Information for the public
There are 2 different versions of corneal collagen cross‑linking: epithelium‑off and epithelium‑on. For more information on how these are done see the procedure. Either can be done with other procedures to improve eyesight. NICE made different recommendations for each type of procedure because there was different evidence about their benefits and risks.
The epithelium‑off procedure combined with other procedures, and all epithelium‑on procedures: there is not much good evidence about how well these procedures work or how safe they are. They should only be used if extra care is taken to explain the risks to patients and extra steps are put in place to record and review what happens to patients who have these procedures.
When health professionals are deciding who should be offered one of these procedures, they should check how thick the patient's cornea is and how likely their disease is to progress.
Only specialists in diseases of the cornea who are trained in using UV light, or trained staff under their supervision, should carry out these procedures.
More research is needed into these procedures, especially the epithelium‑on and combination procedures.
Other comments from NICE
NICE said that these procedures might be useful for disabled people with keratoconus or keratectasia who can't wear contact lenses.
Your health professional should fully explain what is involved in having one of these procedures and discuss the possible benefits and risks with you. You should also be told how to find more information about the procedure. All of this should happen before you decide whether you want to have this procedure or not.
If you are offered the epithelium‑on procedure or either of the procedures combined with another procedure, your health professional should explain the uncertainty about how well it works and its possible side effects.
Your health professional might ask you if details of your procedure can be used to collect more information about using corneal collagen cross‑linking to treat keratoconus. Ask your health professional for more information about this.