What is Keratoconus?

Keratoconus is a progressive condition affecting the cornea of the eye. The cornea is the clear window at the front of the eye. It is a curved structure. The precise shape of the curve allows it to act as a lens, projecting an image into the eye. The cornea is made up of bundles of protein called 'collagen'. These bundles are normally held tightly together by chemical links between the collagen strands. This ensures that the shape of the cornea is constant. In the keratoconic cornea the normal chemical links between collagen strands are deficient, causing the cornea to be unusually elastic. The pressure inside the eye then pushes the cornea into a distorted, conical shape. This spoils the quality of the image projected into the eye, and the vision becomes progressively blurred.

Keratoconus affects about 1 in 7000 people.

How is keratoconus treated?

Glasses may be sufficient in the early stages of keratoconus, but contact lenses are needed when the cornea becomes so misshapen that glasses are no longer effective in correcting vision. Although soft contact lenses can sometimes be used, contact lenses for keratoconus are usually 'hard' gas-permeable lenses. Gas-permeable hard lenses are not always comfortable and may only be worn for a limited number of hours each day, but without them the vision is very blurred.

In some cases, the corneal shape becomes too distorted even for contact lenses to help. Also, scarring may develop, causing vision to become clouded. At this stage, a corneal transplant is usually needed. Corneal transplantation is quite major surgery and carries significant risks.

The transplant stops the keratoconus progressing and provides a clear window into the eye. However, the shape of the cornea is usually far from perfect. Some people will see adequately with glasses after corneal transplantation, but most will still need contact lenses to see well.

Full thickness ('penetrating') corneal transplants do not last forever and may have to be repeated every fifteen years or so. Deep lamellar transplants could last indefinitely but can still fail and most people will still need a rigid contact lens afterwards to see as well as is possible.

This is why we offer C3-R / CXL at our London practice. C3-R / CXL is a non-surgical treatment for keratoconus that can stop keratoconus from progressing to the stage where contact lenses or corneal transplantation becomes necessary.

C3-R / CXL

Corneal collagen crosslinking with riboflavin (C3-R or CXL) is the only non-surgical treatment that is proven to prevent the progression of keratoconus, and it may even be able to reverse the condition to some extent. Developed in Europe in the late 1990s, C3-R has now proven itself in international clinical studies and is approved throughout the European Union for the treatment of keratoconus. Mr Steven Bailey is pleased to offer corneal collagen crosslinking with riboflavin (C3-R) for his London keratoconus patients as a treatment that is both effective and non-surgical.

How does C3-R / CXL help?

Corneal collagen crosslinking with riboflavin causes the formation of normal chemical links between the collagen protein strands in the cornea. This makes the cornea more rigid and will stop the keratoconus from progressing in about 97% of cases. The treatment can even cause the keratoconus to reverse to some extent.

C3-R / CXL may prevent the need for contact lenses if performed early on. Even where contact lenses are already needed, C3-R / CXL can eliminate the need for corneal transplantation. No other treatment for keratoconus can offer this; C3-R / CXL is unique.

Current evidence is that the effects of treatment are permanent.

Who is suitable for C3-R / CXL?

Anyone with progressive keratoconus is potentially suitable. Patients with very advanced keratoconus or whose vision is already spoiled by scarring will usually not be good candidates for the procedure.

The earlier the treatment is done, the better, but C3-R / CXL can still be beneficial decades after keratoconus has begun to develop. To find out how you might benefit from corneal collagen crosslinking with riboflavin (C3-R / CXL), contact our London practice today.

How is C3-R / CXL keratoconus treatment performed?

At our practice in London, C3-R / CXL keratoconus treatment is a safe, painless, out-patient procedure. Our new method of C3-R / CXL treatment means that there is minimal discomfort afterwards; maybe a slight feeling of grittiness for the first 24 hours. The treatment involves absorbing riboflavin eye-drops into the cornea and then bathing the surface of the eye in a very specific wavelength of light. The combination of the light and riboflavin causes chemical bonds to form within the cornea, increasing its rigidity and stability.

The whole process takes about one-and-a-half hours. After the procedure, a protective soft contact lens is worn for a few days, and eye drops need to be instilled four times daily for five days and then twice daily for the next four weeks.

The technical specifications of C3-R / CXL instruments vary, particularly in their ability to provide even illumination at the cornea. Mr Bailey has carefully chosen what he considers to be currently the best equipment for the C3-R / CXL procedure.


How can I schedule an appointment?

If you have any questions about corneal collagen crosslinking with riboflavin (C3-R / CXL), please contact our London practice and schedule an appointment to discuss this advanced keratoconus treatment method with Mr Steven Bailey. Please fill out our online form or call Jennie on +44 (0)7973 691727.

C S Bailey BSc FRCS DO CertLRS, 99 Harley Street  London W1G 6AQ. Tel: +44 (0)207 935 1010  Fax: +44 (0)20 7084 7729