Moorfields’ Corneal cross-linking (CXL) results

How many CXL treatments have Moorfields performed?

Total number of eyes = 4,620

Does CXL work?

The aim of CXL is to stabilise the corneal shape. Stability can be proven by comparing corneal shape scans (topography) taken before and after treatment. Success is defined by the corneal shape being either the same or better at least 1 year following treatment.

Our three-year success rates are:

  • 94.4 % 1 year following CXL          
  • 94.0 % 2 years   
  • 93.6 % 3 years

Even if the corneal shape does not stabilise after CXL, in most cases the rate of progression is slowed down and many patients maintain the same level of vision in either glasses or contact lenses.

If CXL fails to stabilise the cornea, the treatment can be repeated. However, it is not known whether a second treatment is any more, or less likely to succeed.  Repeat CXL is rarely necessary – only 32 Moorfields patients have required a second CXL treatment to date.

Is CXL safe?

In general, CXL is very safe, but like all operations problems do occasionally occur. Temporary corneal haze (a form of healing) can affect your vision for the first few months.

In the rare occasions that your vision is permanently worse, rigid contact lenses can often restore the quality of vision. Failing that, a corneal transplant may be required. Of 4,620 treatments performed at Moorfields since 2013, only 2 eyes (0.001%) have required a corneal transplant to restore vision. It is important to remember that before CXL was available, approximately 1 in 5 (20%) patients with keratoconus historically required a corneal transplant to maintain their vision.

An updated spectacle or contact lens prescription may needed to get the very best vision after CXL. Accurate and reliable vision tests in spectacles are normally only possible in patients with mild keratoconus. For this group of patients, the percentage of patients with the same or better vision is:

  • 96.8 % 6 months following CXL
  • 97.8 % 1 year
  • 94.5 % 2 years
  • 97.1 % 3 years

Last updated: 16th April 2018