When your doctor recommends for you to undergo a medical procedure, it can seem scary at first. Your mind may be racing with questions such as Will it hurt? How long will the procedure take? What will my recovery be like? People want to absorb as much information as possible so they know what to expect and feel prepared going to their appointment. Your doctor will tell you everything you need to know about the medical procedure, but if you’re looking for some additional information, the internet, family, and friends can also be useful.

For people diagnosed with progressive keratoconus, it’s likely that iLink® FDA-approved cross-linking will be recommended to halt or slow the progression of the condition. Whether your cross-linking procedure is scheduled or you’ve been considering it for a while now, you may be interested in learning more about this minimally invasive procedure. To help, we’re providing an overview of what to expect before, during, and after the iLink® procedure by answering some of your commonly asked questions. Continue reading to learn more.

Before iLink® FDA-Approved Cross-Linking

First and foremost, if you’re planning to receive cross-linking to treat progressive keratoconus, it is imperative to confirm that you’re receiving iLink® FDA-approved cross-linking. Not all cross-linking procedures are the same and there is only one that is FDA-approved and covered by insurance. Before scheduling a procedure, make sure that your doctor is offering iLink® FDA-approved cross-linking, and don’t be afraid to ask for a second opinion if they tell you it is not approved or not covered by insurance.

Maybe you have additional questions around FDA-approved cross-linking, insurance coverage, or what you need to do before the procedure? Good news – we’re answering them below.

Which corneal cross-linking procedures are currently FDA-approved in the US?

iLink® epi-off cross-linking performed with Photrexa® Drug Formulations, Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution), and ultra-violet A (UVA) light from the KXL® System is the only cross-linking procedure approved by the FDA.

How can you make sure you are receiving the FDA-approved cross-linking procedure?

Check our physician locator to find a list of U.S. physicians performing iLink® FDA-approved cross-linking.

Is corneal cross-linking covered by insurance?

iLink® epi-off cross-linking with the Photrexa® drug formulations is the only cross-linking procedure covered by insurance. Greater than 95% of the commercially insured population has access to this sight-preserving treatment. For additional information on insurance coverage and to view the latest list of insurers and their policies covering cross-linking, visit the Insurance Information page.

Will I need to be out of my contact lenses for this process?

Yes. Typically, patients are asked by their doctor to stop wearing contact lenses prior to surgery for a period of several weeks. Once treated, your doctor may direct you not to wear contact lenses for one month. If you wear contact lenses, make sure to talk to your doctor about what is the right timeline for you.

During iLink® FDA-Approved Cross-Linking

Throughout this entire process, you’re probably most curious about what to expect during the cross-linking procedure itself. You may be wondering what exactly happens during the procedure, if it will hurt, and how long it will take. To help provide some insight, we’ve included an overview of the procedure and included some of your frequently asked questions below.

What Can I Expect During the Corneal Cross-Linking Procedure?
  • After numbing drops are applied, the epithelium (the thin layer on the surface of the cornea) is gently removed.
  • Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution) eye drops will be applied to the cornea for at least 30 min;
  • Depending on the thickness of your cornea, Photrexa® (riboflavin 5’-phosphate ophthalmic solution) drops may also be required.
  • The cornea is then exposed to UV light for 30 minutes while additional Photrexa Viscous drops are applied.
How long does the treatment take?

The actual procedure takes about an hour, but you should plan to be at the office for about two hours in total to allow sufficient time for preparation and recovery before you return to the comfort of your own home.

Is the procedure painful?

Don’t worry, there is not usually any discomfort experienced during the procedure as numbing eye drops are applied to the surface of the eye.

Am I awake during the procedure?

Typically, you will be awake during the treatment. You may be given medication to help you relax and numbing anesthetic drops to ensure you don’t feel any discomfort.

After iLink® FDA-Approved Cross-Linking

Prior to undergoing iLink® FDA-approved cross-linking, you may find it helpful to study up on the proper maintenance and care that will be needed after your procedure. Below are five suggestions to follow after your iLink® procedure as well as what to expect during the recovery process.

What should I do following my cross-linking procedure?
  • You should not rub your eyes for the first five days after the procedure.
  • You may notice a sensitivity to light and have a foreign body sensation. You may also experience discomfort in the treated eye and sunglasses can help with light sensitivity.
  • If you experience severe pain in the eye or any sudden decrease in vision, you should contact your physician immediately.
  • If your bandage contact lens from the day of treatment falls out or becomes dislodged, you should not replace it and should instead contact your physician immediately.
  • Ulcerative keratitis, a potentially serious eye infection, can occur after treatment. Your doctor should monitor defects in the outermost corneal layer of the eye for resolution. The most common ocular side effect to occur is haze. For the full list of potential side effects, see Prescribing Info.
When can I wear contacts again?

Once treated, you will typically be allowed back into contact lenses after one month. Talk with your doctor about when it’s okay to resume wearing your lenses.

How painful is corneal cross-linking?

There can be irritation during the immediate recovery but usually not during the treatment. Immediately following treatment, a bandage contact lens is placed on the surface of the eye to protect the newly treated area. After the numbing drops wear off, there is some discomfort, often described as a gritty, burning sensation. This discomfort can often be managed with Tylenol and artificial tears. If your pain is severe, make sure to discuss this with your doctor, as oral narcotic medications may be used.

Does corneal cross-linking help vision?

The goal of the iLink® procedure is to stiffen the cornea to slow or prevent further progression of the condition and preserve your vision. Cross-linking is not intended to eliminate or reduce dependence on refractive correction.

Can anyone tell by my appearance that I have had cross-linking?

No. There is no change in the appearance of your eyes following cross-linking.

Watch a Firsthand Account of a Cross-Linking Patient

Don’t just take our word for it. If you’re interested in hearing from someone who has already undergone iLink® FDA-approved cross-linking, look no further. Bekah video blogged her cross-linking journey before and after the procedure to share with others she had connected with along her way. Watch Bekah’s Video Journal below.


Next Up: iLink® FDA-Approved Cross-Linking!

There’s no need to feel nervous or apprehensive about receiving iLink® FDA-approved cross-linking, especially now that you know what to expect before, during, and after receiving the procedure. With this information under your belt, we hope you’re feeling better prepared to take these exciting next steps in your KC Journey. If you have any additional questions or concerns, don’t hesitate to contact your doctor. You can also connect with others in the keratoconus community who may be going through a similar experience.

Don’t forget to follow Living with KC on Facebook, Twitter, and Instagram for more information on keratoconus and iLink® FDA-approved cross-linking.