No, CXL is not a cure for keratoconus. Its primary goal is to halt, or significantly slow down, the progression of the condition, thereby preventing further vision loss and often avoiding the need for a future corneal transplant. 

The primary goal of CXL is NOT improvement in vision. The aim is to halt, or significantly slow down, the progression of keratoconus. 

Some patients may experience a modest improvement in vision or corneal shape after the procedure. This is a 'bonus'.

Riboflavin (Vitamin B2) acts as a photosensitizer. When the riboflavin is exposed to ultraviolet A (UV-A) light, a photochemical reaction is triggered. This reaction creates new cross-links between the collagen fibres, making the cornea stronger and more stable.

The entire process, including numbing, riboflavin saturation, and U-VA light exposure takes approximately 60 minutes for one eye and 90 minutes for both eyes.

This in-room procedure is performed under topical anaesthesia (numbing eye drops are applied to the surface of the eye/s) so you should not feel any pain. 

After the procedure, once the numbing drops have worn off, some discomfort is common. This discomfort can be managed with over-the-counter pain medication and the prescribed eye drops and usually subsides within 3-5 days.

The technique that we employ is exceedingly safe, with an overall risk factor of only 0.1%.

Although the CXL procedure is extremely safe, there are complications that can occur.  Some of the potential complications include:

• Temporary corneal haze

• Infection

• Scarring

• Delayed epithelial healing

• Temporary or, in rare cases, permanent decrease in vision.

• Dry eye symptoms

CXL is generally recommended for patients with documented progressive keratoconus or other ectatic corneal diseases. Corneal thickness is a crucial factor, as the cornea needs to be thick enough for the procedure to be safe and effective. 

Active ocular surface infection is an absolute contra-indication. 

A relative contra-indication would be a cornea that is simply too thin and needs a corneal transplant.

This procedure is covered by most medical aids. The practice will contact your medical aid on your behalf to apply for authorisation. We will contact you before the procedure if:

• There are any problems with the authorisation process and/or

• The full amount is not covered by your medical aid.

HPCSA Ethical Guidelines prohibit us from placing procedure costs on our website. Please contact our practice for information pertaining to the cost of this procedure.

• REMOVE ALL MAKEUP. Please do not wear any mascara or eye makeup on the day of surgery. Be sure to clean all makeup off thoroughly. 

• Arrange transportation. Whether your procedure will involve one or both eyes, it will be necessary to arrange transportation for after surgery. 

• Avoid bringing excessive accessories and dress comfortably. The theatre gown provided will be worn over your own clothes.

• Use the bathroom BEFORE the procedure begins. 

The procedure is done under topical anaesthesia (drops are used to numb the eye/s). This means that you can eat and drink as normal before your procedure.

Yes, you can continue taking your chronic medication. No change in your medication routine is required.

Fully healed is a relative term, or healing has a few variables.

• In terms of vision, it is the next day usually. Again, vision should remain unchanged mostly, with only minor shifts that can occur over time. Sometimes there are minor fluctuations the first week or so. 

• In terms of final full quality in vision, we expect full stabilization with minimal shift at the 3-month mark. But, long term small shifts are still possible for even up to 3 years after the procedure. Usually, however, if we are aiming to get new spectacles, we advise doing this at that 3-month mark.

• In terms of full back to baseline ocular surface tear film, it can take longer. Some patients have zero dryness. Some patients have minor dryness symptoms for a month. While others feel they need lubricating drops for even 6 months afterwards. This is very variable. But most, if not all, return to baseline ocular surface in the end.

Generally speaking, vision is on point within 1 day; sensation is more than comfortable in most before the end of day 7; and dryness symptoms usually resolve in a month or 3.

• Once the effects of the numbing drops wear off, some discomfort is common. This is often described as a gritty, burning sensation or foreign body sensation and can be managed with over-the-counter pain medication and the prescribed eye drops. Discomfort usually subsides within 3-5 days.

• Your vision will likely be blurry immediately after the procedure, but should recover to baseline within 24 hours. Please read the above for more information on this.

• Light sensitivity and mild irritation are common. Sunglasses can help.

• You may need new glasses or contact lenses once your vision stabilizes, at about the 3-month mark.

YES, most patients will still require glasses or contact lenses (often specialized contact lenses) to achieve their best vision after CXL. Remember, CXL aims to stabilize the cornea, not to correct your spectacle error / the focus point of the ocular system. 

You can resume wearing your contact lenses 2 days post-procedure. 

Yes, you can continue as normal. 

Just be sure to AVOID:

• Eye rubbing or pressure, and  

• Tap water going directly into the eye/s for the first week. 

• Avoid swimming or wearing eye makeup during the first 24 hours after the procedure, or until the eyes feel comfortable.

• DO NOT rub your eyes. 

Dependent on comfort, full duties can usually be resumed in a day or two.

This is not an absolute necessity. However, light sensitivity and mild irritation are common after the procedure so you can wear sunglasses if you are not comfortable without them. 

Drive the next day. Fly the next day.

You can resume your exercise routine the next day. 

Just avoid swimming during the first 24 hours post-procedure (or until the eyes feel comfortable).