Corneal Cross-Linking
San Francisco

Corneal cross-linking is a clinically proven treatment designed to slow or stop the progression of keratoconus. While keratoconus once required corneal transplants in advanced cases, new technologies like FDA-approved cross-linking now offer a safe, effective way to stabilize the cornea and preserve vision. This minimally invasive procedure strengthens the corneal structure, helping patients maintain clearer, more stable eyesight for the long term.

Life in Focus

What is Corneal Cross-Linking?

Corneal cross-linking, or corneal collagen cross-linking, is a technique that was first used in 1998 to treat patients with a disease called keratoconus. In keratoconus, the cornea (the front clear window of the eye) can become weak, thin, and irregularly shaped. Instead of keeping its normal round shape, corneas with keratoconus can bulge forward into the shape of a cone causing poor vision.

This minimally invasive procedure uses a combination of ultraviolet (UV) light and riboflavin (vitamin B2) eye drops to strengthen the corneal fibers by creating new collagen bonds, or "cross-links." These cross-links increase the cornea’s rigidity, helping to halt or significantly slow the progression of keratoconus, preserve vision, and reduce the likelihood of needing a corneal transplant in the future.

How Corneal Cross-Linking Strengthens & Stabilizes Eyes

Normal corneas have crosslinks between its collagen fibers that keep it strong and able to retain its normal shape. In keratoconus, the cornea is weak with too few cross-links or support beams. This weakened structure allows the cornea to bulge outwards. The cross linking procedure adds cross-links or “cross beams” to the cornea, making it more stable, holding its shape and focusing power better. These new cross-links help strengthen the cornea which stops the thinning process and further loss of vision.

By reinforcing the cornea at a microscopic level, corneal cross-linking helps preserve its natural shape and function. This added structural stability prevents further bulging and thinning, which are hallmarks of keratoconus and related conditions. While the procedure doesn’t reverse existing damage, it effectively stops the progression of the disease in most cases. This can significantly reduce the need for more invasive treatments like corneal transplants later in life, making cross-linking a critical early intervention for long-term visual health.

What to Expect During Corneal Cross-Linking Treatment

The CXL treatment is an outpatient procedure performed in our office using only numbing eye drops and, if needed, a mild sedative like a Valium tablet. You’ll lie comfortably on your back in a reclining chair and look up at a soft blue light during the treatment. To begin, the epithelium—a thin, clear layer of protective tissue covering the cornea—is gently removed. Vitamin B2 eye drops (riboflavin) are then applied, and you’ll be asked to continue looking at a special blue (ultraviolet) light.

Over the next several minutes, the UV light activates the riboflavin in your cornea, triggering a chemical reaction that forms new collagen cross-links. These strengthen the cornea and help halt the progression of keratoconus. The entire procedure takes about an hour. Afterward, a soft bandage contact lens is placed on your eye to support healing as the epithelium regenerates. Under the expert care of Dr. Ella Faktorovich—San Francisco’s only private-practice surgeon offering FDA-approved corneal cross-linking—you can feel confident you’re receiving the most advanced and trusted treatment available.

Who is a candidate for Corneal cross-linking?

Corneal cross-linking in San Francisco is typically recommended for patients diagnosed with keratoconus or corneal ectasia—conditions that cause the cornea to weaken and bulge over time. Ideal candidates are those experiencing progressive vision changes, thinning of the cornea, or increasing astigmatism. The treatment is most effective when performed in the early to moderate stages of the disease, before permanent damage occurs. Patients should have a cornea that is thick enough to safely undergo the procedure, and overall good eye health is essential. A comprehensive evaluation by our specialists at Pacific Vision Institute will determine if cross-linking is the right option for preserving your vision.

Optical surgeons inspecting a patient's eyes on a monitor

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Recovery from Corneal Cross-Linking

After your corneal cross-linking procedure, a soft bandage contact lens will be placed on your eye to protect it while the surface heals. You may experience mild discomfort, light sensitivity, or blurred vision for a few days—these are normal and typically resolve as healing progresses. Prescription eye drops will help prevent infection and reduce inflammation.

Most patients can return to normal activities within 3 to 5 days, though vision may continue to improve over several weeks. Follow-up appointments are important to track your healing and ensure the treatment is working as expected. With expert care from Dr. Ella Faktorovich and the Pacific Vision Institute team, your recovery will be closely monitored every step of the way.

Dr. Seibel with cataract patient at Pacific Vision Institute

Why Choose Pacific Vision for Corneal Cross-Linking?

If you need to undergo corneal cross linking in San Francisco, we believe you deserve access to the most advanced FDA-approved technology and a team with unparalleled expertise in treating keratoconus. At Pacific Vision Institute, we’re proud to be recognized as leaders in corneal stabilization, offering precise, effective care and a patient-focused experience.

Under the care of Dr. Faktorovich and Dr. Seibel, both members of the American Society of Cataract and Refractive Surgery, you can feel confident knowing your treatment plan is backed by experience, innovation, and a commitment to long-term visual health.

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Corneal Cross-Linking FAQ

How soon will I notice results after corneal cross-linking?

While some patients may notice improvements in corneal shape and vision within a few weeks, most experience gradual changes over several months. The primary goal is to stop progression, with visual enhancements often being a secondary benefit over time.

Can both eyes be treated at the same time?

Typically, only one eye is treated at a time to allow for proper healing and to monitor results. If both eyes require treatment, the second eye is usually treated a few weeks after the first.

Is corneal cross-linking a permanent solution?

For most patients, corneal cross-linking effectively halts the progression of keratoconus long-term. While it may not eliminate the need for glasses or contacts, it can help preserve existing vision and reduce the likelihood of more invasive procedures, such as a corneal transplant.

Are there any risks or side effects?

As with any medical procedure, there are some risks, including infection, delayed healing, or haze on the cornea. However, these are rare and minimized when the procedure is performed by an experienced specialist like Dr. Faktorovich using FDA-approved technology.

Will I still need glasses or contacts after the procedure?

Possibly. While corneal cross-linking stabilizes the cornea, it does not fully correct vision. Many patients still wear glasses or contact lenses after the procedure but often notice improved comfort and fit, especially with specialty lenses.

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Corneal Cross-LinkingSan Francisco