Crosslinking (CXL): The Gold Standard in Halting Keratoconus
Warsaw · Krakow · Vienna · Zurich
If you have been diagnosed with keratoconus, the most important and urgent step is to halt its progression. At Swisslaser, we employ the gold standard in treating this condition—the Crosslinking (CXL) procedure. We perform it at our clinics in Poland (Warsaw, Krakow), ensuring the highest level of safety, based on unique international experience and groundbreaking technology.
Why Is Our Approach to Crosslinking Unique?
At Swisslaser, we do not “just” perform Crosslinking. We offer comprehensive stabilization therapy at the highest global standard.
What Is Crosslinking? Strengthening the Eye’s Foundation
Imagine the cornea as a scaffold built from collagen fibers. In keratoconus, the connections between these fibers weaken, and the entire structure loses stability. Crosslinking is a process that rebuilds and strengthens these connections. The procedure is simple and ingenious: we saturate the cornea with vitamin B2, then activate it with UVA light, creating hundreds of new, strong cross-links. In over 95% of cases, disease progression is effectively and permanently halted.
Experience That Cannot Be Replicated
Dr. Victor Derhartunian has been performing Crosslinking procedures since 2007, from the very beginning of this method’s existence in Europe. Moreover, he learned it in Zurich directly from its inventor, Prof. Theo Seiler. This guarantees that you are under the care of a surgeon with absolutely unique knowledge and experience.
Combining CXL with Laser: Precision “Tailored to You”
We often combine Crosslinking with therapeutic laser treatment (Trans-PRK/PTK). Thanks to our groundbreaking Total Corneal Wavefront technology (MS-39 2nd generation), we create a three-dimensional model of your entire cornea. It is like the difference between a flat map and a precise, satellite-based 3D model. This allows us to precisely “smooth” its irregular surface with accuracy that was previously unattainable.
Treatment of Thin Corneas: For Us, It Is Standard, Not an Exception.
Many patients are told that their cornea is “too thin” for the procedure. At Swisslaser, thanks to years of experience, safe treatment of thin corneas using the sub400 protocol is a standard procedure. Complex cases are our daily routine.
Comparison of the Most Advanced Methods
| Feature | Epi-off Crosslinking (Gold Standard) | Epi-on Crosslinking (Alternative) |
| Procedure | We gently remove the top layer of corneal cells (epithelium) to allow vitamin B2 to penetrate deeper. | The epithelium remains intact or is specially loosened. |
| Advantage | Maximum efficacy and the highest proven rate of halting the disease. | Less discomfort and faster recovery in the first days after the procedure. |
| Indications | Used in the vast majority of cases to provide the patient with the best and most lasting possible outcome. | Reserved for special cases. |
Am I a Candidate?
SwissLaser Traffic Light System
Green Light
(Ideal Candidates)
- Patients with documented keratoconus progression.
- Age typically below 40 years (when the disease is most active).
- Corneal thickness allowing for safe performance of the procedure (thanks to the sub400 protocol, we also treat thinner corneas).
Yellow Light
(Consultation Required):
- Patients with very rapid or very slow disease progression.
- Coexisting conditions, e.g., severe dry eye syndrome.
- Very thin cornea requiring a special protocol.
Red Light
(Not Qualified – but alternatives exist):
- Patients with advanced, central corneal scars.
- Active infections or inflammatory conditions of the eye.
- Pregnancy and breastfeeding (the procedure should be postponed).
Procedure Course and Recovery: What to Expect Step by Step
We understand that the prospect of the procedure may cause concern, so we present its exact course.
Preparation
Upon arrival at the clinic, you will receive anesthetic drops that will completely eliminate pain during the procedure.
Procedure
While lying comfortably, your cornea will first be saturated with vitamin B2 drops. This will be followed by several minutes of UVA light exposure. The entire process for one eye takes approximately one hour.
After the procedure
A special bandage contact lens is placed on the eye to support healing. You will receive a set of medications and detailed instructions.
First Days
The first 2-3 days after the Epi-off procedure are crucial for healing and may be uncomfortable. It is essential to follow the recommendations.
Return to Activity
Return to office work is usually possible after 5-7 days. Full physical activity can be resumed after approximately one month.
Stop the Disease, Regain Control. Schedule a Consultation.
Do not let keratoconus determine your future. The first and most important step is to halt its progression. At Swisslaser, we will do so based on the highest standards of safety and experience.
Frequently Asked Questions (FAQ)
Czy zabieg Crosslinking boli?
The procedure itself is completely painless thanks to anesthetic drops. However, the first 2-3 days after the procedure may be uncomfortable. Patients experience pain, burning, and photophobia, which we effectively alleviate with prescribed medications.
Jaka jest cena zabiegu Crosslinking w Polsce?
The price of the procedure at Swisslaser reflects the highest standard of performance, the surgeon’s experience, and the use of the latest technologies. During the consultation, you will receive a transparent, detailed cost estimate. We also offer convenient installment payment systems.
Czy zabieg Crosslinking jest refundowany przez NFZ?
Yes, the CXL procedure is included in the NFZ benefits package. However, you should expect a long waiting time. At Swisslaser, we perform the procedure without queues, often in combination with additional procedures (such as laser with Total Corneal Wavefront), which are not available under the NFZ.
Jak długo trwa rekonwalescencja po zabiegu CXL?
The first phase of healing takes approximately 5-7 days. Return to office work is possible after about one week. Full vision stabilization may take several months.
Czy po zabiegu będę lepiej widzieć?
The primary goal of CXL is to halt the disease. However, in some patients, especially when we combine the procedure with laser treatment planned using Total Corneal Wavefront technology, there is a significant improvement in vision quality and reduction of irregular astigmatism.
Czy moja rogówka nie jest “za cienka” na zabieg?
This is one of the most common concerns. At Swisslaser, thanks to years of experience and the use of the special sub400 protocol, we are able to safely treat many patients who have been disqualified at other centers.
Na czym polega połączenie Crosslinkingu z laserem?
It is a “2-in-1” therapy. The laser (Trans-PRK/PTK), planned based on a three-dimensional map of the entire cornea, precisely “smooths” its irregular surface. Crosslinking immediately “fixes” this new, improved shape and halts the disease.
Jak długo utrzymuje się efekt zabiegu Crosslinking?
According to long-term studies, the corneal strengthening effect is permanent. The procedure is performed once to halt the disease for life.
Kiedy mogę wrócić do prowadzenia samochodu?
Only when your vision has stabilized and visual acuity meets legal requirements. This is usually possible several weeks after the procedure, which we confirm during a follow-up visit.
Czy można wykonać zabieg na oboje oczu jednocześnie?
For safety reasons and for your comfort, we perform procedures separately for each eye, usually at intervals of one to several weeks.
Jakie są ryzyka związane z zabiegiem?
Crosslinking is one of the safest procedures in ophthalmology. The risk of complications, such as infection or temporary corneal haze, is very low, especially in the hands of such an experienced surgeon as Dr. Derhartunian.
Czym różni się Epi-off od Epi-on? Która metoda jest lepsza?
Epi-off, with epithelium removal, is recognized worldwide as the “gold standard” due to its highest proven efficacy. Epi-on is a less invasive method, but potentially less effective, which is why we reserve it only for very specific cases.
Czy muszę dalej nosić soczewki twarde po zabiegu?
The goal of combined treatment (CXL + laser) is to improve the corneal shape so that it becomes possible to wear comfortable glasses or soft contact lenses instead of cumbersome and often poorly tolerated hard lenses.
Mam już ponad 40 lat. Czy zabieg ma jeszcze sens?
Yes, if our precise diagnostics show that the disease is still progressing. Although progression after age 40 is less common, it still occurs, and in such cases Crosslinking is absolutely indicated.
Dlaczego powinienem wybrać Crosslinking w Swisslaser, a nie w innym miejscu?
Because at Swisslaser you do not just receive a procedure—you receive comprehensive care based on three pillars: the surgeon’s globally unique experience, access to groundbreaking technologies (Total Corneal Wavefront, sub400 protocol), and international safety standards.
