Corneal cross-linking, also known as CXL, is a recently released FDA approved treatment for mild to moderate keratoconus. CXL is considered a minimally invasive procedure and has been found to be effective for many patients diagnosed with keratoconus.
Keratoconus a thinning and weakening of the cornea. It causes the cornea, which is usually shaped like a dome, to bulge out, into more of a cone shape. Having a cone-shaped cornea means that vision will become blurry and distorted, which requires special contacts and glasses. If you have keratoconus, you will not qualify for Lasik.
When people are first diagnosed with keratoconus, it can be treated using glasses and soft contact lenses. As the disease progresses, a more aggressive treatment regimen becomes necessary. Once keratoconus has progressed beyond a certain point, eyeglasses and contacts are no longer effective treatment options. Instead, many patients find that severe keratoconus is treated by undergoing a corneal transplant. However, for patients who have mild to moderate keratoconus, there is a FDA approved treatment option available called Corneal Cross-Linking (CXL).
Corneal cross-linking is a procedure that aims to strengthen the cornea while slowing down the effects of keratoconus. CXL does not reverse or fix keratoconus; it is done to halt the progression of the disease and potentially stave off a corneal transplant. CXL is performed in two ways: epithelium-off and epithelium-on.
In epithelium-off CXL, the eye doctor will remove the first layer of the cornea, which is known as the epithelium. Removing the epithelium ensures that treatment is most effective. The epithelium removal process is painless and performed very quickly. When the epithelium has been fully removed, your eye doctor will apply liquid riboflavin drops to the eye. When the drops have been absorbed into your eye, they are then activated by using UV light. During the activation step, you will sit with the light in your eye for an extended period, which will be determined by your eye doctor. Next, a special kind of contact lens will be placed on your eye to help with healing.
When performing epithelium-on CXL, your eye doctor will place the liquid riboflavin over the epithelium. The epithelium is not removed, and the UV light is then used on your eye. When having epithelium-on CXL, you must sit under the UV light for a longer amount of time. This ensures that the liquid will fully penetrate the cornea’s surface.
If you suffer from keratoconus and want to learn more about CXL as a treatment option, please book a consultation with one of our highly qualified cornea experts at Denver Eye Surgeons. If you are suffering from severe keratoconus, you may have progressed too far to be a good candidate for receiving corneal cross-linking. If you have mild to moderate keratoconus, CXL may help you avoid receiving a cornea transplant.
Denver Eye Surgeons has been treating cornea related issues successfully for over 40 years!
The female surgeon I saw was very professional and gave me information about my eye that should have been given at my last visit about a spot on back of my eye. She was informative and thorough.
The staff and the doctor I saw for my upcoming cataract surgery was fantastic they were polite courteous and answered every question that I had I'm getting my first cataract surgery done next month
I recently saw Claire Purser, OD and Kassidy Campton, contac lens technician at Denver Eye Surgeons. They were both professional, knowledgeable and personable. Took time to answer all questions. The entire staff at the office deserve 5 star ratings.
I want to commend Kayla M. for her care and understanding with patients during check in. She is always cheerful and calm, never rushing anyone. A true professional!
They have taken excellent care of our eyes for years! I am confident they know what they are doing. The appointments are easy to schedule and there are plenty of comfortable chairs to wait for your appointment. The waiting time is brief. We are always satisfied!
Incredible customer service!!! Everyone was engaging, kind, supportive and professional ~all the way from the front desk, visit, exit. Dr Noguchi was excellent- bedside manner, medical intervention, demeanor. He is a world class physician and a classy gentleman. Thank you all for treating me like family
Tania was very nice and personable. She answered all my questions. Very very friendly! Dr. Costin was also very personable and good.
Tania came in to the exam room to perform the pre appointment examination before meeting with Dr. Purser. Tania was very thorough, professional and personable. A very good experience.
I was so impressed by your staff. One person really went out of her way, Tonia. Very helpful and kind. She has great patient care ethics. Great job team.
Everyone was wonderful and explained everything very thoroughly, including billing. Both office staff and doctors were great! I had a past retinal detachment and they treated it very seriously.
Kassidy did a fantastic job fitting me for my contacts. She was very patient and friendly and I am seeing great in my new monovision set up. Thanks Kassidy!
Great experience with Kassidy after cataract surgery for contact lens fitting. She explains everything in layman’s terms that make it easy to understand what I am experiencing very easy to understand. Thank you Kassidy.
Dr Costin was amazing. She is highly professional, very honest, and would recommend her to anyone. In fact, the entire staff was amazing.
Dr Crosby, her Tech and her assistant... First Dr Crosby's tech. I was so pleased with her. She did the exam and front end of my appointment. She was very detailed and thorough, as well as kind. The best I have had in many years of exams. Dr Crosby was new for me after my prior Dr left. Much better manner then the prior Dr. She answered all my questions and was very thorough and kind as well. Her assistant was very helpful, and I suspect the employee who helped me with a lost prescription. To conclude, a happy experience!
Able to see me quickly for an eye infection and staff very friendly including Joanna and Dr Crosby!
Thank you Kassidy for the contact fitting after cataract surgery. I know the second eye will be just as great a fitting!
Chi checked me in before I was seen by the doctor. Chi was very nice, pleasant and very patient with me when setting me up with my exams. Chi is very customer service oriented she’s a keeper in my books.
On the 13th of March 2026 I went in for a problem that had been increasing over time. The doctors assistant was attentive, professional and cheerful. Much appreciated. I was lucky to get Ophthalmologist Jonathan Noguchi, M.D.. He was professional, likeable and was calm during my apprehension. He identified my problem and explained what it was and how he could solve it. This procedure was to remove enflamed and plugged tear ducts and he had to insert a needle in 3 different places on both eyes, and I mean next to the eye to numb these spots. Then he simply removed the inflammation with small scissors. I would recommend this doctor. He was easy to like, knew what he was doing and he got right on it and had me going out the door lickety split..Thanks doc. I look and feel much better!
I went in for an appointment on Friday. I was greeted by Kayla. She is amazing and very helpful and friendly. Thank you for all your help Kayla💯❗
As stressful as eye appointments can be. This place eased all my worries! Samantha G at the front desk is the absolute best. She is patient and worked with me to ensure I was seen and taken care of!!! Thank you to your entire team!!
Chi was very knowledgeable and professional. She should go back to school! Dr. Crosby was amazing as well. I love going to DES and have been going to them for years. Would recommend.
Samantha G was very friendly and accommodating with the Dr's schedule and got me an appointment that was more convenient for me!!
Had a routine eye exam with Dr. Crosby and was seen by Manuel beforehand. Both were great; I would highly recommend this office!
Denver Eye has amazing physicians and staff! Everyone is so attentive and the whole process during the visit was very efficient. I would highly recommend them for your eye care needs.
