Epi-on and epi-off procedure
There are two approaches to crosslinking that differ in the treatment of the top layer of the cornea (epithelium):
- Epi-off procedure: The top layer of the cornea is removed to allow the riboflavin to better penetrate. This procedure is particularly effective and preferred for advanced keratoconus. However, the healing process may take a little longer and there may be some temporary discomfort.
- Epi-on procedure: The epithelium remains intact, making the procedure more gentle. This method is suitable for selected patients whose disease has not progressed as much. Healing is faster, but corneal stabilization may be less pronounced than with the epi-off procedure.
Benefits of crosslinking
- Effective corneal stabilization: Stops the progression of keratoconus in most cases.
- Minimal invasiveness: a gentle, low-risk procedure.
- Long-term stability: studies show that the cornea remains stable even years after treatment.
- Flexible options: Epi-on and Epi-off methods allow adaptation to the patient’s needs.
Coverage by health insurance companies
Coverage for crosslinking depends on the diagnosis and progression of the disease:
In the case of keratoconus: Health insurance companies usually cover the costs if disease progression is diagnosed and the procedure is medically necessary.
Other indications: In the case of corneal degeneration or rare diseases, coverage is assessed on an individual basis. In most cases, private health insurance companies will cover treatment based on a doctor’s recommendation.
Postoperative care and healing process
After treatment, patients should avoid physical activity and rubbing their eyes for the first few days. Minor discomfort, such as foreign body sensation or sensitivity to light, is normal and subsides within a few days.
There may be a temporary decrease in visual acuity, but this usually subsides within a few weeks or months. Regular check-ups ensure the success of treatment.
