{"id":17028,"date":"2025-12-02T13:49:05","date_gmt":"2025-12-02T12:49:05","guid":{"rendered":"https:\/\/swisslaser.pl\/cross-linking-keratoconus-treatment\/"},"modified":"2026-10-03T13:14:55","modified_gmt":"2026-10-03T11:14:55","slug":"crosslinking-keratoconus-treatment","status":"publish","type":"page","link":"https:\/\/swisslaser.pl\/en\/crosslinking-keratoconus-treatment\/","title":{"rendered":"Crosslinking (Keratoconus Treatment)"},"content":{"rendered":"\n<div id=\"wp-block-themeisle-blocks-advanced-columns-c7b04e1f\" class=\"wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset bg-gradient\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-70c58721\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<div id=\"wp-block-themeisle-blocks-advanced-columns-b6d2ae52\" class=\"wp-block-themeisle-blocks-advanced-columns has-2-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-collapsedRows-layout has-vertical-unset\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-08a62e96\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h1 class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-1\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">Corneal Crosslinking (CXL): The procedure that halts keratoconus progression \u2013 protocols, procedure, price<\/h1>\n\n\n\n<p class=\"sl-stadt-untertitel has-neve-link-color-color has-text-color has-link-color wp-elements-2 wp-block-paragraph\">Warsaw \u00b7 Krakow \u00b7 Vienna \u00b7 Zurich<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Crosslinking (corneal collagen crosslinking, CXL) is the only method that halts the progression of keratoconus instead of merely correcting its effects. The cornea is saturated with riboflavin and irradiated with a controlled dose of UVA, which creates new bonds between collagen fibers and stiffens the tissue. At SwissLaser, we have been performing CXL since 2007, using standard, accelerated, sub400 protocols for thin corneas, and in combination with laser. Warsaw and Krakow, PLN 3,600 per eye.<\/p>\n\n\n<div class=\"wp-block-group sl-answer sl-zacma\" style=\"border-width:1px;padding-top:20px;padding-right:20px;padding-bottom:20px;padding-left:20px\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-container-core-group-is-layout-4597e620 wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-heading\">Crosslinking at a glance<\/h2>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Goal:<\/strong> to halt the progression of keratoconus (also post-LASIK ectasia). Efficacy in long-term studies: 90\u201398% of eyes without further progression after 10 years. CXL does not improve visual acuity; this is the task of subsequent stages.<\/li>\n\n<li><strong>For whom:<\/strong> documented progression (Kmax +1 D per year, corneal thinning), typically aged 10\u201340 years, cornea from 400 \u00b5m; thinner corneas are treated with the sub400 protocol with an individualized UVA dose.<\/li>\n\n<li><strong>Procedure:<\/strong> approximately 60 minutes per eye, topical anesthesia, epithelial debridement (epi-off), 10\u201330 minutes of riboflavin saturation, 10\u201330 minutes of UVA irradiation, bandage contact lens. No hospitalization.<\/li>\n\n<li><strong>Price:<\/strong> PLN 3,600 per eye with two follow-up appointments in the first month; variant with laser (Cretan, Athenian, or Total Corneal Wavefront protocol) PLN 8,700. Qualification with tomography PLN 400. <a href=\"https:\/\/swisslaser.pl\/en\/keratoconus-pricing\/\">Price list and installments<\/a>.<\/li>\n\n<li><strong>Recovery:<\/strong> 3\u20135 days of discomfort during epithelial healing, office work after 5\u20137 days, sports after 2\u20134 weeks. The cornea stiffens over subsequent months; the effect is assessed tomographically after 6 and 12 months.<\/li>\n<\/ul>\n\n\n<p class=\"sl-proof-line wp-block-paragraph\">SwissLaser in numbers: crosslinking since 2007, method learned from Prof. Theo Seiler in Zurich \u00b7 over 25,000 refractive procedures by the chief surgeon \u00b7 MS-39 and Anterion tomography \u00b7 one team in Warsaw, Krakow, Vienna, and Zurich \u00b7 Google: 4,8 (Warsaw) and 5,0 (Krakow)<\/p>\n\n<\/div><\/div>\n\n\n\n\n<div class=\"wp-block-buttons is-content-justification-left is-layout-flex wp-container-core-buttons-is-layout-63375db1 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-primary\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/swisslaser.pl\/en\/book-an-appointment\/\">Book an appointment<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-secondary\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/swisslaser.pl\/test-kwalifikacji\/\" target=\"_blank\" rel=\"noopener\">Preliminary Eligibility Assessment<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<div id=\"wp-block-themeisle-blocks-advanced-column-ffe82568\" class=\"wp-block-themeisle-blocks-advanced-column\"><\/div>\n<\/div><\/div>\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-49aa1e92\" class=\"wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-22ce3b7c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 class=\"wp-block-heading\">Crosslinking \u2014 Quick Answers<\/h2>\n\n\n\n<ul class=\"wp-block-list sl-answer\">\n<li><strong>Is crosslinking effective?<\/strong> Yes, it is the best-documented method in keratoconus treatment: 90\u201398% of eyes show no progression after 5\u201310 years. In 2\u20135% of patients, mainly very young ones, the procedure needs to be repeated. Efficacy is assessed by tomography after 6 and 12 months.<\/li>\n\n<li><strong>Does crosslinking hurt?<\/strong> The procedure itself is painless thanks to anesthetic drops; you will feel touch and light. The first 2\u20133 days of epithelial healing are difficult: burning, tearing, and photophobia, which are alleviated with painkillers and a bandage contact lens. From day 4\u20135.<\/li>\n\n<li><strong>How long does the crosslinking procedure take?<\/strong> Approximately 60 minutes per eye for the standard protocol (30 minutes saturation and 30 minutes irradiation), approximately 45 minutes for the accelerated protocol, and approximately 75 minutes for variants with laser. You spend a total of 2\u20133 hours at the clinic.<\/li>\n\n<li><strong>When can I return to work and sports after crosslinking?<\/strong> Office and computer work after 5\u20137 days, physical work in dusty environments after 2 weeks, non-contact sports after 2 weeks, swimming pool, sauna, and contact sports after 4 weeks.<\/li>\n\n<li><strong>Is crosslinking reimbursed by the NFZ (National Health Fund)?<\/strong> Yes, since September 2023, in selected hospitals, usually with the standard epi-off protocol and with waiting times ranging from several weeks to several months. At SwissLaser, the procedure is private (PLN 3,600), without a waiting list, and includes sub400 and laser protocols.<\/li>\n<\/ul>\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-bfd75669\" class=\"nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-bfd75669c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"na-czym-polega\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-3\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">What is corneal crosslinking?<\/h2>\n\n\n<p class=\"wp-block-paragraph\">The cornea owes its stiffness to cross-links between collagen fibers. In keratoconus, there are too few of these bonds, so the tissue yields to intraocular pressure and bulges. Crosslinking adds bonds: riboflavin (vitamin B2) saturates the corneal stroma, and UVA light at 365 nm activates it, releasing singlet oxygen, which links adjacent collagen fibers. The cornea becomes about 300% stiffer, and the aging process, which naturally stiffens the cornea after the age of 40, is, in a way, accelerated.<\/p>\n\n\n<p class=\"wp-block-paragraph\">The method was developed in Dresden and Zurich by Prof. Theo Seiler, Eberhard Spoerl, and Gregor Wollensak; the first procedures were performed in 1998, the method received CE certification in 2007, and the American FDA approved it in 2016. Dr. Derhartunian learned crosslinking directly from Prof. Seiler at the IROC clinic in Zurich and has been performing it since 2007.<\/p>\n\n\n<h3 class=\"wp-block-heading\">What crosslinking does and does not do<\/h3>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Halts the disease:<\/strong> in 10-year studies (Raiskup and Seiler, Dresden), progression ceased in over 90% of eyes; in some, the cornea flattened by 1\u20132 D.<\/li>\n\n<li><strong>Does not intentionally improve visual acuity.<\/strong> The distortion that has already occurred remains; we correct it later with lenses, laser, CAIRS, or ICL.<\/li>\n\n<li><strong>Does not replace lenses:<\/strong> after the procedure, you return to glasses or contact lenses, usually with the same or slightly lower prescription.<\/li>\n\n<li><strong>Protects against transplant:<\/strong> since the widespread adoption of CXL, the number of corneal transplants due to keratoconus has decreased by more than half in Europe.<\/li>\n<\/ul>\n\n\n<h3 class=\"wp-block-heading\">Video: What is keratoconus treatment with crosslinking?<\/h3>\n\n\n<p class=\"wp-block-paragraph\">A short video from the SwissLaser channel: how collagen crosslinking works and why it halts the disease.<\/p>\n\n\n<div class=\"sl-video-wrap\" style=\"position:relative;padding-bottom:56.25%;height:0;overflow:hidden;max-width:100%;border-radius:8px\"><\/div>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-c48d12cd\" class=\"nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-c48d12cdc\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"wskazania\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-4\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">When is crosslinking indicated, and when is it better to wait?<\/h2>\n\n\n<p class=\"wp-block-paragraph\">Progression is the indication, not merely the diagnosis. According to the international consensus (Global Consensus on Keratoconus, 2015), progression is evidenced by a change in at least two of three parameters between tomographic examinations:<\/p>\n\n\n<ul class=\"wp-block-list\">\n<li>steepening of the anterior corneal surface: Kmax by more than 1 D within 12 months<\/li>\n\n<li>steepening of the posterior corneal surface or increase in ABCD scale indices<\/li>\n\n<li>thinning of the thinnest corneal point by more than 5% or increasing refractive error<\/li>\n<\/ul>\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table class=\"has-fixed-layout\"><thead><tr><th>Situation<\/th><th>Our approach<\/th><\/tr><\/thead><tbody><tr><td>Teenager or young adult with diagnosed keratoconus<\/td><td>with clear progression or very steep cornea: CXL without delay; with uncertain results: second tomography after 3 months<\/td><\/tr><tr><td>Adult 30\u201340 years old, stable keratoconus in two examinations<\/td><td>observation every 6\u201312 months; focus on vision correction<\/td><\/tr><tr><td>Cornea thinner than 400 \u00b5m after epithelial debridement<\/td><td>sub400 protocol with individually calculated UVA dose (according to Hafezi) or hypoosmolar riboflavin; we do not automatically refuse<\/td><\/tr><tr><td>Ectasia after LASIK or PRK<\/td><td>CXL as for keratoconus, usually with accelerated protocol<\/td><\/tr><tr><td>Pregnancy, breastfeeding, active eye inflammation<\/td><td>procedure postponed; tomographic control every 3 months<\/td><\/tr><tr><td>Central scars, thickness below 300 \u00b5m<\/td><td>CXL is not effective; we discuss CAIRS or transplant<\/td><\/tr><\/tbody><\/table><\/figure>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-cb200ca1\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-cb200ca1c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"warianty\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-5\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">Crosslinking protocols we use<\/h2>\n\n\n<p class=\"wp-block-paragraph\">There is no single crosslinking. The dose, time, and method of riboflavin administration are chosen based on corneal thickness, age, and tomographic map. All variants are performed in Warsaw and Krakow.<\/p>\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table class=\"has-fixed-layout\"><thead><tr><th>Protocol<\/th><th>What it involves<\/th><th>For whom<\/th><th>Time<\/th><th>Price per eye<\/th><\/tr><\/thead><tbody><tr><td><strong>Epi-off standard (Dresden)<\/strong><\/td><td>epithelial debridement, riboflavin 30 min, UVA 3 mW\/cm\u00b2 for 30 min<\/td><td>most patients; longest studied protocol (10-year data)<\/td><td>approx. 70 min<\/td><td>PLN 3,600<\/td><\/tr><tr><td><strong>Epi-off accelerated<\/strong><\/td><td>same energy dose (5.4 J\/cm\u00b2) at higher intensity: 9 mW\/cm\u00b2 for 10 min<\/td><td>young patients, post-LASIK ectasia, lower tolerance for long procedure<\/td><td>approx. 45 min<\/td><td>PLN 3,600<\/td><\/tr><tr><td><strong>Sub400 (individual dose)<\/strong><\/td><td>irradiation time calculated from corneal thickness after saturation to protect endothelium<\/td><td>corneas thinner than 400 \u00b5m, advanced keratoconus<\/td><td>approx. 60 min<\/td><td>PLN 3,600<\/td><\/tr><tr><td><strong>Epi-on (transepithelial)<\/strong><\/td><td>epithelium remains; riboflavin with penetration enhancers, higher UVA dose<\/td><td>exceptionally: intolerance to epithelial healing, very thin epithelium; lower efficacy<\/td><td>approx. 60 min<\/td><td>PLN 3,600<\/td><\/tr><tr><td><strong>Cretan protocol: CXL + PTK<\/strong><\/td><td>epithelium removed by excimer laser transepithelially, deeper over the cone apex, then CXL<\/td><td>irregular cornea without sufficient thickness for refractive ablation<\/td><td>approx. 75 min<\/td><td>PLN 8,700<\/td><\/tr><tr><td><strong>Athenian protocol: CXL + topographic PRK<\/strong><\/td><td>laser smooths the cornea according to a topographic map (up to 50 \u00b5m) and partially corrects the defect, CXL stabilizes the effect<\/td><td>cornea with sufficient thickness, dominant irregular astigmatism<\/td><td>approx. 75 min<\/td><td>PLN 8,700<\/td><\/tr><tr><td><strong>CXL + Trans-PRK Total Corneal Wavefront<\/strong><\/td><td>ablation plan from a three-dimensional model of both corneal surfaces (MS-39 2nd gen.), then CXL<\/td><td>complex aberrations of the entire cornea, not just its shape<\/td><td>approx. 75 min<\/td><td>PLN 8,700<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n<p class=\"wp-block-paragraph\">All laser variants halt the disease just as effectively as CXL alone; they differ in how much visual quality can be recovered incidentally. The Schwind Amaris 1050RS laser removes a maximum of 50 \u00b5m of tissue, ensuring the cornea retains a safe thickness after the procedure. The term &#8220;Athenian protocol&#8221; comes from Prof. Kanellopoulos&#8217;s team in Athens, and &#8220;Cretan&#8221; from Prof. Kymionis in Heraklion.<\/p>\n\n\n<h3 class=\"wp-block-heading\">Video: crosslinking combined with laser<\/h3>\n\n\n<p class=\"wp-block-paragraph\">Dr. Victor Derhartunian on combining crosslinking with laser corneal regularization: halting the disease and improving visual quality in one procedure.<\/p>\n\n\n<div class=\"sl-video-wrap\" style=\"position:relative;padding-bottom:56.25%;height:0;overflow:hidden;max-width:100%;border-radius:8px\"><\/div>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-7f80670a\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-7f80670ac\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"przebieg\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-6\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">How the Crosslinking Procedure Works Step-by-Step<\/h2>\n\n\n<div id=\"wp-block-themeisle-blocks-timeline-49f031ca\" class=\"wp-block-themeisle-blocks-timeline\"><div class=\"o-timeline-root\">\n<div id=\"wp-block-themeisle-blocks-timeline-item-7a1774fb\" class=\"wp-block-themeisle-blocks-timeline-item\"><div class=\"o-timeline-container\"><div class=\"o-timeline-icon\"><\/div><div class=\"o-timeline-content\">\n<h3 class=\"wp-block-heading has-32-px-font-size\"><strong>Qualification<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"840\" height=\"540\" src=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-tomografia.png\" alt=\"Icon: corneal tomography \u2013 qualification examination\" class=\"wp-image-26366\" srcset=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-tomografia.png 840w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-tomografia-300x193.png 300w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-tomografia-768x494.png 768w\" sizes=\"auto, (max-width: 840px) 100vw, 840px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">MS-39 tomography with epithelial map, Anterion, pachymetry, endothelial evaluation. Comparison with previous examinations determines progression and protocol. Approximately 90 minutes, PLN 400. Discontinue contact lenses: soft 7 days, hard 3\u20134 weeks prior.<\/p>\n<\/div><\/div><\/div>\n\n\n\n<div id=\"wp-block-themeisle-blocks-timeline-item-0dacfcad\" class=\"wp-block-themeisle-blocks-timeline-item\"><div class=\"o-timeline-container\"><div class=\"o-timeline-icon\"><\/div><div class=\"o-timeline-content\">\n<h3 class=\"wp-block-heading has-32-px-font-size\"><strong>Day of Procedure<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"840\" height=\"540\" src=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-cxl-uva.png\" alt=\"Icon: crosslinking \u2013 riboflavin and UVA light corneal irradiation\" class=\"wp-image-26367\" srcset=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-cxl-uva.png 840w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-cxl-uva-300x193.png 300w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-cxl-uva-768x494.png 768w\" sizes=\"auto, (max-width: 840px) 100vw, 840px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Topical anesthesia, disinfection, eyelid speculum. Gentle epithelial debridement in the 8\u20139 mm zone (or by laser in the Cretan protocol), riboflavin saturation for 10\u201330 minutes with thickness control, UVA irradiation for 10\u201330 minutes using the C-EYE system with dose control. Total approximately one hour per eye, pain-free.<\/p>\n<\/div><\/div><\/div>\n\n\n\n<div id=\"wp-block-themeisle-blocks-timeline-item-f217218b\" class=\"wp-block-themeisle-blocks-timeline-item\"><div class=\"o-timeline-container\"><div class=\"o-timeline-icon\"><\/div><div class=\"o-timeline-content\">\n<h3 class=\"wp-block-heading has-32-px-font-size\"><strong>First Days<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"840\" height=\"540\" src=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-pierwsze-dni.png\" alt=\"Icon: first days after the procedure \u2013 bandage contact lens and drops\" class=\"wp-image-26368\" srcset=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-pierwsze-dni.png 840w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-pierwsze-dni-300x193.png 300w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-pierwsze-dni-768x494.png 768w\" sizes=\"auto, (max-width: 840px) 100vw, 840px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Bandage contact lens until epithelium heals (3\u20135 days), antibiotic and anti-inflammatory drops, painkillers. Days 1\u20133 can be unpleasant: burning, tearing, and photophobia, which are alleviated by prescribed medications and a bandage contact lens. From day 4\u20135.<\/p>\n<\/div><\/div><\/div>\n\n\n\n<div id=\"wp-block-themeisle-blocks-timeline-item-7da92701\" class=\"wp-block-themeisle-blocks-timeline-item\"><div class=\"o-timeline-container\"><div class=\"o-timeline-icon\"><\/div><div class=\"o-timeline-content\">\n<h3 class=\"wp-block-heading\"><strong>Follow-up and Effect<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"840\" height=\"540\" src=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-kontrola.png\" alt=\"Icon: follow-up visits after the procedure\" class=\"wp-image-26369\" srcset=\"https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-kontrola.png 840w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-kontrola-300x193.png 300w, https:\/\/swisslaser.pl\/wp-content\/uploads\/2026\/09\/stozek-ikona-kontrola-768x494.png 768w\" sizes=\"auto, (max-width: 840px) 100vw, 840px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Follow-up after one month (both included in price), tomography after 6 and 12 months, then annually. For the first 1\u20133 months, vision may be worse than before the procedure (transient haze), then it returns to baseline or improves. The second eye, if required, is usually operated on after 1\u20134 weeks.<\/p>\n<\/div><\/div><\/div>\n<\/div><\/div>\n\n<h3 class=\"wp-block-heading\">Recovery Day by Day<\/h3>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Day 0:<\/strong> after the procedure, rest at home, dark glasses, drops according to schedule. Do not rub the eye.<\/li>\n\n<li><strong>Days 1\u20133:<\/strong> the most difficult period, epithelial healing; pain is alleviated by prescribed medications, cold compresses, and sleep. We issue sick leave for this period.<\/li>\n\n<li><strong>Days 4\u20137:<\/strong> bandage contact lens removal, return to office work and screen use, driving after doctor&#8217;s approval.<\/li>\n\n<li><strong>Weeks 2\u20134:<\/strong> non-contact sports, eye makeup from week 2, swimming pool and sauna after 4 weeks. Contact lenses after 4\u20136 weeks, new glasses after 3 months.<\/li>\n\n<li><strong>Months 1\u201312:<\/strong> the cornea gradually stiffens and slightly flattens. Moisturizing drops for several months; UV protection (glasses with filter).<\/li>\n<\/ul>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-0b09159b\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-0b09159bc\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"wyniki\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-7\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">Crosslinking Results and Safety: Numbers, Not Promises<\/h2>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Efficacy:<\/strong> progression halted in 90\u201398% of eyes in 5\u201310-year observations (e.g., Raiskup et al. 2015, Dresden; Wittig-Silva 2014, Melbourne). Re-crosslinking is needed in 2\u20135% of patients, most often teenagers.<\/li>\n\n<li><strong>Corneal flattening:<\/strong> average of 1\u20132 D Kmax within 1\u20132 years; in some patients, improvement of best corrected visual acuity by 1\u20132 lines, in most without change.<\/li>\n\n<li><strong>Transient haze:<\/strong> in about 10% of eyes, resolves in 3\u201312 months; persistent haze below 2%.<\/li>\n\n<li><strong>Delayed epithelial healing, sterile infiltrates:<\/strong> 1\u20133%, treated with drops.<\/li>\n\n<li><strong>Corneal infection:<\/strong> below 1%; prevented with antibiotics and bandage contact lens control. This is the most important reason not to rub the eye and to use drops according to schedule.<\/li>\n\n<li><strong>Endothelial damage:<\/strong> risk applies to corneas thinner than 400 \u00b5m with a standard dose; this is why we use sub400 and measure thickness during the procedure.<\/li>\n<\/ul>\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Patients ask if the procedure hurts. The procedure itself does not, but the first three days can be difficult. They also ask if they will see better. I answer honestly: we perform crosslinking so that in ten years there will be no need for a transplant. It is a procedure that provides stability, not an immediate effect. Vision improvement is planned separately, once the cornea is stable.<\/p>\n<cite>Dr. med. Victor Derhartunian, FEBO, FWCRS<\/cite><\/blockquote>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-8834d8f0\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-8834d8f0c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"kwalifikacja\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-8\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">Am I eligible for crosslinking?<\/h2>\n\n\n<h3 class=\"wp-block-heading\">Green light<\/h3>\n\n\n<ul class=\"wp-block-list\">\n<li>documented keratoconus progression (Kmax +1 D per year, thinning, ABCD increase)<\/li>\n\n<li>age 10\u201340 years; in older patients with confirmed progression<\/li>\n\n<li>corneal thickness from 400 \u00b5m after epithelial debridement (thinner: sub400)<\/li>\n\n<li>corneal ectasia after laser vision correction<\/li>\n\n<li>transparent cornea without central scars<\/li>\n<\/ul>\n\n\n<h3 class=\"wp-block-heading\">Yellow light<\/h3>\n\n\n<ul class=\"wp-block-list\">\n<li>stable keratoconus without progression: observation every 6\u201312 months<\/li>\n\n<li>severe dry eye syndrome or acute allergy: first, treatment of the ocular surface<\/li>\n\n<li>very thin cornea 300\u2013400 \u00b5m: sub400 or hypoosmolar riboflavin after endothelial evaluation<\/li>\n\n<li>previous hydrops: procedure after edema subsides and scar is evaluated<\/li>\n<\/ul>\n\n\n<h3 class=\"wp-block-heading\">Red light<\/h3>\n\n\n<ul class=\"wp-block-list\">\n<li>corneal thickness below 300 \u00b5m or dense central scars: consider CAIRS or transplant<\/li>\n\n<li>active infection or eye inflammation<\/li>\n\n<li>pregnancy and breastfeeding: procedure after breastfeeding ends<\/li>\n\n<li>active autoimmune diseases and healing disorders<\/li>\n<\/ul>\n\n\n<p class=\"wp-block-paragraph\">Don&#8217;t have tomography yet? Start with <a href=\"https:\/\/swisslaser.pl\/test-kwalifikacji\/\">online preliminary qualification<\/a> or schedule an examination in Warsaw or Krakow. If you have corneal maps from another center, attach them; comparing them speeds up the decision.<\/p>\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-primary\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/swisslaser.pl\/en\/book-an-appointment\/\">Book an appointment<\/a><\/div>\n\n<div class=\"wp-block-button is-style-secondary\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/swisslaser.pl\/test-kwalifikacji\/\">Preliminary Eligibility Assessment<\/a><\/div>\n<\/div>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-4542ea12\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-4542ea12c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<p class=\"has-text-align-center wp-block-paragraph\">Sign up for a no-obligation visit and consultation to learn how we can improve your vision.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-fe48e5de wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-secondary\"><a class=\"wp-block-button__link wp-element-button\">see how to schedule an appointment<\/a><\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-9f859f78\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-9f859f78c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"cena\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-9\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">How much does crosslinking cost and what is included<\/h2>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Crosslinking (any epi-off, accelerated, sub400, epi-on protocol):<\/strong> PLN 3,600 per eye.<\/li>\n\n<li><strong>Crosslinking with laser (Cretan, Athenian, Total Corneal Wavefront):<\/strong> PLN 8,700 per eye.<\/li>\n\n<li><strong>Included in the price:<\/strong> procedure, riboflavin, bandage contact lens, follow-up the next day and after one month, sick leave.<\/li>\n\n<li><strong>Not included in the price:<\/strong> qualification with tomography PLN 400, post-procedure drops (approx. PLN 100\u2013150 at the pharmacy), follow-up tomographies after 6 and 12 months at the price of a control visit.<\/li>\n\n<li><strong>Installments:<\/strong> Santander Consumer Bank, decision at the clinic or online.<\/li>\n<\/ul>\n\n\n<p class=\"wp-block-paragraph\">Crosslinking has been covered by the NFZ (National Health Fund) since September 2023. Waiting lists and protocols vary in different hospitals; for confirmed progression in a young person, waiting several months means a real loss of tissue and vision. If you decide on NFZ, we will ask for tomography results and help assess how much time you safely have available. Laser variants, sub400 protocol, and CAIRS are not funded by the NFZ.<\/p>\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-secondary\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/swisslaser.pl\/en\/keratoconus-pricing\/\">View full price list<\/a><\/div>\n<\/div>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-effed1a3\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-effed1a3c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 id=\"faq\" class=\"wp-block-heading has-text-align-left has-neve-link-hover-color-color has-text-color has-link-color wp-elements-10\" style=\"border-top-style:none;border-top-width:0px;border-right-style:none;border-right-width:0px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--neve-link-color);border-left-width:4px;padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--40)\">Frequently Asked Questions<\/h2>\n\n\n<div id=\"wp-block-themeisle-blocks-accordion-kc543\" class=\"wp-block-themeisle-blocks-accordion exclusive is-style-default\">\n\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>Will I see better after crosslinking?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">This is not the goal of the procedure. Some patients notice a slight improvement after corneal flattening by 1\u20132 D, but for the first 1\u20133 months, vision may be worse. If you are interested in improving visual acuity, we consider a laser variant (PLN 8,700), and after corneal stabilization, an ICL lens or CAIRS.<\/p>\n<\/div><\/details>\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>Epi-off or epi-on: which crosslinking is better?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">Epi-off (with epithelial debridement) has the best-proven efficacy and is our standard. Epi-on is more comfortable for healing, but riboflavin penetrates the epithelium less effectively, and the rate of disease arrest is lower. We use it only in exceptional situations after discussing its limitations.<\/p>\n<\/div><\/details>\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>Is my cornea too thin for crosslinking?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">The standard protocol requires 400 \u00b5m after epithelial debridement. Thinner corneas (even 300\u2013350 \u00b5m) are treated with the sub400 protocol: the irradiation time is calculated individually from the corneal thickness after saturation to prevent energy from reaching the endothelium. Tomography and pachymetry results are decisive.<\/p>\n<\/div><\/details>\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>Can crosslinking be repeated?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">Yes. If tomography after 12 months or later shows further progression, the procedure is repeated, usually with the accelerated protocol. This applies to 2\u20135% of patients, most often teenagers with aggressive keratoconus.<\/p>\n<\/div><\/details>\n\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>Is crosslinking performed on both eyes simultaneously?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">Usually not. We operate on one eye, and the second after 1\u20134 weeks, when the first has healed enough to function. If keratoconus affects only one eye or the other is stable, the procedure is performed only where there is progression.<\/p>\n<\/div><\/details>\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>Can laser vision correction be performed after crosslinking?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">Classic LASIK remains contraindicated. However, laser corneal regularization combined with CXL (Athenian or Cretan protocol) is possible, and after a year of stability, full correction of the refractive error with an ICL lens, which does not interfere with the cornea.<\/p>\n<\/div><\/details>\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><strong>How long does the effect of crosslinking last?<\/strong><\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p class=\"wp-block-paragraph\">10-year data show stable stabilization in the vast majority of patients. The cornea also naturally stiffens after the age of 40. However, we recommend annual control tomography, as rare late progressions are only detected by examination.<\/p>\n<\/div><\/details>\n\n<\/div>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-c631f041\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-c631f041c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<p class=\"has-text-align-center wp-block-paragraph\">Sign up for a no-obligation visit and consultation to learn how we can improve your vision.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-fe48e5de wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-secondary\"><a class=\"wp-block-button__link wp-element-button\">see how to schedule an appointment<\/a><\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n<p class=\"sl-dla-dociekliwych wp-block-paragraph\"><strong>For the curious:<\/strong> Corneal crosslinking (CXL, collagen crosslinking) is procedure 11.74 (other corneal procedures, crosslinking) in ICD-9-PL; ICD-10 indication: H18.6 keratoconus, H18.7 corneal ectasia. Standard protocol (Dresden, Wollensak 2003): riboflavin 0.1% for 30 minutes, UVA 370 nm, 3 mW\/cm\u00b2 for 30 minutes, dose 5.4 J\/cm\u00b2; accelerated protocols deliver the same dose in a shorter time (Kobashi 2020).<\/p>\n\n<h2 class=\"wp-block-heading\">Sources<\/h2>\n\n<ol class=\"nv-cv-d nv-cv-m wp-block-list sl-sources sl-zrodla-kc\">\n<li>Wollensak G, Spoerl E, Seiler T. Riboflavin\/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol 2003;135(5):620\u2013627. <a href=\"https:\/\/doi.org\/10.1016\/S0002-9394(02)02220-1\" rel=\"nofollow noopener\">doi:10.1016\/S0002-9394(02)02220-1<\/a><\/li>\n\n<li>Raiskup F, Theuring A, Pillunat LE, Spoerl E. Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: ten-year results. J Cataract Refract Surg 2015;41(1):41\u201346. <a href=\"https:\/\/doi.org\/10.1016\/j.jcrs.2014.09.033\" rel=\"nofollow noopener\">doi:10.1016\/j.jcrs.2014.09.033<\/a><\/li>\n\n<li>Koller T, Mrochen M, Seiler T. Complication and failure rates after corneal crosslinking. J Cataract Refract Surg 2009;35(8):1358\u20131362. <a href=\"https:\/\/doi.org\/10.1016\/j.jcrs.2009.03.035\" rel=\"nofollow noopener\">doi:10.1016\/j.jcrs.2009.03.035<\/a><\/li>\n\n<li>Kobashi H, Tsubota K. Accelerated versus standard corneal cross-linking for progressive keratoconus: a meta-analysis of randomized controlled trials. Cornea 2020;39(2):172\u2013180. <a href=\"https:\/\/doi.org\/10.1097\/ICO.0000000000002092\" rel=\"nofollow noopener\">doi:10.1097\/ICO.0000000000002092<\/a><\/li>\n\n<li>McAnena L, Doyle F, O\u2019Keefe M. Cross-linking in children with keratoconus: a systematic review and meta-analysis. Acta Ophthalmol 2017;95(3):229\u2013239. <a href=\"https:\/\/doi.org\/10.1111\/aos.13224\" rel=\"nofollow noopener\">doi:10.1111\/aos.13224<\/a><\/li>\n\n<li>Gomes JAP, Tan D, Rapuano CJ et al. Global consensus on keratoconus and ectatic diseases. Cornea 2015;34(4):359\u2013369. <a href=\"https:\/\/doi.org\/10.1097\/ICO.0000000000000408\" rel=\"nofollow noopener\">doi:10.1097\/ICO.0000000000000408<\/a><\/li>\n\n<li>Regulation of the Minister of Health on guaranteed benefits in hospital treatment \u2013 corneal cross-linking (cross-linking) in the NFZ basket from 2023. <a href=\"https:\/\/www.gov.pl\/web\/zdrowie\" rel=\"nofollow noopener\">gov.pl\/web\/zdrowie<\/a><\/li>\n<\/ol>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-b842b8b3\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset has-light-bg\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-b842b8b3c\" class=\"wp-block-themeisle-blocks-advanced-column\">\n\n\n<h2 class=\"wp-block-heading has-text-align-center\">Related topics<\/h2>\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/swisslaser.pl\/en\/keratoconus\/\">Keratoconus: symptoms, diagnosis, treatment ladder<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/en\/intracorneal-rings-cairs\/\">CAIRS rings for advanced keratoconus<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/en\/keratoconus-pricing\/\">Keratoconus treatment price list<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/en\/lens-surgery\/phakic-lenses\/\">ICL lenses after keratoconus stabilization<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/blog\/leczenie-stozka-rogowki-metoda-crosslinking\/\">Crosslinking: how collagen crosslinking works<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/en\/blog\/corneal-cone-qualification-for-surgery\/\">Qualification for keratoconus procedure<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/en\/keratoconus-treatment-in-warsaw\/\">Crosslinking in Warsaw<\/a><\/li>\n\n<li><a href=\"https:\/\/swisslaser.pl\/en\/keratoconus-treatment-in-krakow\/\">Crosslinking in Krakow<\/a><\/li>\n<\/ul>\n\n\n<p class=\"sl-medical-review wp-block-paragraph\">Content medically verified by Dr. med. univ. (Vienna) Victor Derhartunian, FEBO, FWCRS, a surgeon performing crosslinking since 2007. Last updated: October 2, 2026.<\/p>\n\n<\/div>\n<\/div><\/div>\n\n<div id=\"wp-block-themeisle-blocks-advanced-columns-6d92a90d\" class=\"nv-cv-d nv-cv-m wp-block-themeisle-blocks-advanced-columns alignfull has-1-columns has-desktop-equal-layout has-tablet-equal-layout has-mobile-equal-layout has-vertical-unset sl-standorte\"><div class=\"wp-block-themeisle-blocks-advanced-columns-overlay\"><\/div><div class=\"innerblocks-wrap\">\n<div id=\"wp-block-themeisle-blocks-advanced-column-eca4e40b\" class=\"wp-block-themeisle-blocks-advanced-column\">\n<h2 class=\"wp-block-heading has-text-align-center\">Where We Perform This Procedure<\/h2>\n\n<p class=\"wp-block-paragraph\">We perform the procedure in both our clinics \u2013 same surgeon, same technology, and same prices. Choose a location to see details, directions, and office hours:<\/p>\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/swisslaser.pl\/en\/keratoconus-treatment-in-warsaw\/\">Keratoconus treatment in Warsaw<\/a><\/strong><br \/>ul. Kolejowa 1, 01-217 Warsaw \u00b7 tel. <a href=\"tel:+48221201690\">+48 22 120 16 90<\/a><\/p>\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/swisslaser.pl\/en\/keratoconus-treatment-in-krakow\/\">Keratoconus treatment in Krakow<\/a><\/strong><br \/>ul. Kluczborska 15\/U3, 31-271 Krakow \u00b7 tel. <a href=\"tel:+48123833360\">+48 12 383 33 60<\/a><\/p>\n<\/div>\n<\/div><\/div>\n\n\n\n<script type=\"application\/ld+json\" id=\"swisslaser-post-schema\">\n{\n \"@context\": \"https:\/\/schema.org\",\n \"@graph\": [\n  {\n   \"@type\": \"MedicalWebPage\",\n   \"@id\": \"https:\/\/swisslaser.pl\/en\/crosslinking-keratoconus-treatment\/#medpage\",\n   \"url\": \"https:\/\/swisslaser.pl\/en\/crosslinking-keratoconus-treatment\/\",\n   \"name\": \"Crosslinking (Keratoconus Treatment)\",\n   \"description\": \"Crosslinking halts keratoconus progression in 90\u201398% of patients. Standard, accelerated, and sub400 protocols. PLN 3,600 per eye, Warsaw and Krakow.\",\n   \"inLanguage\": \"en-GB\",\n   \"isPartOf\": {\n    \"@id\": \"https:\/\/swisslaser.pl\/#website\"\n   },\n   \"reviewedBy\": {\n    \"@id\": \"https:\/\/swisslaser.pl\/#victor\"\n   },\n   \"lastReviewed\": \"2026-10-03\",\n   \"breadcrumb\": {\n    \"@id\": \"https:\/\/swisslaser.pl\/en\/crosslinking-keratoconus-treatment\/#breadcrumb\"\n   }\n  },\n  {\n   \"@type\": \"FAQPage\",\n   \"@id\": \"https:\/\/swisslaser.pl\/en\/crosslinking-keratoconus-treatment\/#faq\",\n   \"inLanguage\": \"en-GB\",\n   \"mainEntity\": [\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Will I see better after crosslinking?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"This is not the goal of the procedure. Some patients notice a slight improvement after corneal flattening by 1\u20132 D, but for the first 1\u20133 months, vision may be worse. If you are interested in improving visual acuity, we consider a laser variant (PLN 8,700), and after corneal stabilization, an ICL lens or CAIRS.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Epi-off or epi-on: which crosslinking is better?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Epi-off (with epithelial debridement) has the best-proven efficacy and is our standard. Epi-on is more comfortable for healing, but riboflavin penetrates the epithelium less effectively, and the rate of disease arrest is lower. We use it only in exceptional situations after discussing its limitations.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Is my cornea too thin for crosslinking?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"The standard protocol requires 400 \u00b5m after epithelial debridement. Thinner corneas (even 300\u2013350 \u00b5m) are treated with the sub400 protocol: the irradiation time is calculated individually from the corneal thickness after saturation to prevent energy from reaching the endothelium. Tomography and pachymetry results are decisive.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Can crosslinking be repeated?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Yes. If tomography after 12 months or later shows further progression, the procedure is repeated, usually with the accelerated protocol. This applies to 2\u20135% of patients, most often teenagers with aggressive keratoconus.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Is crosslinking performed on both eyes simultaneously?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Usually not. We operate on one eye, and the second after 1\u20134 weeks, when the first has healed enough to function. If keratoconus affects only one eye or the other is stable, the procedure is performed only where there is progression.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Can laser vision correction be performed after crosslinking?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Classic LASIK remains contraindicated. However, laser corneal regularization combined with CXL (Athenian or Cretan protocol) is possible, and after a year of stability, full correction of the refractive error with an ICL lens, which does not interfere with the cornea.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"How long does the effect of crosslinking last?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"10-year data show stable stabilization in the vast majority of patients. The cornea also naturally stiffens after the age of 40. However, we recommend annual control tomography, as rare late progressions are only detected by examination.\"\n     }\n    }\n   ]\n  },\n  {\n   \"@type\": [\n    \"Physician\",\n    \"Person\"\n   ],\n   \"@id\": \"https:\/\/swisslaser.pl\/#victor\",\n   \"name\": \"Victor Derhartunian\",\n   \"honorificPrefix\": \"dr med.\",\n   \"honorificSuffix\": \"FEBO, FWCRS\",\n   \"url\": \"https:\/\/swisslaser.pl\/o-nas\/dr-victor-derhartunian\/\",\n   \"address\": {\n    \"@type\": \"PostalAddress\",\n    \"streetAddress\": \"ul. Kolejowa 1\",\n    \"addressLocality\": \"Warszawa\",\n    \"postalCode\": \"01-217\",\n    \"addressCountry\": \"PL\"\n   }\n  }\n ]\n}\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"<p>For the curious: Corneal crosslinking (CXL, collagen crosslinking) is procedure 11.74 (other corneal procedures, crosslinking) in ICD-9-PL; ICD-10 indication: H18.6 keratoconus, H18.7 corneal ectasia. Standard protocol (Dresden, Wollensak 2003): riboflavin 0.1% for 30 minutes, UVA 370 nm, 3 mW\/cm\u00b2 for 30 minutes, dose 5.4 J\/cm\u00b2; accelerated protocols deliver the same dose in a shorter time&hellip;&nbsp;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"on","neve_meta_reading_time":"","_themeisle_gutenberg_block_has_review":false,"footnotes":""},"class_list":["post-17028","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/pages\/17028","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/comments?post=17028"}],"version-history":[{"count":40,"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/pages\/17028\/revisions"}],"predecessor-version":[{"id":31252,"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/pages\/17028\/revisions\/31252"}],"wp:attachment":[{"href":"https:\/\/swisslaser.pl\/en\/wp-json\/wp\/v2\/media?parent=17028"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}