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Keratoconus and corneal cross-linking

In keratoconus, the cornea thins and develops a cone shape, impairing vision. Cross-linking strengthens the cornea to slow the progression of the disease.

The principle

Vitamin B2 (riboflavin) is applied to the cornea, which is then exposed to ultraviolet light of a specific wavelength. This reaction creates new bonds between collagen fibres and stiffens the cornea. The aim is to stabilise keratoconus, not to restore a normal cornea.

Who is affected?

Progressive keratoconus, particularly in children, adolescents and young adults, assessed through repeated topography. The assessment includes topography, pachymetry and corneal analysis. Corneas that are too thin may require an adapted technique.

What happens

The procedure takes around an hour with anaesthetic eye drops. The corneal surface may be removed (standard technique) or preserved, depending on the protocol. Discomfort or pain may occur for one to three days; a bandage contact lens is sometimes placed. Eye drops continue for a few weeks.

After cross-linking

Glasses or contact lenses remain necessary to correct vision, sometimes with a prescription adjusted later. Eye rubbing should be avoided. Topography check-ups verify stability. See also scleral lenses and keratoconus.

Frequently asked questions

Is cross-linking painful?

Not during the procedure, under local anaesthesia; pain in the first few days is treated.

Can keratoconus return?

The aim is to stop it; regular check-ups verify stability.

Do allergies make the disease worse?

Eye rubbing is an aggravating factor; treating allergies is important (see eye allergies).

Learn more

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In the event of sudden loss of vision or pain, see eye emergencies.

A question about your situation?

Your ophthalmologist answers your questions during the consultation. For a sudden symptom or sudden loss of vision, seek advice promptly: see the eye emergencies page.

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