Corneal Cross-Linking

Whaat is corneal cross-linking?

Cross-linking is a minimally-invasive, outpatient procedure that combines the use of ultraviolet light and riboflavin eye drops to add stiffness to corneas which have been weakened by disease or refractive surgery. Cross-linking, which has been performed in Europe since 2003, is considered the standard of care around the world for keratoconus and corneal ectasia (bulging) following refractive surgery.¹ At Fuerst Eye Center, we perform the iLink® Cross-Linking Procedure (epi-off), which is the ONLY FDA-approved cross-linking procedure to treat progressive keratoconus.

Corneal Cross-Linking²

• Creates new corneal collagen cross-links
• Results in a shortening and thickening of the collagen fibrils
• Leads to strengthening of the cornea 

Riboflavin

Riboflavin (vitamin B2) is important for body growth, red blood cell production and assists in releasing energy from carbohydrates. Food sources high in riboflavin include dairy products, eggs, leafy green vegetables, lean meats, legumes, and nuts. Breads and cereals are often fortified with riboflavin.

Under the conditions used for corneal collagen cross-linking, riboflavin 5’- phosphate, vitamin B2, functions as a “photoenhancer” which enables the cross- linking reaction to occur.

Ultra-Violet A (UVA)

UVA is one of the three types of invisible light rays given off by the sun (together with ultra-violet B and ultra-violet C) and is the weakest of the three.

A UV light source is applied to irradiate the cornea after it has been soaked in the photoenhancing riboflavin solution. This cross-linking process strengthens the cornea by increasing the number of molecular bonds, or cross-links, in the collagen.

Is crosslinking right for me?

Patients over the age of 14 who have been diagnosed with progressive keratoconus or corneal ectasia following refractive surgery should ask our expert doctors about corneal cross-linking.

Fuerst Eye Center, with locations in Glendale and West Covina, California, is proud to offer our patients the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus. This approval offers an effective treatment for patients who, until recently, had no therapeutic options to limit the progression of this sight-threatening disease. If you have keratoconus or post-LASIK ectasia and want to prevent vision loss, schedule a consultation with the highly skilled providers at Fuerst Eye Center by calling the office or requesting an appointment online.

Is corneal crosslinking covered by insurance?

The medical necessity of FDA-approved iLink corneal cross-linking has become widely recognized.  As a result, the procedure is covered by over 95% of commercial insurance providers.

For information on the FDA approved corneal cross-linking procedure for the treatment of keratoconus and corneal ectasia following refractive surgery, visit www.Livingwithkeratoconus.com

1. Gomes, José P., Donald Tan, Christopher J. Rapuano, Michael W. Belin, Renato Ambrósio, José L. Guell, François Malecaze, Kohji Nishida, and Virender S. Sangwan. "Global Consensus on Keratoconus and Ectatic Diseases." Cornea 34.4 (2015): 359-69. Web.
2. Beshwati IM, O’Donnell C, Radhakrishnan H Biomechanical properties of corneal tissue after ultraviolet-A- riboflavin crosslinking. J Cataract Refract Surg. 2013;39(3):451-62. Doi:10.1016/j.jcrs.2013.01.026.