Corneal Cross-linking (CXL)

Corneal Cross-linking (CXL) treatments abroad

Corneal Crosslinking also known as corneal collagen crosslinking, CXL, C3-R, CCL, KXL, or just simply crosslinking, this is a procedure used to treat keratoconus and ectasia caused by refractive eye surgery. Corneal crosslinking strengthens chemical bonds in the eye, therefore stopping conditions such as ectasia from advancing and preventing the cornea from changing shape (thinning or curving), prohibiting the development of astigmatism or myopia. The procedure involves using riboflavin (vitamin B2) eye drops, UV light, and a photosensitizer .

The riboflavin enhances and maintains the stroma (middle layer) of the cornea by causing new collagen strands to form across already existing ones. Firstly the patient's eye is numbed using local anesthesia eye drops. Then a solution of antibiotics is added to the eye to prevent bacteria from entering the eye and to stop an infection from developing. The ophthalmologist will then use a device called a lid speculum to hold the eye open, while they carefully remove the top layer (epithelium) from the eye. Vitamin B2 (riboflavin) eye drops are then administered every 5 minutes for a period of about half an hour, until the solution can be seen using a blue filter or a slit lamp. A UV (ultraviolet) light is then placed a few centimetres from the patient's eye for a period of 30 minutes or so. After this, antibiotic drops are added to the patients eye again and a protective contact lens is placed over it. The whole procedure generally takes less than an hour and results in stiffer corneas which are more resistant to enzymatic breakdown .

There are different kinds of techniques used in corneal crosslinking, but all of them involve either impairing or extracting the corneal epithelium and using riboflavin to produce collagen bonds to strengthen the cornea. The epithelium-off technique (also known as the Dresden protocol) is the standard procedure used today and was the first to be developed. Another technique is transepithelial cr-linking (epithelium-on). In this technique, as the name suggests, the epithelium is left in place, however more vitamin B2 drops are required and the process takes a little longer.

Am I suitable for corneal crosslinking?

What is to be expected after the treatment? Sufferers of keratoconus, astigmatism, visual acuity that hasn't been corrected, and ectasia caused by refractive eye surgery such as LASIK laser eye surgery or photorefractive keratectomy (PRK) , are the best candidates for corneal crosslinking . Firstly, potential patients will need to go through a few clinical tests, like a corneal CT (computed tomography) scan, endothelial microscopy or biomicroscopy, ultrasonic pachymetry, b-scan sonography, and keratometry. Patients should also be aware that the procedure does not correct vision problems, but it can be used in conjunction with refractive eye surgery for this purpos

Cost of Corneal Cross-linking (CXL) around world

# Country Average Cost Starting Cost Highest Cost
1 India $1500 $1500 $1500

What affects the final cost of Corneal Cross-linking (CXL)?

There are many factors that can affect the costs

  • Types of Surgery performed
  • Experience of the surgeon
  • Choice of hospital & Technology
  • Rehabilitation cost after surgery
  • Insurance Coverage can affect a person's out of pocket expenses
Get Free Consultation

Hospitals for Corneal Cross-linking (CXL)

Click Here

About Corneal Cross-linking (CXL)

Corneal cross-linking (CXL) is a procedure performed to treat patients with keratoconus. Keratoconus is an eye disease that causes the cornea to weaken and become thinner, and the shape of the cornea may also change as it pushes forward, becoming somewhat cone-shaped. The disease can cause problems with vision, such as astigmatism. Patients suffering with keratoconus are often treated first with prescription glasses or contact lenses to help improve their vision, however, a cornea transplant may eventually be necessary.

Corneal cross-linking is performed to prevent vision from getting worse, and in some cases it can prevent the need for a cornea transplant. The cornea has cross-links between its collagen fibers which help the cornea to maintain its strength and shape. Keratoconus causes a break down of the cross-links, which weakens the cornea and causes it to lose its shape. Corneal cross-linking uses UV (ultraviolet) light and Riboflavin (vitamin B2), to help create new cross-links between the fibers in the cornea, to strengthen it and create new bonds which can help prevent vision from deteriorating. The procedure does not correct vision, meaning patients will need to continue wearing glasses or contact lenses afterwards, however, the treatment helps to stop the vision from deteriorating and some patients may experience some improvements with their vision.

Recommended for Treating keratoconus Time requirements Number of days in hospital 1 . Overnight stay not required. Average length of stay abroad 2 - 8 days. Patients usually need to attend a follow-up appointment one week after the surgery. Number of trips abroad needed 1. Time off work 1 weeks. Corneal crosslinking strengthens the cornea tissue and can help prevent further deterioration of the eye. 

Before Procedure / Treatment

Patients will meet the doctor ahead of the procedure to discuss the treatment. The doctor will likely perform a series of tests to determine the suitability of the patient for the procedure, which usually involves measuring the thickness of the cornea.

The procedure cannot be performed on patients who have an extremely thing cornea, or a cornea which has a lot of scarring.,

How it Performed?

Corneal cross-linking (CXL) is a relatively non-invasive procedure which involves numbing the eye with a local anesthetic using eye drops. The eye is then held open using special surgical instruments and the surface skin on the eye is removed. Riboflavin drops are dropped into the eye over a period of around 10 minutes. UV light is then directed at the eye and left in place for around 10 minutes.

A special bandage contact lens is then then put in place to protect the eye. Anesthesia Local anesthetic, sometimes with additional sedation. Procedure duration The Corneal Cross-linking (CXL) takes 45 to 90 minutes. The procedure takes around 45 minutes per eye. Corneal crosslinking is a non-invasive procedure whereby riboflavin is applied to the eye and treated with UV-A light.,


Post procedure care Patients will be prescribed eye drops which are to be administered on an hourly basis on the day after the procedure, and every 4 hours in the subsequent days proceeding the procedure. The bandage lens is to be kept on the eye for around 7 days, however should this lens fall out, it should not be reinserted.

Patients usually need to attend a follow-up appointment one week after the surgery, to allow the doctor the assess the progress of recovery. If the patient normally wears contact lenses, they will need to refrain from wearing them until the surface of the eye has healed, which usually takes around 2 weeks. Possible discomfort Patients may experience sensitivity to light and the eye is likely to be red. Vision may be blurry in the weeks proceeding the procedure, however this return to normal.,

Top 10 Hospitals for Corneal Cross-linking (CXL)

Following are the best 10 hospitals for Corneal Cross-linking (CXL) in the world:

# Hospital Country City Price
1 Apollo Gleneagles Hospital India Kolkata ---    
2 Thainakarin Hospital Thailand Bangkok ---    
3 Medipol Mega University Hospital Turkey Istanbul ---    
4 BLK-MAX Super Specialty Hospital India New Delhi ---    
5 Hospital Mae de Deus Brazil Porto Alegre ---    
6 Premier Medica Russian Federation Moscow ---    
7 American Heart of Poland Poland Bielsko-Biała ---    
8 Apollo Gleneagles Hospital India Kolkata ---    
9 Zulekha Hospital United Arab Emirates Dubai ---    
10 Hospital Universitari Sagrat Cor Spain Barcelona ---    

Best doctors for Corneal Cross-linking (CXL)

Following are the best doctors for Corneal Cross-linking (CXL) in the world:

1 Dr Gul J Nankani Ophthalmologist Rockland Hospital, Manesa...
2 Dr Meher Kothari Ophthalmologist BLK-MAX Super Specialty H...
3 Dr. P. Suresh Ophthalmologist Fortis Hospital Mulund
4 Dr. Mohan R. Mithare Ophthalmologist Fortis Hospital Bangalore
5 Dr. Wong Choy Hoong Ophthalmologist Pantai Hospital, Penang
6 Prof. Igal Leibovitch Ophthalmologist Tel Aviv Sourasky Medical...
7 Dr. Amit Nagpal Ophthalmologist NMC Specialty Hospital Du...

How Mozocare can help you



Search Procedure and Hospital



Choose your Options



Book your program



You are ready for a new and healthier life

About Mozocare

Mozocare is a medical access platform for hospitals and clinics to assist patients access best medical care at affordable prices. Mozocare  Insights provides  Health News,  Latest treatment innovation, Hospital ranking , Healthcare Industry Information and  Knowledge sharing .

The information on this page was reviewed and approved by Mozocare team. This page was updated on 16 Jun, 2020.

Need Help ?

Send Request