Preparing for Corneal Cross-Linking (CXL) Surgery: What to Expect

Preparing for Corneal Cross-Linking (CXL) Surgery: What to Expect

Preparing for Corneal Cross-Linking (CXL) Surgery: What to Expect

Preparing for Corneal Cross-Linking (CXL) Surgery: What to Expect

August 19, 2023

Corneal Cross-Linking (CXL) Surgery, also known as keratoconus treatment, is a procedure done to strengthen and stabilize the cornea if it's thinning or bulging outwards, causing blurry or distorted vision. It's a relatively new technique in the realm of eye surgeries, introduced around the early 2000s, primarily to treat keratoconus and corneal ectasia.

The CXL surgery involves applying riboflavin (vitamin B2) drops to the eye and then activating them with ultraviolet light. The process encourages the fibers within the cornea to cross-link or bond more tightly, preventing further bulging and promoting overall stability. Since the cornea is crucial for focusing light onto the retina, maintaining its shape and strength is essential for clear vision.

Understanding the Need for Corneal Cross-Linking (CXL) Surgery

You may wonder why Corneal Cross-Linking (CXL) Surgery is necessary. Receiving a diagnosis of a corneal disorder is alarming, and the thought of surgery can be daunting. Comprehending the need for this procedure can alleviate some of these fears.

Certain conditions, such as keratoconus or corneal ectasia after refractive surgery, can cause the cornea to weaken, thin, and bulge outward into a cone shape. This bulging alters the cornea's structure, leading to distorted vision that can't be corrected with glasses or contact lenses alone. In such cases, CXL surgery becomes necessary to halt the progression of these diseases and preserve the patient's vision.

Additionally, if left untreated, these conditions can lead to significant vision loss and may eventually necessitate a corneal transplant. Thus, CXL surgery is a preventive measure to avoid more invasive procedures down the line. It's essential to consult with your ophthalmologist who can provide a thorough examination and discuss if CXL surgery is the right option for you.

Steps to Prepare for Corneal Cross-Linking (CXL) Surgery

Firstly, before the surgery, your eye care professional will perform a comprehensive eye exam to check your cornea's thickness and shape. You may be asked to stop wearing contact lenses for a few weeks before these measurements are taken to ensure they are accurate. This step is crucial to ascertain the necessity of the CXL surgery and to plan the procedure accurately.

Secondly, you should discuss your medical history, including any medications or supplements you are currently taking, with your ophthalmologist. Some medications may need to be paused or adjusted before the surgery. It's also essential to discuss any allergies, especially to antibiotics or anesthetics, as these are commonly used during the procedure.

The Corneal Cross-Linking (CXL) Surgery Procedure: What to Expect

The surgery is usually performed on one eye at a time to assess how the first eye responds before treating the second. During the procedure, your eye will be numbed using anesthetic eye drops. A device will be placed to keep your eyes open and prevent blinking. The surface layer of the cornea, the epithelium, may be partially removed in a process called epithelium debridement.

Next, riboflavin eye drops are applied for about 30 minutes, making the cornea receptive to the UV light. The UV light is then applied for another 30 minutes. During this time, you will be asked to look at a blue light. After the procedure, antibiotic and anti-inflammatory eye drops are administered, and a bandage contact lens is placed on the eye to promote healing.

What Happens After the Corneal Cross-Linking (CXL) Surgery?

The post-surgery phase is as crucial as the surgery itself. After the Corneal Cross-Linking (CXL) Surgery, you can expect some discomfort or mild pain in the treated eye. You may also experience blurred vision or sensitivity to light for a few days or weeks.

Your eye care professional will prescribe antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation. The bandage contact lens will remain in place for about a week to aid in the healing process. It's important to attend all follow-up appointments so your doctor can monitor the healing process and assess the effectiveness of the treatment.

Tips for Quick Recovery After Corneal Cross-Linking (CXL) Surgery

To ensure a swift and successful recovery after Corneal Cross-Linking (CXL) Surgery, here are some tips that helped me. Firstly, make sure to use all prescribed medication as directed by your optometrist. This will help prevent infection and promote healing.

Avoid rubbing or pressing your eyes as this can hinder the recovery process. Wear sunglasses to protect your eyes from light sensitivity, which is common after the procedure. Maintain good eye hygiene and avoid swimming or using hot tubs until your optometrist gives you the green light.


Undergoing Corneal Cross-Linking (CXL) Surgery can be a challenging experience, but with the right information and guidance, you can navigate it with confidence. Remember that this procedure is a preventive measure to preserve your vision and avoid more invasive treatments in the future.

For more information on what to expect during Corneal Cross-Linking (CXL) Surgery, contact Modern iCare Optometry at 760-674-7272. Our staff will be more than happy to answer your questions. You may also visit our office in Palm Desert, California.

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