A new study in journal of cataract and refractive surgery increases our knowledge of cross linking in keratoconus patients. Cross linking, as you may recall is a newer treatment for bulging cornea. The strength of the cornea is increased by adding riboflavin and activation it by UV radiation. This affects the nerves in the cornea.
This study on keratoconus patients undergoing cross linking compared the return of corneal sensation. It divided the patients into two groups. One group had epi off cross linkage and the other had epi on cross linkage.The Keratoconus experts analyzed the results. They came to the conclusion that the nerve sensation recovered in both methods. The recovery was faster in pi on or transepithelial corneal cross linking.
Currently the most efficous method for corneal collagen cross linking is the epithelium off Dresden protocol. Research in cross linking is further needed to make epithelium on more beneficial as it has quicker recovery and less patient discomfort.
Each individual eye is different. A keratoconus surgeon can discuss with you which treatment protocol would be best for your eye.