Corneal Cross-Linking (CXL)

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Corneal Cross-Linking (CXL)

An additional procedure that may be recommended to support corneal stability during vision correction.

What Is Corneal Cross-Linking (CXL)?

Corneal Cross-Linking (CXL) is a procedure used to help strengthen the cornea. For some individuals, especially those with naturally thinner corneas or reduced corneal rigidity, CXL may be incorporated into TransPRK to provide additional structural support.
During laser vision correction, a small amount of corneal tissue is removed to reshape the eye. In thinner corneas, this may increase the likelihood of the cornea changing shape over time. When indicated, CXL is performed to help reinforce the cornea and support long-term stability after the reshaping process.

How Does Corneal Cross-Linking Work?

CXL uses a combination of riboflavin (Vitamin B2) eye drops and a controlled amount of UVA light. When these interact, they help form new “cross-links” between collagen fibres within the cornea. These cross-links help the cornea maintain its shape.

CXL Steps (Performed Immediately After TransPRK):

  • Completion of the TransPRK procedure
  • Application of riboflavin (Vitamin B2) eye drops to the cornea
  • Exposure of the riboflavin-soaked cornea to UVA light
  • Application of postoperative medication as instructed
CXL itself usually takes only a few minutes and does not significantly change the expected TransPRK recovery timeline.

Who May Benefit From CXL?

Your suitability for CXL is assessed during your pre-surgery evaluation.
CXL may be recommended if you have:
  • Thin or biomechanically soft corneas
  • Irregular corneal measurements
  • A history of corneal injury, surface disease, or scarring
  • A higher corneal biomechanical risk during laser correction
If CXL is advised, it may help support:
  • Corneal stability after laser reshaping
  • Reduced likelihood of postoperative shape changes
  • Maintaining the intended visual correction outcome
(These effects are based on the mechanism of CXL and are not guarantees of individual results.)

What to Expect During the Procedure

CXL is performed in the same session as TransPRK. Most patients do not feel significant discomfort during the light exposure, though the overall recovery still follows the usual TransPRK process. You will receive detailed postoperative instructions and medications to support healing.

CXL Fees

(Inclusive of 9% GST)
Procedure Fee
Corneal Cross-Linking – One Eye
$642
Corneal Cross-Linking – Both Eyes
$1,284

How CXL Works (At a Glance)

Step 1 – After TransPRK
Your TransPRK procedure is completed, and the corneal surface is prepared.

Step 2 – Riboflavin Application
Vitamin B2 (riboflavin) drops are applied to the surface of the cornea.

Step 3 – UVA Light Activation
A controlled amount of UVA light is directed at the riboflavin-soaked cornea.
This helps form natural cross-links between collagen fibres.

Summary Box:
These cross-links help reinforce the cornea and support long-term stability after laser reshaping.

Key Takeaways About CXL

  • CXL is not required for all TransPRK patients; it is recommended based on individual corneal measurements.
  • It helps reinforce thinner or biomechanically softer corneas.
  • The procedure uses riboflavin drops and UVA light to create collagen cross-links.
  • CXL does not correct refractive power; its role is stability support.
  • When indicated, CXL is performed immediately after TransPRK in the same session.
  • Recovery remains similar to standard TransPRK recovery.

Frequently Asked Questions

1. Is Corneal Cross-Linking (CXL) mandatory for all TransPRK patients?

No. CXL is only recommended when corneal scans indicate a need for additional biomechanical support.

2. Can CXL be done without TransPRK?

CXL can be used in other medical contexts, but in the setting of laser vision correction at London Eye & Retina, it is used specifically as an add-on to TransPRK when clinically indicated.

  1. Will I feel anything during CXL?

Most patients do not experience significant discomfort during the riboflavin and UVA light stages. The overall recovery still follows the standard TransPRK timeline.

4. Does CXL change my vision?

CXL itself does not correct refractive power. It is performed to help support the stability of the cornea after laser reshaping.

5. How long does CXL take?

CXL usually takes a few minutes and is performed immediately after TransPRK.

6. Why is CXL recommended for thinner corneas?

Thinner corneas may benefit from additional reinforcement to help maintain corneal shape after laser reshaping.

7. Does CXL prolong recovery?

Not significantly. Recovery remains similar to a standard TransPRK timeline.

8. How will I know if I need CXL?

Dr James Ng will evaluate your scans and advise if CXL is recommended based on corneal thickness, strength, and safety considerations.

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Dr. James Ng

Dr. James Ng

Consultant Ophthalmic Surgeon

MBBS (UK), MRCOphth (UK), FRCOphth (UK), FAMS (SG)

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