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CCL (CORNEAL CROSS-LINKING)


The aim of Corneal Cross-Linking (CCL) treatment is to strengthen the corneal structure and stop the progression of the disease.

Application of Riboflavin (vitamin B2) Eye Drops 

Prior to treatment, the eye is anesthetized with topical anesthetic drops. Following topical anesthetic eye drops, the corneal epithelium is removed mechanically using a blunt spatula. 2 drops of riboflavin solution are applied over the cornea without epithelium at 5-minute intervals for 30 minutes.

UV Light Application

After 30 minutes, the patient is placed under a biomicroscope. After the fluorescence of the riboflavin is observed in the anterior chamber, the patient is taken back to the operating room. The cornea is exposed to 370 nm UV light for 5-10 minutes at 4-5 cm distance, within a space of 7 mm. During UV application, 2 drops of riboflavin are applied once every 1 minute. At the end of this procedure, a bandage contact lens is applied to the eye, but the eye is not covered.

UV Cross-Linking (Cross Linking in the Molecular Level) Treatment

UV Cross-Linking can stop the progression of the keratoconus disease by using UVA light and riboflavin to impact the collagen molecules of the cornea thus increasing the biomechanical strengthening of the cornea.

Outcomes of CCL Operations

The first scientific study of Dünyagöz Hospitals regarding this topic was presented at the European Society of Cataract and Refractive Surgeons (ESCRS, 8–12 September 2007) in Stockholm and approved to be presented at the American Academy of Ophthalmology (AAO) Congress.

Pre-Operative Tests and Examinations

  • Level of vision with and without eyeglasses
  • Refractive error with and without eye drops
  • Corneal topography (Orbscan II, Oculus Topography)
  • Corneal thickness (Sonogage 50Hz)
  • Endothelial cell count (Specular Microscope, Conan)
  • Fundus examination

Dünyagöz Difference in CCL Treatment

The first CCL treatment in Turkey has been applied by Dünyagöz Hospitals. The first "Keratoconus Diagnosis and Treatment Center" has been established within Dünyagöz Hospitals. These centers are equipped with all the necessary devices related to the diagnosis and treatment of keratoconus.

Dünyagöz is the most experienced center in the field of CCL in Turkey. Dünyagöz Hospitals have performed the greatest number of CCL treatments until today (over 20,000). Collaborative works with IROC Clinic (Zurich, Switzerland with Prof. Seiler and his team) where CCL was invented and developed are still continuing.

An archive system is very important due to the importance of the follow-up in keratoconus disease. Dünyagöz Hospitals have patient-specific archiving.

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