Corneal Haze from Cross-linking

[Lynn White]

Hi All,

Yes it is different with everyone and there is also the consideration that with this procedure, the hope is that corneal shape will be improved.

For that to happen, some quite remarkable changes have to take place in your cornea. As an analogy, suppose we were trying to straighten up the leaning tower of Pisa? You can't just push it straight, can you? All sorts of issues arise if you just did that. The whole structure has got used to being lopsided and adjustments have to be made throughout as the tower is gradually straightened.

I have seen remarkable changes in the cornea quite quickly after CXL. Sometimes, though, this can lead to an apparent change in vision.

For example, if your cone is low, vision may be reasonable in glasses because the distorted area is below your pupil so you are not really looking through the distortion. I have noticed in some people, that the cone lifts quite quickly post op and this then may mean you are suddenly looking through more distortion. I feel this explains some of the reports we have where vision seems to drop although haze etc is no worse than someone else who reports vision is not much different.

As the cornea adjusts its shape, there are also changes that go on in e back surface of the cornea. So sometimes, even if the front surface topography looks the same, vision may be better or worse than it was before.

Whatever happens, this procedure does not give you the end result days or weeks after surgery. It is more gradual than that.

Most of my patients get better without realising it. 18 months after surgery, I can ask someone how the ghosting at night is now. Quite often I get a puzzled look. I have to remind them that they were constantly complaining about it.

Lynn

[Hayley]

I had mine done epi-off, this is because I had the Athen's procedure not just the CXL.
James,
I am trying to leave work before dark bacause I am more comfortable driving in day light! Car lights drive me mad and I'm getting alot of halos etc. I am still light sensitive, but nothing compared to the first week or so after surgery. I'm not really sure if the drops are making a differance or not yet, Its hard to tell if my vision is improving or if I'm getting used to it... Please do let us know how your follow up appointment goes?
Hayley

[bappy]

I guess I'll show my ignorance here but can someone explain how cross linking affects the shape of the cornea?

From what I understand, cross-linking is merely administering riboflavin and UV light. I understand that it locks things in place but I'm not sure why the cornea shape improves. I always thought that in order to change the shape of the cornea, something like T-CAT or Keraflex was required, the CXL would merely lock this shape change in place.

[Prism]

Hi James and everyone. Out of curiousity James, how are things now RE this thread? Did the bluriness go away? Sorry if you've mentioned this elsewhere.

[James_Ldn]

Hi Prism,

I think it took about 3 months after the CXL for my vision to return to 'normal'. Whether this is the result of the 'haze' or not I'm not sure.

Regards,
James.

[nordigian]

my cross linking and haze vision story so far...

So its been one month since my cross linking procedure. i have just visited the recommended optician to learn my eye has become 3 times worst compared to a eye test i done just before the operation. i thought this was due to the operation and medication and would go away but the smart a**e optician advised yes it will go away with contacts. nobody explained at any stage that my sight would deteriorate so much and when i question it with the doctor its brushed under the carpet.
iv been advised that my eye sight is so bad now in my left eye where i had the operation that glasses wont help. it took the optician 35 minutes to get the contact in. nobody said anything about the liquid/air bubbles... i was very reluctant to get the cross linking operation and only did it to protect my vision but they have completely ruined it. the optician they sent me to got angry when i started asking about glasses. i will be proceeding for a second opinion on the glasses before committing to contacts.

As i read you guys all are saying your vision is coming back but why would they want to give me a prescription if my vision might change?

[HT57]

As Lynn explained, and as my doctor also explained to me, haze indicates the CXL is working to mitigate the kerataconus. I had such good results (improved corneal map/flattening of the cornea) that my corneal haze got so bad about a year after my CXL that my doctor removed it with a corneal wipe procedure. Since the the CXL has continued fighting the kerataconus at 2 years post-CXL, I have some minimal haze back. After 2 years though, my doctor says my cornea looks the best he’s seen since prior to the CXL. My left eye now has 90 percent reduced astigmatism and 20/40 corrected vision. So hang in there. Improvements with CXL are gradual, but, after 2 years, remarkable. CXL is an amazing 98 percent effective treatment for kerataconus, so expect great results over time.

[RachelfromCanada]

Hey Everyone!

I just had my CXL done on December 5 and I'm experiencing a lot of blurriness (now December 13). I definitely cannot drive and I'm wondering how long it might be before I am able to. I'm also finding it difficult to use my cellphone - did everyone else have the blurred effect for both near and far vision? I'm glad to read this is fairly normal for CXL patients, I was getting worried for a little here. I'm on holidays for the next two weeks, so I hope I am able to return to regular work in the new year.

Let me know!

[Barry1983]

Hi, can anyone tell me there thoughts on cxl? I had it last week, vision is terrible, now been reconmended to have procedure on my ‘good’ eye, but totally unsure as of yet.

[Anne Klepacz]

Hi Barry and welcome,
Have a look at this thread viewtopic.php?f=1&t=16404 and many others like it on this forum. People's experience post CXL seems to vary a lot (and on a forum like this, we're more likely to get posts about the negatives than the positives because people who have a very smooth outcome don't post!) but the general consensus is that vision post CXL can take several weeks to return to 'normal' and for some the effects take longer. Hopefully you'll see an improvement soon, but presumably there's no rush to get the 'good' eye done until you know more about how the eye with CXL is progressing.