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Corneal Cross-linking (CXL)

Chicago Cornea Consultants™ has been offering CXL to our patients since 2010. We have performed more corneal crosslinking procedures than any other practice in the metro Chicago area. Patients are referred to us for CXL from throughout the midwest.

Corneal Cross-Linking (CXL) has revolutionized the treatment of corneal ectasia, which is an abnormal shape of the cornea.  The cornea is the transparent “window” of the eye and plays a very significant role in how well we see.  In various disease processes, like keratoconus and post-LASIK corneal ectasia, the cornea loses its normal shape, becoming thin and “cone-shaped”.

These changes in the cornea can continue to progress over months and years leading to frequent changes in prescription and, if undetected or untreated, may result in permanently decreased vision.  Often at a late stage, the only remedy is corneal transplantation, which is a major surgical procedure.

Fortunately, with early detection and CXL treatment, many patients may be able to maintain good vision and prevent the need for corneal transplant surgery.

CXL is an in-office procedure in which Riboflavin (Vitamin B2) and Ultraviolet (UV) light are used to create cross-links between the collagen fibers of the cornea, making it more rigid and preventing further changes from occurring.

The use of CXL was first reported in 1998 and has been performed routinely for these conditions, worldwide, since 2006.  However, the treatment of corneal ectasia with CXL was not approved in the USA until 2016. With FDA-approved “epithelium-off” CXL, the epithelium or top layer of the cornea is removed prior to treatment.

Both eyes are generally NOT treated simultaneously with this technique. Because the surface layer of the cornea is removed, a “bandage” contact lens is placed for comfort and to promote healing. This lens is typically removed several days after the procedure, once the surface layer has healed.  However, vision will likely be blurrier than it was prior to surgery during the healing, process, which can take many weeks.

Many studies have demonstrated the extremely high success rate of CXL in preventing further vision loss and enhancing contact lens tolerance.  It is important to remember that CXL is unlike LASIK or PRK in that the goal of the procedure is to PREVENT vision loss.

Patients will still require glasses or contact lenses in order to correct their vision after this procedure. We have found that patients achieve a SUBSTANTIAL improvement in contact lens tolerance following CXL, particularly when specialized keratoconus contact lenses are properly fitted.

Many patients who have previously become contact lens INTOLERANT find that they can once again wear them successfully. While most people do not require more than one treatment, CXL can be repeated when necessary.

When is it Time for CXL?

If you have a diagnosis of keratoconus or corneal ectasia, you may be a candidate.  Please call any of our offices and schedule your consultation now.

Epithelium-ON CXL

“Epithelium-ON”, or “trans-epithelial” CXL may available to some patients as an “off-label” procedure.  This technique IS usually performed bilaterally, as there is generally only one night of blurry vision and minimal discomfort after this procedure.

The team at Chicago Cornea Consultants™, Ltd. is pleased to be able to offer both forms of CXL to most of our patients with keratoconus or corneal ectasia.  We successfully performed “epithelium-ON” CXL on over 2,000 eyes as part of the “CXL-USA” clinical trial from 2010-19, with excellent results.

We hope to continue to offer this procedure as part of another clinical trial.  Both eyes can undergo treatment simultaneously, the visual recovery is faster than with the “epithelium-off” technique and there is decreased risk of scarring, infection, and discomfort.

Chicago Cornea Consultants™ has participated in publications discussing Epithelium-ON CXL, which can be reviewed here:

Does Insurance Cover CXL Treatment?

Insurance coverage for FDA-approved cross-linking is now widely available as an increasing number of commercial insurance carriers are recognizing the medical necessity of the procedure. Greater than 95% of the commercially insured population has access to this potentially sight-protecting treatment.

Closeup of Woman's Corneas

Is Financing Available?

Convenient, affordable financing is available to help our patients get the treatment they need before their keratoconus or another similar condition progresses to the point where they can no longer have CXL.

Financing With CareCredit

CareCredit LogoCareCredit® is a payment plan that fits your individual needs and financial circumstances. If you’ve been putting off having an ophthalmic procedure due to budget constraints, CareCredit® can help. Click here or call our office for details.



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