Corneal cross-linking (CXL) is the established treatment for post-LASIK ectasia — a rare complication in which the cornea progressively weakens and bulges after laser eye surgery, causing worsening short-sightedness, astigmatism and blurred vision. CXL uses riboflavin (vitamin B2) drops and controlled UV-A light to create new bonds between collagen fibres, stiffening the cornea and halting progression. It does not reverse the existing change, but it stabilises the cornea to protect the vision you have. Private CXL costs from £2,950 per eye, all-inclusive of scans, treatment and follow-up.
What is post-LASIK ectasia?
Post-LASIK ectasia (also called iatrogenic keratectasia) is a progressive thinning and forward bulging of the cornea that can develop months or years after LASIK or other laser eye surgery. Creating the LASIK flap and removing corneal tissue reduces the cornea's structural strength; in a small number of eyes — particularly those with thin corneas, high correction or undetected sub-clinical keratoconus — the remaining tissue is not strong enough to hold its shape.
The result resembles keratoconus: the cornea steepens irregularly, vision becomes blurred and distorted, glasses no longer correct it well, and the prescription keeps changing. Left untreated, ectasia tends to progress. Cross-linking is the intervention that stops that progression.
Symptoms of post-LASIK ectasia
- Deteriorating vision months or years after successful LASIK
- Increasing short-sight and astigmatism — a regressing or shifting prescription
- Blurred or distorted vision not fully corrected by glasses
- Glare, halos and ghosting, especially at night
- Frequent prescription changes as the cornea reshapes
Vision changing after LASIK? A corneal tomography scan confirms whether ectasia is present and whether cross-linking can stabilise it.
Book a corneal assessmentCross-linking options
All cross-linking works the same way — riboflavin plus UV-A to strengthen the cornea — but it can be delivered with or without removing the thin surface layer (epithelium). Your surgeon chooses the protocol based on your corneal thickness and how far the ectasia has progressed.
Where the cornea is too thin or vision is already significantly affected, cross-linking can be combined with, or followed by, corneal ring segments such as Intacs or CAIRS, or visual rehabilitation with scleral contact lenses. An iontophoresis CXL protocol is another epithelium-sparing option your surgeon may discuss.
What happens during cross-linking
Cross-linking is an outpatient procedure performed under local anaesthetic drops. You stay awake and feel no pain during treatment. Each eye takes around 60 minutes, most of which is the riboflavin-loading and UV-A exposure.
- Numbing drops are placed in the eye.
- For epi-off treatment, the thin surface epithelium is gently removed so the riboflavin can soak in; epi-on protocols skip this step.
- Riboflavin (vitamin B2) drops are applied for around 10–30 minutes until the cornea is saturated.
- The cornea is exposed to controlled UV-A light, which activates the riboflavin and forms new cross-links between collagen fibres.
- A bandage contact lens is placed to protect the surface while it heals, and you rest before going home.
Recovery week-by-week
Epi-off recovery involves a few days of surface healing; epi-on recovery is faster. Here is the typical epi-off course:
Days 1–3
Gritty, watery, light-sensitive eye while the surface heals under the bandage lens. Use prescribed drops and rest; vision is blurry.
Days 3–5
The epithelium heals over and the bandage lens is removed at review. Comfort improves quickly.
Weeks 1–4
Vision settles but may fluctuate. Anti-inflammatory drops continue. Most people return to work within a few days to a week.
Months 1–6
The cornea remodels and stiffens. Vision stabilises and some flattening may modestly improve the shape.
Beyond 6 months
Repeat scans confirm the cornea is stable. Updated glasses or contact lenses are fitted, and any further rehabilitation is planned.
Cross-linking cost
Our cross-linking prices are all-inclusive: corneal scans, the riboflavin and UV-A treatment, the bandage contact lens, post-op drops and follow-up reviews to confirm stability. There are no hidden extras.
- Epi-off CXL: from £2,950 per eye
- iLink (Avedro) accelerated CXL: from £3,500 per eye — see the iLink cost guide
- Epi-on / iontophoresis protocols: by individual quote after assessment
- Insurance: often covered where ectasia is documented — we handle authorisation
- Finance: 0% over 12 months available
For the full breakdown see our corneal cross-linking cost guide. If you are researching laser eye surgery generally, see LASIK and our laser eye surgery overview.