Corneal transplant is an invasive surgical procedure that requires the removal of a section of the cornea and its replacement with the donor tissue. Transplantation involves risks such as infections, rejection, cataracts, glaucoma, astigmatism, and other intraoperative dangers. It is likely that young patients with keratoconus will need one or more repeated transplants during their lifetime. Generally, it takes about 1 year to recover one’s vision after a very successful corneal transplant.
The cross-linking procedure is instead an outpatient surgery that works by increasing the cross-links to the collagen, the natural “anchors” inside the cornea. These “anchors” are essential to prevent the cornea from protruding forward and assume an irregular shape. Cross-linking involves creating a superficial scratch on the cornea which is much less invasive than a corneal transplant. The surgery is much safer and takes about only 1 week to heal significantly. Having performed a cross-linking treatment does not exclude the possibility of undergoing a cornea transplant in the future. In contrast, patients who have performed corneal transplants cannot undergo cross-linking anymore.