-linking is the only method designed to stop the progression of keratoconus and is the preferred method for targeting stromal instability.

The goal of cross-linking is to stop the cornea from getting thinner, weaker, and more irregular in shape, and may keep your vision from getting worse. However,  it cannot make your cornea normal in shape again. In rare cases, your eye may start getting weak again, requiring another treatment.


Here are some of the most common or serious risk and side effects from the procedure:

  • Pain: You will probably have pain and be sensitive to light for a few days. You may not be able to drive or work for up to a week after your procedure.
  • Infection: You could get an eye infection from the surgery. The infection might cause your cornea to scar and make your vision worse. You will get a prescription for eye drops to help prevent infection. If you had an eye infection called HSV (herpes simplex virus) in the past, it could come back.
  • Vision problems: Your vision will be poor for a few days or weeks. This poor vision may last longer if you have an infection or your eye does not heal well. You may need to wear contact lenses for up to 6 months after your procedure. Your vision may stay this way.
  • Changes to your cornea: Your cornea might not heal well, or it might take a long time to heal. It could become cloudy instead of clear (corneal scarring).
  • Continuous corneal changes: Your cornea may keep changing shape for many months. You may need to get new glasses or contact lenses while the shape is changing, and again after the shape stops changing.

Cross-Linking Alternatives

To learn more about cross-linking and alternative treatment options, please schedule an appointment with Northwest Eye physician Dr. Berestka today.