Since 2006, we have been successfully treating keratoconus patients with UV Riboflavin cross linking (CXL)

UV Riboflavin cross linking creates an increased number of chemical cross linking between the fibers of the corneal tissue to provide more stability. This cross linking of the cornea is achieved by a combination of UV radiation with administration of Riboflavin eye drops, a vitamin B2 derivate. We have 13 years of good experience to look back on and can offer a short treatment of 5 minutes per eye to you. The new (link: en/treatments/iontophorese-crosslinking-i-cxl text: cross linking by means of iontophoresis [I-CXL]) is even more gentle. With UV Riboflavin cross linking, the corneal bulging typical for keratoconus is frozen, so to say, but is not reversed. Therefore, early treatment is important with keratoconus patients in order to preserve quality of vision. Until now, treatment with UV cross linking used to take approx. 30 minutes. With a new device, this time was reduced to only 5 minutes. We consider this a significant improvement and a major relief for the patient.
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UV Riboflavin cross linking creates an increased number of chemical cross linking between the fibers of the corneal tissue.

UV Riboflavin cross linking with the CCL Vario

CCL Vario
CCL Vario

We perform UV cross linking in an outpatient procedure with local anesthesia by means of eye drops. To enable the Riboflavin eye drops to reach the deeper corneal tissue, the eye's sealing layer of the cornea, the epithelium, is removed carefully since the Riboflavin does not penetrate the epithelium.

Subsequently, the Riboflavin solution is dripped onto the cornea until it is well-saturated. Finally, we are treating the cornea for 5 minutes with UV-A light, with the intensity chosen in such a manner that the radiation does not reach the eye structures situated below the cornea. At the end of the operation, an occlusive lens is placed on the cornea: It will remain in the eye for some days until the epithelium has regenerated itself. Only then, it will be removed.

Numerous studies provide proof of the effectiveness of the procedure

Even though cross linking has been applied to several thousands of patients successfully, CXL still has not been approved by the German Association of Statutory Health Insurance Physicians. However, numerous studies provide proof of its effectiveness so that it is considered a method of the future by specialists (3).

After the operation

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Is grafting a transplant still possible after cross linking?

Due to the operation, part of the corneal surface is open. This can cause severe pain in some cases, which is comparable to "arc eyes" when welding or "snow blindness". Generally, this pain resolves slowly and usually disappears completely within 48 hours: Pain medication can help you during this time. In the first three days, we will check the course of healing daily. Until the sixth week, you have to be very diligent in administering anti-inflammatory antibiotic eye drops in the morning and in the evening. For about two weeks, significant redness of the operated eye will persist. A stinging, biting and burning sensation may persist for the first six to eight weeks; artificial tears will provide some relief, and you may apply them as often as you like. Likewise, your vision may be blurrier than before during this time, and strong light may blind you more than before. All of this is part of the normal course of healing: After this stage and after the post-surgical symptoms have resolved, our keratoconus patients have the same or a better visual acuity than they had before the operation.