What is collagen cross-linking?
Corneal collagen cross-linking is the only procedure that can strengthen the cornea to slow or stop the progression of keratoconus, protecting vision and delaying or potentially eliminating the need for a corneal transplant. This minimally invasive treatment increases the cornea’s collagen connections (cross- links), thus helping the cornea retain its firmness and shape. Corneal cross-linking has also been successful in treating patients with corneal ectasia, a steepening of the cornea that may occur as a complication of previous laser refractive surgery.

Corneal cross-linking has been used successfully in Europe and other countries for more than 15 years and has been approved in the United States for 6 years. OCLI Vision’s team of corneal specialists was part of the original FDA clinical trial that showed excellent results and has over 12 years of experience. OCLI Vision physicians have performed the most treatments of any group in the region.

How does corneal cross-linking work?
Collagen is the structural protein that provides strength and firmness to our corneal tissue. Corneal cross-linking works by forming new cross-links between collagen fibers, which are the natural “anchors” within the cornea. These anchors are responsible for preventing the weakened cornea from bulging out and becoming steep and irregular. The addition of these “crossbeams” acts like adding rungs on a ladder to stiffen and strengthen the cornea, allowing it to focus light more efficiently and accurately.

How is corneal cross-linking performed?
The procedure is performed in our office. First, you will be given anesthetic (numbing) eye drops to prevent discomfort. The corneal epithelium, a thin layer of clear, protective “skin” that covers the cornea, may be left in place, or partially or totally removed by the doctor, depending on the severity of the keratoconus. Next, vitamin B2 (riboflavin) eye drops are instilled in the eye, one drop every two minutes for 30 to 90 minutes. Next, a UVA (ultraviolet) light will be shined into your eye to “activate” the riboflavin, which causes the cross-linking of the collagen fibers. A soft contact lens may be placed on your eye immediately after the procedure, and antibiotic and steroid eye drops are then instilled.

How effective is corneal cross-linking?
By strengthening collagen links, corneal cross-linking is the first keratoconus treatment that goes to the root of the disease. Many research studies have shown that cross-linking prevents further vision loss, with many patients getting improved vision. As with many conditions, the earlier the condition is treated, the better the results.
If cross-linking is performed early, it may be possible to prevent the signs and symptoms of keratoconus in some eyes with “preclinical” keratoconus.

Can corneal cross-linking prevent the need for a corneal transplant?
Many studies have shown that cross-linking can often prevent the need for a corneal transplant and allow patients to wear contact lenses or glasses more comfortably and safely again.

Can corneal cross-linking be performed on anyone with keratoconus?
During your consultation, the doctor will determine if cross-linking might be an appropriate treatment option for you. Patients who have corneal scarring or whose corneas are too thin or too steep may not be good candidates for corneal cross-linking. Patients who are female must not be pregnant or nursing.

How long does corneal cross-linking treatment last?
Based on cross-linking results from more than a decade, the beneficial effects of corneal cross-linking appear to last for a long time, and there is evidence that this strengthening effect may be permanent. In many studies, most patients respond to a single cross-linking treatment and do not need to have the procedure repeated. For the occasional patient in whom this treatment is not successful, cross-linking can be repeated.

Cornea providers

Cynthia Hsu, MD Cornea, Laser Cataract & Refractive Surgeon
Mary Ann Bonomo Hosey, OD Optometrist
Adam Chubak, MD Cornea & Laser Cataract Surgeon
Cary M. Silverman, MD Laser Cataract, Refractive Surgeon & Comprehensive Ophthalmologist
Thierry Hufnagel, MD Ophthalmologist
David M. Armesto, MD, FACS Cornea, Laser Cataract & Refractive Surgeon
Lucy Sun, MD Cornea, Laser Cataract & Refractive Surgeon
Shyam Patel, MD Cornea, Laser Cataract & Refractive Surgeon
Elzbieta Mechel, MD Comprehensive Ophthalmologist, Cornea & Laser Cataract Surgeon
Ghulam Dastgir, MD Comprehensive Ophthalmologist
Richard J. Mackool, MD Cataract, Refractive, Cornea and Glaucoma Microsurgery
Julia Schneider, MD Cornea, Laser Cataract & Refractive Surgeon
Marta McKeague, MD Cornea, Laser Cataract & Refractive Surgeon
Gerard D'Aversa, MD Cornea, Laser Cataract & Refractive Surgeon
R. J. Mackool, MD Cataract, Refractive, Cornea and Glaucoma Microsurgery
Ravi A. Shah, MD Cornea, Laser Cataract & Refractive Surgeon
John R. Wittpenn, MD Cornea & Laser Cataract Surgeon
Harry Koster, MD Cornea, Laser Cataract & Refractive Surgeon
Surajit Saha, MD Cornea, Laser Cataract & Refractive Surgeon
Henry D. Perry, MD Corneal Specialist & Comprehensive Ophthalmologist
Stuart B. Carter, MD Comprehensive Ophthalmologist & Refractive Cataract Surgeon
Eric D. Donnenfeld, MD Cornea, Laser Cataract & Refractive Surgeon
Jonathan Stein, MD Laser Cataract & Refractive Surgeon
David Sachs, MD Comprehensive Ophthalmologist, Cornea & Laser Cataract Surgeon
Marguerite McDonald, MD, FACS Cornea, Laser Cataract & Refractive Surgeon
Sima Doshi, MD Cornea, Laser Cataract & Refractive Surgeon
Sahas Narain, MD Cornea, Laser Cataract & Refractive Surgeon

Hear what our patients are saying.

Great office, great doctor. Every employee was very friendly and knowledgeable.

Carolina Monteiro
Since you arrived you will be attended by great staff. They do a complete eye exam. They are very careful with the cleaning of every machine before you use it. You don’t have to wait too long in order to see the doctor who by the way is very clear to explain your condition. He is very professional and polite. I will highly recommend this place. Let me know if you have any questions or need anything else.

Laura Rodriguez
The entire staff is cordial and competent. Appropriate questions are asked and answered. One can feel very confident in the treatment offered.

Merle Price
The staff are very professional and thorough. I have confidence in the doctors.

Alyssa Rebhun
By far, the best group of Drs. in the industry. I have seen 3 of their Drs. and they were all above and beyond!! If you have any eye issues they will greatly help you with their great knowledge and compassion!! Would recommend OCLI over and over again!!

Lainey Ruocco
The whole process was easy from setting up the appointment to checking in to the exam. Great front office staff, technicians, and doctors!

Teresa Lamsam

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