Hudson Valley Eye Surgeons PC Logo
Hours of Operation:
Mon-Fri 8:00 AM - 6:00 PM
Sat 8:00 AM - 12:00 PM

200 Westage Business Ctr Dr Suite #110, Fishkill NY 12524


According to the Cleveland Clinic, Corneal collagen cross-linking (CXL) is a technique that was first used in 1998 to treat patients with keratoconus. In keratoconus, the cornea can become weak, thin, and irregularly shaped. Instead of keeping its normal round shape, corneas with keratoconus can bulge forward into the shape of a cone causing poor vision. CXL is now being performed for patients with this condition in approximately 450 centers throughout the world. Our practice is now able to provide this treatment to our patients who could benefit from this advanced technology.
What is Keratoconus?
Keratoconus is a common disease that occurs in approximately 1 in 750 Americans. In this condition, the cornea becomes weak, progressively thinner, and irregular in shape which can cause high levels of astigmatism. Instead of a normal, relatively round shape resulting in clear vision, the cornea in keratoconus can become cone shaped. This can interfere with the ability to see clearly. Often keratoconus patients first require glasses, then contact lenses, and, if the condition progresses to a severe level, a corneal transplant may be required
How can Collagen cross linking help?
Normal corneas have crosslinks between its collagen fibers (see the diagram below form the Avedro website) that keep it strong and able to retain its normal shape. In keratoconus, the cornea is weak with too few cross-links or support beams. This weakened structure allows the cornea to bulge outwards. The cross-linking procedure adds cross-links or “cross beams” to the cornea, making it more stable, holding its shape and focusing power better. These new cross-links help strengthen the cornea which stops the thinning process and further loss of vision.
Many research studies have shown that CXL may prevent further vision loss in over 95% of patients. The studies have also shown that CXL can often prevent the need for a corneal transplant and allow patients to wear contact lenses or glasses more comfortably and safely again. In most instances, the majority of patients responds to a single vitamin and light CXL treatment and do not need to have the procedure repeated. CXL can safely be repeated if necessary.
Since keratoconus is a condition that often runs in families, it’s important to arrange a screening for all family members of patients with keratoconus. If caught early, there is a good chance that CXL can halt the progression of keratoconus and prevent the need for uncomfortable contact lens wear and/or corneal transplant.
How is CXL performed?
The CXL treatment is an outpatient procedure performed in the doctor’s office using only numbing eye drops and a mild sedative like a Valium tablet. The patient will lie flat on their back in a reclining chair and will look up at a soft blue light during the treatment. The epithelium, the thin layer of clear, protective tissue that covers the cornea is removed for the CXL procedure. Next, vitamin eye drops (riboflavin) are generously applied to the eye, followed by the patient looking at a special blue (ultraviolet) light. The procedure takes approximately an hour per eye.

PROKERA ® is a corneal bandage devices are used by eye doctors to heal and treat eye diseases such as keratitis, common dry eye, recurrent corneal erosions , filamentary keratitis , herpetic ulcers, and many other ocular surface diseases.
Natural, Therapeutic Healing
The amniotic membrane tissue in PROKERA ® products, has natural therapeutic actions that help damaged eye surfaces heal. PROKERA ® products provide faster and more effective healing of the cornea with less pain, scarring and inflammation, leading to clear corneas and improved clinical outcomes.
The Healing Process
PROKERA ® biologic corneal bandage devices are safe and effective with no risk of intraocular pressure (IOP) spikes or delayed healing. PROKERA® products can be inserted in the doctor’s office , or may be inserted in a surgical or hospital setting in conjunction with other procedures. PROKERA ® products can also be used in combination with topical agents.