Cross-linking is the one treatment shown to stop keratoconus progressing. It is a single outpatient session, you go home the same day, and for most eyes it settles the question permanently. We perform it on Avedro KXL systems — the same equipment we supply to hospitals across Pakistan.
Cross-linking stiffens the cornea so the cone stops advancing. Both sides of this drawing have the same shape on purpose: the treatment holds your cornea where it is. It does not flatten a cone that has already formed.
If you are a hospital, clinic or procurement team looking to buy, service or tender for ophthalmic equipment — including KXL cross-linking systems — that is the other half of Hospitek, and it has its own page.
Is it
right for me?
The treatment stops progression. That means the case for it is evidence that your cornea is actually getting worse — usually two scans a few months apart. A single abnormal scan is a reason to be watched, not automatically a reason to be treated.
New glasses every several months, increasing astigmatism, or an optometrist who has mentioned that your cornea is an unusual shape. This is how most keratoconus is first picked up.
Particularly if you are in your teens or twenties. Keratoconus progresses fastest in younger eyes, so younger patients are usually treated sooner after diagnosis rather than watched for a year first.
Corneal ectasia after LASIK or PRK behaves much like keratoconus and is treated the same way. If your sight has drifted since refractive surgery, it is worth a scan.
A cornea too thin to treat safely, active infection such as herpetic eye disease, or dense central scarring where the damage is already done. We will tell you at the assessment rather than after you have paid for it.
Not sure which of these is you? That is exactly what the assessment is for. Bring any previous scans or prescriptions you have — old records are genuinely useful, because progression is the whole question.
What the
treatment does
Your cornea is built from layers of collagen fibres. In keratoconus those fibres slip against each other, so the cornea thins and bulges into a cone. Cross-linking adds new bonds between the fibres — vitamin B2 drops soak into the cornea, then a measured dose of ultraviolet light sets off the reaction that locks them together.
Four things, in order. None of them hurt at the time — your eye is numbed with drops throughout.
We would rather you heard this from us now than felt misled in three months.
Detailed corneal scans, thickness measurement and refraction, read against any earlier scans to confirm the cone is genuinely progressing. If it isn’t progressing, we don’t treat it.
The surgeon settles which technique suits your cornea, treats one eye per session in most cases, and walks you through recovery — including the temporary drop in vision over the first month.
Anaesthetic drops only — no needle, no general anaesthetic. For the standard technique the thin outer skin of the cornea is removed so the drops can reach the layers underneath.
Given at intervals while you rest, until the surgeon confirms the cornea has absorbed enough. Your corneal thickness is measured again before any light is switched on.
You lie still under the arm of the machine and look at a small fixation light. Four to eight minutes, depending on the protocol. It does not hurt, and you can talk to us throughout.
A soft protective contact lens goes on, with antibiotic and anti-inflammatory drops to take home. Arrange a lift — you should not drive yourself.
Lens removed once the surface has healed, then reviews at one, three, six and twelve months with repeat scans to confirm the cornea has stabilised.
Please read this part. Cross-linking is a clinical decision, and everything on this page is general information rather than medical advice, a diagnosis, or a promise of outcome. Whether it suits you, which technique is used, and what the risks are in your case are all settled with the treating ophthalmologist in consultation. Like any procedure it carries risks — infection, haze and slow healing among them — which will be explained to you in full before you consent.
Recovery,
honestly
Most of the anxiety we see comes from people who weren’t told what to expect. So here it is plainly. Take the week off if you can, and arrange for someone to be around for the first two days.
Watering, grittiness and real light sensitivity. Painkillers help and you should use them. Keep the room dim, wear sunglasses, stay off screens, and sleep as much as you can — sleeping through it is the best strategy anyone has.
Once the surface has closed we remove the bandage lens at your review, and comfort improves quickly from that point. Vision will still be blurry and that is entirely expected.
Work, school and driving are usually fine again. Vision stays hazy and fluctuates day to day. Resist getting new glasses yet — your prescription is still moving and you would be buying the wrong ones.
Vision steadies. Around months three to six is the time for a new prescription or a contact lens refit. Scans at six and twelve months confirm the cornea has stopped changing.
Costs &
insurance
We don’t advertise a headline price, for one reason: the assessment is what decides whether you should be treated at all. Quoting a figure before we have seen your scans would be quoting for something we haven’t established you need.
What the price depends on is the protocol your cornea needs, whether one eye or both are treated, and the follow-up schedule. After the assessment you get the whole thing in writing, including follow-up, before you commit to anything.
Some employer and private insurance schemes in Pakistan cover cross-linking for documented progressive keratoconus. We will provide whatever clinical documentation your insurer asks for — ask us early, because pre-authorisation takes time.
Glasses and contact lenses after treatment are not included.
Cross-linking at Hospitek is performed by a qualified consultant ophthalmologist, with informed consent, written documentation and a structured follow-up schedule. We supply the platform, the consumables and the theatre support; the clinical decision about whether to treat you, and how, rests entirely with the surgeon.
You are entitled to know who is treating you and what their qualifications are. Ask us at the assessment and we will tell you.
The eye
& where we fit
Everything we supply and everything we perform addresses a specific part of this drawing. Patients usually arrive knowing their diagnosis; clinics usually arrive knowing their gap. Either way, this is the map — each structure listed with the conditions that affect it and the instruments that see or treat it.
Keratoconus, ectasia after laser surgery, corneal scarring and thinning.
Topographer · Scheimpflug tomographer · Pachymeter · Avedro KXL
Raised eye pressure, glaucoma, inflammation inside the eye.
Slit-lamp biomicroscope · Non-contact tonometer · Gonioscopy
Cataract — the clouding that makes vision progressively dim and hazy.
Optical biometer · Phacoemulsification platform · Surgical microscope
Diabetic retinopathy, macular degeneration, retinal detachment.
Spectral-domain OCT · Fundus camera · B-scan · Vitrectomy
Glaucoma damage and other optic neuropathies — often silent until late.
OCT nerve-fibre analysis · Perimetry · Fundus camera
Cross-linking sits at 1, on the cornea. It is the only one of these we perform ourselves — the rest we equip, install, calibrate and keep running for the units that do.
Questions
patients ask
Usually not, and you should go in expecting that. The purpose is to stop your cornea getting worse. A minority of eyes do flatten slightly over the following year and see a small improvement, but that is a bonus rather than the aim — and in the first few weeks your vision will be noticeably worse than before while the surface heals.
The right way to judge it is this: cross-linking protects the sight you have now from the sight you would otherwise have in ten years.
Not during. Your eye is numbed with drops throughout, and the light itself feels like nothing at all. Afterwards is a different matter — once the anaesthetic wears off, expect three to four days of real soreness, watering and light sensitivity while the surface heals. Painkillers help and you should take them rather than tough it out.
It is often more urgent in younger patients, because keratoconus progresses faster in adolescence. Paediatric cases are usually treated sooner after diagnosis rather than after a long period of watching. The surgeon may favour a technique that leaves the corneal surface intact where a child is unlikely to tolerate the recovery of the standard method. This is decided case by case, with parents involved throughout.
Plan on three to four days off, and a week if you can manage it. After that most people are back to normal activity with hazy, fluctuating vision that improves over the following months. Avoid swimming and dusty environments for two weeks, and don’t drive until your vision is reliable enough that you would be comfortable being tested on it.
If your keratoconus is genuinely progressing and you leave it, the cornea continues to thin and steepen. Glasses stop working, then rigid contact lenses become harder to fit, and in the worst cases the cornea scars or becomes so irregular that a corneal transplant is the remaining option. A transplant is major surgery with a lifetime of follow-up.
That is the honest case for treating early. It is also why we won’t treat a cornea that is not progressing — there is nothing to prevent.
Usually we treat one eye per session, because having both eyes sore and light-sensitive at once is genuinely difficult to manage at home. The second eye typically follows a few weeks later. Where both eyes are progressing quickly the surgeon may recommend treating them closer together — that is a conversation to have at the assessment.
Book a
consultation
You don’t need a referral, and you don’t need to know whether cross-linking is right for you — that is what the assessment decides. Most people find it easiest to call or send a WhatsApp message.
Bring any previous scans or prescriptions you have, however old — they are how we prove whether the cornea is changing. If treatment goes ahead on the day, bring someone who can take you home, and sunglasses for the journey.