What to Expect Before Epi-off Corneal Cross-Linking
Epi-off corneal cross-linking (CXL) is an FDA approved treatment designed to strengthen a weakened cornea, most commonly in people with keratoconus or post-LASIK ectasia. The goal is to stop or slow progression, not to perform “laser vision correction” like LASIK.
Preparing properly before your procedure makes the experience smoother and helps your surgeon get the most accurate measurements and safest outcome. Use this page as a checklist in the days leading up to your treatment.
Your CXL appointment details
- Location: 31824 Village Center Rd, Suite F, Westlake Village, CA 91361.
- You will receive a specific date and time for your CXL procedure and your 1-day follow-up.
- You will be given a kit with after-care instructions and eye protection immediately after your procedure.
Contact Lens Removal Before CXL
Contact lenses temporarily change the shape of your cornea. To get accurate topography and measurements, lenses must be discontinued well before treatment.
Soft contact lenses
- Stop wearing soft contact lenses at least 3–7 days before your CXL procedure.
- If you wear soft toric lenses for astigmatism, your doctor may prefer the full 7 days.
Gas permeable / hard lenses
- Gas permeable or hard contact lenses are usually stopped 3–4 weeks before treatment.
- Your surgeon will individualize this based on your corneal shape and wear schedule.
If you accidentally wear lenses after the cutoff date, tell the office. Your surgeon may decide to repeat measurements or adjust your schedule.
Antibiotic Eye Drops Before CXL
To lower the risk of infection, you will start antibiotic drops the day before your procedure. The exact brand may vary (for example, Moxifloxacin, Gatifloxacin, Zymaxid, Vigamox, or Besivance), but the schedule is the same.
Antibiotic drop schedule
- Start: 1 day before your CXL procedure.
- Dose: 1 drop in the eye (or eyes) being treated, 4 times per day.
- Continue: for 5 days after the procedure, unless your surgeon changes the plan.
- Do not touch the eye or lashes with the bottle tip.
Bring all of your eye drop bottles with you on the day of your procedure. This avoids confusion and lets staff verify that everything is correct.
Day of Your CXL Procedure
Fragrance, makeup, and skin products
- No fragrance, cologne, or scented lotions on your face, neck, or chest on procedure day.
- Remove all facial and eye makeup at least 24 hours before your procedure.
- Avoid all eye makeup (mascara, eyeliner, eye shadow) for at least 3 days before your CXL date.
- Make sure there is no residual mascara or eyeliner along the lashes.
Food, drink, and medications
- Eat a light meal at regular mealtime before your procedure, as instructed by your surgeon.
- You may take your usual medications as necessary, with small sips of water.
- No smoking on the day of your procedure.
- No alcoholic beverages on the day of your procedure.
Transportation and support
- Arrange a responsible adult to drive you to and from the office.
- In many cases, the same person can help bring you to your 1-day follow-up visit.
What to bring
- Your prescribed eye drops.
- Sunglasses to wear home.
- Your insurance card and photo ID (if applicable).
- A list of medications and allergies.
Quick day-of checklist
- Stopped contact lenses for the recommended time.
- Used antibiotic drops as instructed.
- No makeup or fragrance(s) (perfumes, colognes, lotions, etc).
- No smoking/vaping or alcohol consumption.
- Ride arranged to and from the office.
- Sunglasses and eye drops packed.
Frequently Asked Questions Before CXL
Will I be awake during epi-off CXL?
Yes. Epi-off CXL is usually done with numbing eye drops and sometimes a mild oral sedative, such as xanax. You should not feel sharp pain, but you may feel pressure or light sensitivity from the UV light.
Can I drive myself home after cross-linking?
No. Your vision will be blurred and you will be light-sensitive. You must arrange a driver for the trip home and should not plan to drive until your eye doctor confirms it is safe.
How long will I be at the office?
Expect to be at the office for a couple of hours. This includes check-in, pre-procedure measurements, the procedure itself, and immediate post-op instructions.
What if I feel sick or have a cold the day of my procedure?
Call the office. In some situations, your surgeon may prefer to reschedule so that you can lie comfortably and keep your eye still during the procedure.