What Is CXL?

CXL is a treatment designed to stop keratoconus from worsening. It strengthens the cornea and prevents further thinning or bulging.

Important: CXL does not usually improve vision; its main goal is to prevent progression of the condition.

Who Can Have CXL?

• People with progressive keratoconus.
• Typically under 40 years old.
• Corneas must be thick enough for safe treatment.

Before the Procedure

• Comprehensive eye examination, including corneal thickness measurements.
• Stop wearing contact lenses for a few days if advised.
• Discuss pain relief options; mild analgesics may be given before or after the procedure.

During the Procedure

1. Preparation: The outer corneal layer (epithelium) may be gently removed.
2. Riboflavin Application: Vitamin B2 drops applied to the cornea.
3. UV Light Exposure: UV light activates the riboflavin to strengthen corneal collagen.
4. Bandage Contact Lens: Placed on the eye to reduce discomfort while healing.

After the Procedure

• Pain and discomfort: pain levels vary, some people experience mild discomfort, while others more severe pain in the first few days. usually managed with prescribed pain relief and lubricating drops.
• Light sensitivity and blurred vision: Common for several days.
• Follow-up care: Regular appointments to check healing and corneal stability.
• Activity precautions: Avoid eye rubbing and follow instructions on work, screen use, and sports.

Recovery

• Discomfort usually lasts a few days to a week.
• Full healing in terms of corneal stabilisation takes several months.
• Most patients will still need glasses or contact lenses after the procedure for the best vision.

Risks

• Infection (rare)
• Temporary blurred vision
• Corneal haze or scarring (usually mild and resolves over time)
• Eye discomfort or pain

Key Takeaways for Parents

• CXL is Effective: The most widely studied non-surgical treatment for stopping keratoconus progression.
• Long-Term Benefits: Can provide lasting stabilization, reducing the risk of needing a corneal transplant.
• Treatment Protocols Matter: Different CXL methods exist; your eye care provider will choose the safest and most effective option.
• Retreatment is Possible: If progression continues after initial treatment, a second CXL may be effective.

Evidence & Research 

CXL is supported by large, well-conducted studies:

• Effective at stopping progression: Over 800 eyes studied showed stabilization and improved corneal shape within 12 months¹.
• Long-term benefits: Registry studies show corneal stability is maintained for 5 years or more².
• Different protocols: Accelerated CXL may offer higher success rates than alternative methods³.
• Retreatment possible: If keratoconus continues to progress, a second CXL can be effective⁴.