The Benefits of CXL Epithelium ON Crosslinking for Keratoconus

The standard technique for crosslinking has been the epithelium “ON” techniques where the outer layer corneal cells intact. Unlike Epithelium “OFF” techniques where the skin is removed to cause a corneal abrasion, The epithelial “ON” technique has a couple advantages over epithelium “OFF” crosslinking. First the visual recovery rate is FAST as the skin epithelial layer is intact to see clearly after one’s crosslinking procedure. One can resume activities right after epithelium on crosslinking. With epithelium “OFF” crosslinking, the vision is blurry for 5 days from the abrasion on the cornea and the recovery rate is slower. Another advantage of crosslinking is that there is no pain with the epithelial “ON” technique. This is because the epithelium is intact and makes one comfortable after the procedure. With epithelium “OFF” crosslinking the induced abrasion may cause pain and discomfort for the first 5 days while wearing a bandage contact lens in the eye for protection. Also with epithelium “ON” crosslinking, no medicine eye drops are used after one’s procedure. The patient usually uses artificial tears in the eye for a week. With the epithelium “OFF” technique one must use post-operative medicines for a week to prevent infection and control inflammation. Lasty with epithelium “ON” crosslinking one is less like to obtain postoperative infections or the development of haze unlike the epithelium “OFF” technique.