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Corneal Cross-Linking

stopping the degeneration
of your eye sight

Keratoconus is a progressive disease of the cornea which usually affects young people and can lead to irreversible vision loss. Early detection and treatment are key. At Advanced Vision Care, we helped pioneer the only current FDA approved cross-linking eye surgery to stop its progression.


Conventional, non-surgical treatments for Keratoconus

Usually, surgery is the last option recommended to patients because it is invasive. First, our doctors recommend non-invasive treatments that won’t put too much stress on your body.

To treat Keratoconus, you may be prescribed custom-designed soft contact lenses for Keratoconus, gas permeable contact lenses, hybrid contact lenses, and scleral/semi-scleral contact lenses.

Why does Keratoconus develop?

Keratoconus develops because of the loss of structural integrity within the cornea. When there is a limited supply of enzymes in the cornea, the cornea is at risk of oxidation and being damaged by free radicals. Additionally, eye rubbing and enzyme imbalance can lead to the breaking of the collagen bonds that hold the cornea to the rest of the eye. This can make the eye weak, thin, bulged out and misshapen.

Typically, people with Keratoconus have a genetic predisposition to the condition. However, constant and intense exposure to UV rays, chemicals and pollutants can also result in this condition.

Treatment options for Keratoconus
at Advanced Vision Care

Surgery is a great option to treat Keratoconus, as it allows the doctor to target the specific problem area and provide focused treatment. This hastens the healing process and restores much better vision and eye health, compared to non-surgical treatments.

Additionally, non-surgical treatments are just a temporary fix to mild Keratoconus.

To prevent severe problems and to offer an almost-permanent treatment, surgery is the best option.

With corneal cross-linking, in particular, the progression of Keratoconus will stop and it will ensure you don’t experience further vision challenges. If you are not a candidate for corneal cross-linking, you may be eligible to receive a cornea transplant.

What is Corneal Cross-Linking?

With corneal cross-linking, you can halt the progression of keratoconus by strengthening your cornea. If you have been recently diagnosed with keratoconus, or think that your vision is changing, be sure not to hesitate seeking expert consultation. If caught early, it may be possible to maintain your vision. Progression is irreversible, and without treatment, a corneal transplant may be needed.

How does Corneal Cross-Linking work?

In 2016 the United States Food and Drug Administration (FDA) approved Avedro Inc.’s corneal cross-linking system for progressive keratoconus. This is a novel, office-based procedure to treat Keratoconus as well as corneal thinning after LASIK (known as post-LASIK ectasia). Advanced Vision Care was involved in the initial FDA trial that led to the cross-linking’s approval in the United States.

During the in-office procedure, a riboflavin solution placed on the eye is activated by UV light. This strengthens the collagen bonds within the cornea. The cross-linking procedure takes approximately one hour. The entire cross-linking treatment can be done in two ways:

Epithelium-off cross-linking: In this technique, the epithelium on the cornea is removed and then the cross-linking procedure is performed. This is the current FDA approved procedure.

Epithelium-on cross-linking: Here, the epithelium is left as it is and then the cross-linking procedure is performed. This is currently undergoing FDA approval.


  • Corneal cross-linking is an in-office treatment that takes approximately 1 hour.
  • Eye drop anesthesia provides complete comfort. No other anesthesia is required.
  • After the procedure, an anti-inflammatory contact lens is placed on the eye for comfort and healing.
  • The contact lens will be removed by your doctor. There is no maintenance required.
  • After the procedure, and for a few days following, discomfort in and around the eye is common and expected. We provide our patients with appropriate pain medications to minimize discomfort.
  • You should expect to be absent from work or school for one week.
  • Your vision will be blurry for the first 4-6 weeks but will gradually improve over that time period.
  • You will use eye drops for 3 months.
  • You will return to the office the day after your procedure, and then 2-3 days after the procedure. Your doctor will determine subsequent follow-ups based on how the eye is healing.
  • If corneal cross-linking is planned for both eyes, your surgeon will discuss the timing for the second eye after the first eye has completely healed.

Corneal Cross-Linking &
its impact on corneal transplant

A corneal transplant is a very serious surgical procedure that is performed when all other cornea treatment options have failed to yield results. The benefit of undergoing corneal cross-linking is that it will reduce the need for a corneal transplant.

The corneal cross-linking procedure provides strength and shape to the cornea by reinforcing the collagen bonds, this way it is less likely that your cornea will continue to change shape and therefore reduces your chances of needing a cornea transplant.

Corneal cross-linking is the standard of care procedure for patients with keratoconus and vision complications after LASIK. By recognizing and treating early, these patients may not need a cornea transplant.

At Advanced Vision Care, our Century City Office is one of the most reputed eye surgery clinics in Los Angeles. We have extensive experience performing corneal cross-linking and we are part of the FDA trial for approval. Visit us for a consultation.

Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at 310-229-1220.
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