Corneal crosslinking is performed in a sterile environment in the operating room, with the patient locally anaesthetised with drops, lying down, covered with a sterile drape and an eyelid fixator fitted to expose the cornea correctly and evenly throughout the treatment. In the first part of the treatment, two substances of different concentrations of riboflavin are instilled onto the surface of the cornea, one after the other, uniformly and timed according to the manufacturer's instructions, which will penetrate the cornea uniformly. In the second part of the treatment, the patient will be exposed to UV rays, under the action of which, in the presence of riboflavin, the actual process of accelerated corneal cross-linking will take place. All these steps take about 15 minutes.

The corneal cross-linking device used in our clinic is from Avedro. The cross-linking procedure is non-invasive and combines the use of ultraviolet light with the KXL® system and Photrexa riboflavin formulas.Using Photrexa® Viscous (riboflavin 5′-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5′-phosphate ophthalmic solution) and the KXL® System, Avedro's corneal cross-linking procedure is the first and only FDA (Food and Drug Administration - the federal agency of the U.S. Department of Health and Human Services) approved therapeutic procedure for patients with progressive keratoconus or corneal ectatia. The procedure is performed without the need to remove the corneal epithelium, so healing and post-interventional comfort are much faster compared to traditional cross-linking, which involves removing this corneal layer. This method is based on state-of-the-art pulsed light, the effectiveness of which considerably reduces the duration of treatment and the exposure of ocular tissues to ultraviolet radiation.

La sfârșitul tratamentului, se va aplica o lentilă de contact terapeutică, în ciuda faptului că nu s-a realizat dezepitelizarea corneană și se vor instila o serie de picături și unguent. Pacientul nu este nevoit sa mai rămână sub supraveghere medicală, el va pleca din clinică fără pansament, cu schema de tratament ce se va iniția chiar din seara aceleiași zile  și va veni la un control scurt a doua zi de dimineață. Peste câteva zile se va scoate lentila de contact terapeutică , se va monitoriza aspectul cornean, iar pacientul va fi nevoit sa continue tratamentul topic încă două săptămâni. 

In the first days after the operation, mild symptoms such as blurred vision, pain, foreign body sensation are described, which will subside with the recommended treatment.

Corneal cross-linking is a safe procedure with low complication and failure rates, but in certain situations some complications may occur, although very rarely, such as: ocular infections, corneal ulcer, corneal oedema, corneal endothelial damage, peripheral corneal infiltrates, corneal scarring, reactivation of herpetic keratitis.