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Crosslinking is the safest and most effective treatment for keratoconus and PMD: the formation of the corneal anomaly is stopped and the corneal tissue is stabilized by stimulating collagen connections.

With timely treatment, you can avoid permanent damage and have the option of having your defective vision permanently corrected with a subsequent Trans-PRK or ICL lens.

What is corneal crosslinking?

What is crosslinking?

Was versteht man unter Crosslinking

Crosslinking is used in the treatment of keratoconus, keratorus (PMD), keratoglobus and corneal ectasia:

In crosslinking, the cornea is treated with vitamin B2 (riboflavin) and UV light, which stimulates the formation of new, strong collagen bonds in the tissue. This makes your cornea stable so that it cannot bulge further, does not become thinner and has a more regular shape in the long term.

As an alternative to crosslinking, you can have a corneal transplant – this is expensive, risky and much more complicated.

Find out more about keratoconus (protrusion of the cornea), its symptoms, causes and treatment options at EyeLaser Zurich:

Keratoconus glossary

Requirements for crosslinking: Am I suitable?

Do you suffer from keratoconus, keratorus (PMD), corneal ectasia after LASIK laser eye surgery or keratoglobus? Crosslinking is a promising treatment method for all of these conditions.

  • Corneal thickness: min. 250 µm
  • Curvature value: < 55 diopters

In order for the procedure to be carried out, your cornea must be at least 400 µm thick. A cornea that is too thin makes the procedure too risky and ensures poor effectiveness.

Contraindications for crosslinking (cxl) treatment:

  • Old age – the younger you are, the better
  • Acute or chronic eye infections
  • Pregnancy and breastfeeding
  • Scars on the cornea
  • Dysfunctional epithelium

Arrange a crosslinking suitability test now:

Do you already know that you suffer from keratoconus or another corneal disease that can be treated effectively and safely with crosslinking? At EyeLaser Zurich, we create clarity for you:

As part of your non-binding suitability test, we will examine your eyes and determine whether you have a degenerative eye disease or defective vision and to what extent this can be treated using the latest methods.

Aptitude test

After measuring your cornea (pachymetry and topography), you will know whether you are suitable for crosslinking.

Arrange an aptitude test

Preliminary examination

After a comprehensive preliminary examination, we will draw up a treatment plan tailored to your eyes (TARMED benefit).

Arrange a preliminary examination

Advantages of crosslinking for corneal bulging

The crosslinking mechanism of action: How your cornea is stabilized by collagen crosslinking

The two active ingredients used are riboflavin (vitamin B2) and UV radiation. By removing the uppermost corneal layer (epi-off procedure), the vitamin B2 can penetrate deeper into the stroma, where it is activated by UV radiation to produce the desired effect:

Keratoconus is stopped by the fact that the active ingredients stimulate the formation of collagen cross-links and cross-links on the cornea . The absence or insufficient presence of these cross-links causes the instability that ultimately results in the protrusion.

After crosslinking, your cornea has so many stabilizing crosslinks that further curvature is not possible and the cornea can even regulate itself. This in turn creates the perfect conditions for subsequent vision correction.

Your eyes will be anesthetized 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 and 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 irradiated with 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 the cornea from bulging further. The corneal curvature is then much more uniform, so that the visual defect can be corrected by wearing glasses or by refractive treatment (e.g. lens implantation or Trans-PRK).

Warum EyeLaser Zürich auf epi-off Crosslinking setzt:

The so-called epi-off crosslinking is the variant that has been around longer, has been better researched and has a significantly higher success rate than epi-on crosslinking.

Depending on the individual case, we decide what is right for you and which treatment has the right balance between benefit, efficacy and risk. The somewhat tissue-sparing epi-on treatment can be considered if the keratoconus is not very pronounced.

1. epi-off Crosslinking:

The uppermost cell layer of the cornea is removed so that the UV radiation and vitamin B2 can penetrate as deeply as possible – right into the stroma.

Penetration depth of the riboflavin: 400 µm

Success rate: more than 95

Stabilize the cornea & improve the quality of vision if desired

Painless, fast and effective: Keratoconus can have a major negative impact on your life and does not disappear on its own – which is why crosslinking can change your life for the better. At EyeLaser Zurich, we have already helped many patients to get rid of the corneal bulge and live a sustainably better life.

In addition to stabilizing the cornea, visual defects such as myopia, farsightedness and astigmatism can finally be permanently corrected after successful crosslinking.

Follow-up treatment for crosslinking: Improving the quality of vision (VISUS)

Crosslinking can slow down, stop or slightly reverse the protrusion of your cornea. However, visual defects that have already developed remain . Your visual defect can be improved with the help of lens implantation or trans-PRK.

However, before we can correct your visual defect, the cornea must stabilize through crosslinking and the existing (regular or irregular) astigmatism needs time to regularize. Follow-up treatments are possible after six months:

Crosslinking costs: TARMED benefit & assumption of costs by the health insurance company

100 percent cost coverage

Crosslinking is now a so-called TARMED health insurance benefit in Switzerland. If you are diagnosed with keratoconus or a similar eye condition, the treatment costs will be covered by your health insurance – even by your basic insurance.

Costs for a life without glasses: Crosslinking vision correction

Since crosslinking has been covered by health insurance as a TARMED service, even the costs for subsequent vision correction – as a combination treatment – can be covered. Crosslinking can be combined with Trans-PRK Premium or ICL treatment:

Healing after crosslinking: what you can expect

After epi-off crosslinking – the preferred method at EyeLaser Zurich – the cornea needs a certain amount of time to regrow the ablated tissue.

Effective & safe: crosslinking risks at a glance

Keratoconus has been successfully treated with crosslinking for over 20 years. 95 percent of all treatments have the desired effect and for every 100 treatments, fewer than three patients have complications – usually only minor ones. This makes crosslinking extremely low-risk, effective and safe for patients.

The UV radiation used has no negative effects on the cornea or the eye. Studies have shown that the exposure is too short and not intense enough to cause damage.

Only a few side effects and after-effects have been documented since 2002, and no serious, irreparable damage has been observed since then. In exceptional cases, it is possible that a:

  • prolonged wound healing.
  • scarring of the cornea, although this is particularly rare and reversible.
  • infection of the cornea (probability > 1 percent).

Get to know the eye experts

Discover our laser eye surgeons in the heart of Zurich

Dr. Victor Derhartunian
Dr. Victor Derhartunian
Ophthalmologist, specialist in refractive surgery
FEBO

Having learned his craft from the two pioneers of laser surgery, Dr. Victor Derhartunian is one of the leading surgeons in Europe. The senior eye surgeon at EyeLaser in Zurich can advise his patients in 5 languages.

LEARN MORE
Dr. Valery Vinzent Wittwer
Ophthalmologist and eye surgeon
FEBO

Since 2024, Dr. Valery Lenzt Wittwer joins the EyeLaser Zurich team. He specializes in lens surgery and enables patients to live without cataracts and/or visual defects through cataract surgery and ICL lens implantation.

Learn more
Dr. Victor Derhartunian
Dr. Victor Derhartunian
Ophthalmologist, specialist in refractive surgery
FEBO

Having learned his craft from the two pioneers of laser surgery, Dr. Victor Derhartunian is one of the leading surgeons in Europe. The senior eye surgeon at EyeLaser in Zurich can advise his patients in 5 languages.

LEARN MORE
Dr. Valery Vinzent Wittwer
Ophthalmologist and eye surgeon
FEBO

Since 2024, Dr. Valery Lenzt Wittwer joins the EyeLaser Zurich team. He specializes in lens surgery and enables patients to live without cataracts and/or visual defects through cataract surgery and ICL lens implantation.

Learn more

Questions & answers about crosslinking: