Early results of the first nurse-led corneal collagen cross-linking service in the UK

Sister Melanie Mason, Moorfields’ lead clinical nurse specialist for the corneal & external disease service, presented early results from the CXL service at the recent Royal College of Ophthalmologists’ Annual Congress in Birmingham.  Her six-month results demonstrated her practice to be as safe and effective as CXL performed by an ophthalmologist.

Collagen cross linking is the only interventional treatment available to halt progression in keratoconus, a debilitating eye condition in adolescence and earlier adulthood. Building on Moorfields’ experience in establishing nurse-led intravitreal injections, Melanie is pioneering the way forward as the first nurse to perform the full CXL procedure in the UK, having completed more than 100 cases to date.

Keratoconus causes very aggressive steeping and thinning of the cornea, causing a cone-like bulge to develop which causes poor vision by affecting the ability of the eye to focus. The disease often progresses through a patient’s twenties and thirties and although initially corrected with glasses or gas permeable lenses, can often require a corneal transplant in later years.

The treatment itself involves stabilising the vision by removing the epithelial layer and injecting the cornea with vitamin B before exposing the eye to ultra violet light for four minutes. The whole procedure is over in between 20-30 minutes. It can be painful for the first two days but is aimed at stopping the disease getting worse.

With support from Dan Gore, clinical research fellow, and consultant ophthalmologist Bruce Allan, two further nurses are currently undergoing training, together helping to expand capacity in Moorfields’ CXL service, meeting the growing demand for keratoconus intervention.

Tracy Luckett, director of nursing and allied health professionals at Moorfields said: “We are tremendously proud of the nurse-led CXL service and the steps that our nurses are taking in pioneering the development of new ways of delivering services and the key roles they are now playing in different  treatments.

“We are delighted to offer our nurses these opportunities for development. Other recent successes include: nurse-led clinics for intravitreal injection treatments; nurse led botox clinics; and the development of a new qualification with our partners at UCL – a post-graduate certificate in ophthalmic practices for nurses and allied health professionals. Ophthalmic nursing has much to offer nurses interested in specialising in a fascinating area of medicine.








Notes to editors

  • Moorfields is one of the world’s leading eye hospitals, providing expertise in clinical care, research and education. We have provided excellence in eye care for more than 200 years and we continue to be at the forefront of new breakthroughs and developments.  We are an integral part of one of the UK’s first academic health science centres, UCL Partners, and also one of the new academic health science networks. We were one of the first NHS organisations to achieve foundation trust status in 2004. 
  • We treat the entire range of eye diseases, from common complaints to rare conditions which require treatments not available anywhere else in the UK. We dealt with more than 528,824 attendances in 2012/13 at our main hospital base in London’s City Road and at 21 other sites in and around the capital, enabling us to provide expert care closer to patients’ homes.
  • With our research partners at the UCL Institute of Ophthalmology, we run one of the largest ophthalmic research programmes in the world and have the highest measure of scientific productivity and impact in the world for our research activity.

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