For over 20 years, crosslinking has offered patients a safe, effective and gentle treatment that stops curvature and allows the cornea to stabilize through new collagen connections.
Crosslinking is used in refractive surgery to stabilize the cornea.
This is necessary, for example, if the patient suffers from keratoconus or keratoderma (pellucid marginal degeneration of the cornea).
In contrast to a complex and risky corneal transplant, crosslinking (clx) can trigger a chemical reaction through the use of vitamin B2 (riboflavin) and UV light, which stimulates collagen crosslinking in the cornea.
This strengthens and stabilizes the cornea.
Protrusion can be prevented, slowed down or even easily reversed.
Find out more about the eye disease “keratoconus”, the symptoms, causes and treatment options:
Keratoconus glossaryThe most important prerequisite for promising and safe treatment with crosslinking is sufficient corneal thickness:
This value is determined during your preliminary examination.
If the corneal thickness is lower, the UV radiation cannot be sufficiently absorbed and there is a risk of damage to the endothelial cells on the inside of the cornea, which are responsible for pumping out water.
In addition, the curvature value should be less than 55 diopters amount.
The Chances of success decrease with
Free cxl suitability test & non-binding preliminary examination:
Do you recognize the symptoms described above in yourself or your loved ones or do you already know that you have keratoconus?
At EyeLaser Vienna and Linz, we can use state-of-the-art diagnostics to detect keratoconus and check whether you are suitable for crosslinking.
As part of your free suitability test, a measurement of the corneal thickness (pachymetry) and a surface measurement (topography) will be carried out.
You will then have certainty and can decide on the basis of medical facts to act quickly and correctly!
After your free suitability test with world-renowned eye surgeons, you will know whether you have keratoconus and whether crosslinking is promising for you: Arrange a suitability test
During your aptitude test in conjunction with a non-binding, holistic preliminary examination (200 euros)*, we will develop an individual treatment plan for you: Arrange a preliminary examination
*If you opt for treatment at EyeLaser, these costs will be deducted from the laser eye surgery costs.
Stop, slow down or even slightly reverse the cone-shaped protrusion through crosslinking.
More stable, stronger cornea thanks to new collagen cross-linking.
Well over 95 percent of patients respond to crosslinking and the cornea is stabilized.
If the effect diminishes, it can be repeated.
Hardly any risks.
The corneal curvature becomes more regular.
As a result, subsequent treatment (lens implantation or trans-PRK) can significantly improve your vision in the long term.
Crosslinking for keratoconus and similar corneal diseases is gentle on the tissue, as the eye does not have to be “opened”, takes a maximum of two hours in total and can be performed on an outpatient basis at EyeLaser in Vienna or Linz.
Your eyes are anaesthetized with eye drops so that you do not feel any pain during the treatment.
The top layer of the cornea is then removed, allowing the vitamin B2 (riboflavin) to penetrate deeper into the tissue so that the UV light is not filtered out as much.
The riboflavin ensures that the UV-A radiation to which the eye is subsequently exposed can be sufficiently absorbed.
In crosslinking, the eye is exposed to UV radiation for half an hour after the administration of vitamin B2.
The intensity of the radiation is regulated in such a way that no tissue damage occurs and yet the formation of new cross-links on the cornea is stimulated.
These cross-links provide the necessary stability and prevent further curvature of the cornea.
The corneal curvature is then significantly more even, so that the visual defect can be corrected by wearing glasses or undergoing refractive treatment (e.g. lens implantation or trans-PRK).
Unfortunately, stabilization of the cornea cannot be permanently guaranteed by crosslinking.
The cornea renews itself completely within eight years.
If the keratoconus is due to a hereditary predisposition, the instability will therefore develop again.
For this reason, most patients require further treatment after seven years.
If you repeat the procedure in good time before the keratoconus progresses, you will prevent the protrusion from intensifying.
If you have your visual defect corrected by lens surgery or laser eye surgery after the first crosslinking, this visual defect correction will remain stable even after the second, third and subsequent treatments.
There are currently two methods for UV crosslinking.
At EyeLaser Vienna and Linz, we mostly use the classic epi-off crosslinkingas the success rate is significantly higher.
Based on your individual case, we will decide which option is promising and best suited for you.
For particularly mild keratoconus, the epi-on procedure may well be an option.
In principle, however, we see the increased effectiveness (epi-off) as a reason to accept the slight discomfort – e.g. burning sensation – in the days following treatment, but the certainty that the cornea is sufficiently stabilized.
The upper corneal layer is scraped off as it significantly impairs UV absorption.
This allows the vitamin B2 to penetrate much deeper into the cornea and reach the stroma.
With correct aftercare and treatment, the risk of infection from the scraping is negligible.
Penetration depth of vitamin B2: 400 µmSuccess rate: over 95 percent
Transepithelial crosslinking does not involve scraping the corneal surface.
This means that the cornea does not have to heal after the treatment.
A special formulation and process modifications are used to ensure that the riboflavin still penetrates.
Penetration depth of vitamin B2: 150 µmSuccess rate: 60 to 70 percent
Keratoconus, PMD or keratoglobus can have a lasting negative impact on your quality of life and get worse and worse if you don’t treat it.
At EyeLaser Vienna and Linz, we have already helped thousands of patients to stop the corneal bulge and sometimes even correct all visual defects in a follow-up treatment.
What happens if you opt for crosslinking:
To begin with, the abnormal corneal curvature must be diagnosed.
At EyeLaser, we use state-of-the-art diagnostic equipment to precisely measure and record your corneal thickness, corneal structure and other parameters.
This measurement data is also relevant for the subsequent crosslinking treatment.
We use different methods for this.
Progressive keratoconus, for example, is diagnosed by the change in corneal refractive power over a certain period of time.
As soon as the preliminary examinations have been completed, we will advise you on the most promising treatment and, if desired, draw up your individual treatment plan including
including all the documents you need for your health insurance.
The actual treatment takes around 60-90 minutes – you should allow two hours for pre- and post-treatment care.
The eye is anesthetized with eye drops so that you do not feel any pain.
The top layer of the cornea is removed mechanically so that the active ingredient riboflavin can penetrate deep enough into the cornea and not filter out too much of the UV-A radiation.
A small amount of vitamin B2 is now applied / dripped every three minutes for half an hour.
To stimulate the metabolism, the reconnection of the fibers and the formation of collagen compounds, your eye is then irradiated by a UV lamp for 30 minutes – the riboflavin continues to be dripped during this time.
The cornea needs time to heal after crosslinking.
During this phase, slight pain and other mild side effects (e.g. red eyes, itching, burning, sensitivity to light, dryness) cannot be avoided.
To alleviate these symptoms and prevent infection, you will be given a drip schedule of anti-inflammatory eye drops containing an antiobiotic agent and tear substitutes to keep the eyes moist.
In the first few days after crosslinking, your eye will be protected by a hard contact lens (bandage lens).
If complications arise or you need our advice outside of the scheduled follow-up appointments, we are of course always happy to help.
A slight clouding of the stroma may occur in some cases.
However, this disappears by itself after a few months and hardly affects your everyday life.
The clarity of the cornea is then restored.
As soon as healing is complete, you can use soft contact lenses again.
If these do not fit, wait at least 3 months after the treatment before refitting.
Only then will the shape of your corneal tissue be stable enough for the lenses to be made to fit permanently.
With a follow-up treatment you can independent of wearing glasses or contact lenses make.
The fact that the cornea is significantly more stable after crosslinking and the corneal curvature is more regular means that vision correction is much easier. for some patients possible – at the earliest six months after the procedure.
We insert an artificial lens (EVO VISIAN ICL) in addition to your natural lens.
This additional lens corrects the visual defect – regardless of whether it is short-sightedness, long-sightedness or astigmatism.
With this method, we can reliably correct even severe visual defects.
As an alternative to lens surgery, the visual defect can also be improved by laser surgery.
The epithelium is removed and the surface of the cornea causing the visual defect is regularized so that you can then see more clearly again.
There is no contact or flap, which makes the treatment particularly gentle and the procedure can also be used on thin and/or irregular corneas.
Find out whether lens surgery is possible for you. Perfect for patients who are considering having their vision corrected.
No one should have to suffer from the effects and consequences of keratoconus.
That’s why we offer attractive financing options at EyeLaser Vienna and Linz.
You do not necessarily have to pay the entire amount at once, but can significantly improve your quality of life with just a small monthly installment.
Interest-free cross-linking financing over 6 months:
Cure your keratoconus without bureaucracy and without long-term credit commitments.
Pay in six convenient monthly installments without having to add a cent of interest.
284 euros per month Crosslinking financing for less than 29 euros per month over 5 years: Together with our partner banks, we can offer you a loan over five years so that you only have to make a small contribution to your budget each month. 29 euros per month*
* The term is five years.
Effective annual interest rate: 6.6 percent.
The prices refer to one eye.
Whether your health insurance covers the costs of crosslinking depends on the individual case.
Statutory health insurance companies are usually not willing or obliged to cover the treatment costs.
However, there are also exceptional cases in Austria in which the statutory health insurance has covered the costs in full.
The likelihood of crosslinking costs being covered is significantly higher with private health insurance.
Many insurance companies cover the costs – but not all of them.
It depends on the contractually agreed benefits and possible supplementary insurance.
In any case, it is worth clarifying this question with your health insurance company in advance in order to have the necessary financial security.
After the preliminary examination, we will be happy to provide you with the necessary medical documents, which you can submit to your health insurance company with a justification.
They will then check whether the costs will be reimbursed.
We will discuss whether and which follow-up treatment can permanently correct your defective vision after crosslinking during your preliminary examination or after the crosslinking treatment at the Eye Laser Center Vienna / Linz.
Together we will find the best solution for your eyes that suits your visual impairment, your lifestyle and your budget.
Make an appointmentAfter epi-off crosslinking (clx) in particular, the removed corneal layer must heal and regress.
Therefore, after the procedure, a soft, protective Contact lens (bandage contact lens) until the top layer has healed again.
This usually takes between three and five days.
Until the healing is complete, you should return to your check-up appointments to ensure that there is no infection.
But even after the acute healing phase, you can come to our laser eye center in Vienna or Linz at any time – apart from the regular check-up appointments – in case of complications or uncertainties.
We will take care of you!
After treatment, many patients complain of pain, burning, watery and reddened eyes and a foreign body sensation. To alleviate this, EyeLaser will provide you with appropriate painkillers and/or eye drops.
Once the first phase of healing is complete, there are only mild symptoms such as a foreign body sensation or itchy eyes.
Visual acuity increases until it is as it was before the treatment or even better after four to six weeks.
Sometimes after crosslinking there is a slight slight (!) clouding of the corneawhich, however, only slightly impairs vision, is normal and disappears again within three to a maximum of six months.
With a success rate of over 95 percent and a complication rate of well under 3 percent – including minor complications – crosslinking is considered to be extremely safe and low-risk for you as a patient.
It has been used worldwide since 2002 to stimulate the cross-linking of the cornea.
Damage to the eyes caused by UV-A radiation is prevented by the precise determination of the harmless intensity.
There are hardly any side effects and there are no serious consequences, such as damage to the retina or lens have been documented.
In over 97 percent of patients, there are no complications after crosslinking.
Discover Austria’s most popular laser eye surgeons in the heart of Vienna and Linz
After learning his trade from the two pioneers of laser surgery,
Dr Victor Derhartunian is among the leading surgeons in Europe. He heads the practice in Vienna and can advise his patients in 5 languages.
Dr. Paul Jirak is a co-founder of one of the most renowned centers for laser eye surgery in Austria and has been treating patients in Linz since 2014. He specialises in ophthalmology, optometry, eye surgery and eye lasers.
Dr. Leydolt is an ophthalmologist specialised in cataract and lens surgery. She leads a research group with this focus, trains young surgeons and gives international and national lectures.
No, crosslinking itself does not cause any pain.
Before the treatment, your eyes are anaesthetized with special eye drops so that you will not feel any pain.
Only in the days following crosslinking, when the corneal surface heals, may you experience some unpleasant pain.
You have the option of treating this with eye drops and painkillers.
You should no longer feel any pain after a week at the latest.
This depends on the individual case.
If crosslinking is the most suitable medically necessary treatment for keratoconus, statutory health insurance may also cover this treatment.
As a rule, however, crosslinking is not covered by statutory health insurance.
If you have private health insurance, the likelihood of costs being covered is higher – but this is not guaranteed here either.
In any case, ask in advance – preferably with medical findings – and find out whether you can expect partial or full cost coverage.
If you undergo crosslinking treatment at EyeLaser, our surgeons and doctors will explain to you exactly what you need to pay attention to so that the healing process is as quick and complication-free as possible.
We have put together a short overview of the most frequently asked questions after crosslinking:
What to do if your eye itches?
You should definitely avoid applying friction and mechanical pressure to the eye in the first few weeks.
Constantly touching the eye should cause the keratoconus to progress further.
When can I do sports after crosslinking?
In the first week after treatment, you should avoid strenuous activity if possible.
Sweat poses a risk of infection to your eye.
As soon as the healing of the corneal surface is complete, you can slowly resume your activities.
When can I drive after crosslinking?
This depends on your eyesight or your visual impairment.
At least immediately after treatment, you should make sure that you are picked up or take public transport home.
This is safer.
How long will I be on sick leave after crosslinking?
Usually only a few days to a week.
The important thing is that you can then see well enough to carry out your work safely as usual and are not restricted.
How often and which eye drops after crosslinking?
Your doctor will tell you this.
You will be given a precise drip schedule, which you should never deviate from without authorization.
Regular dripping with suitable eye drops is essential for healing.
When can I start wearing my contact lenses again after crosslinking?
Wait at least four weeks.
It is possible that your “old” lenses no longer fit you or that they fit poorly.
In this case, your contact lenses should be adjusted.
It only makes sense to have your lenses fitted after three months.
When can I shower / swim after crosslinking?
Make sure that no water gets into the eye during the first week.
Small drops are not a problem.
However, you should avoid swimming and saunas completely until the corneal surface has healed.
7 years.
Unfortunately, the stabilization of the cornea through crosslinking is not permanent.
This is because the cells of the cornea regenerate completely every 8 years on average.
The collagen cross-links responsible for the lack of stability have reformed due to the predisposition and renewed treatment with vitamin B2 and UV light may be necessary.
However, the treatment prevents the protrusion of the cornea from developing further and increasing.
Re-treatment with crosslinking maintains the improved visual acuity that was made possible by the follow-up treatment after the first crosslinking.
At the same time, renewed treatment by crosslinking maintains the improvement in visual acuity that was made possible by follow-up treatment after the first time.
Keratoconus is the “opposite” of keratoconus.
In contrast to a thinned cornea, keratoconus (also known as PMD) affects the edge of the cornea.
This thickens and stiffens.
This form of eye disease is not easy to distinguish from keratoconus and is often confused.
However, PMD can usually be corrected well with glasses.
This is because the center of the cornea is not affected, but is only “distorted” by the stiffened corneal edge.
Keratosis (pellucid marginal degeneration of the cornea) can also be treated with UV crosslinking.
