Concierge ophthalmology · London
Corneal crosslinking, to halt keratoconus in its tracks.
A short, awake procedure — riboflavin drops and ultraviolet-A light — that strengthens corneal collagen and stops progressive keratoconus getting worse. By a consultant corneal surgeon, with both epi-off and accelerated protocols on the table.
Why patients choose us
- 01
A consultant corneal surgeon, not a technician
Crosslinking is a small procedure with lifelong consequences — the person doing it should be a corneal specialist who does it every week.
- 02
Both epi-off and accelerated on the table
The Dresden protocol is the gold standard. Accelerated CXL can suit some eyes. We say which fits yours before you commit.
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Progression documented before we treat
CXL halts progressive keratoconus — not stable keratoconus. We check topography over time before recommending treatment.
Indicative pricing
What private corneal crosslinking costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures per eye, with any combined procedure priced separately.
In short
Epi-off Dresden CXL in our network: £2,400–£3,800 per eye, home the same day.
| Procedure | Indicative range | Typical duration | Follow-up |
|---|---|---|---|
| Epi-off CXL (Dresden protocol) — one eye | £2,400–£3,800 | 45–60 min | 6–12 month review |
| Accelerated CXL — one eye | £2,200–£3,500 | 30–45 min | 6–12 month review |
| Epi-on (transepithelial) CXL — one eye | £2,400–£3,800 | 45–60 min | 6–12 month review |
| CXL plus intracorneal ring segments | £4,500–£7,500 | Half-day | Staged review |
| CXL plus topography-guided PRK | £4,800–£7,800 | Half-day | Staged review |
| Consultation and topography only | £300–£550 | 45 min | Same visit |
Prices vary by clinic, by the surgeon, by protocol (epi-off, epi-on or accelerated), and by whether ring segments or topography-guided PRK are combined with CXL. We come back with a firm quote within one working day.
The problem
The right protocol, at the right moment.
Crosslinking is the only proven way to halt progressive keratoconus — but done to a stable eye it is unnecessary, and done to the wrong eye it can hurt. Getting the diagnosis and timing right matters more than the technology.
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Is it actually progressing?
CXL is for eyes that are getting worse. We insist on documented topographic change before treating.
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Which protocol fits your eye?
Epi-off, epi-on or accelerated — each has trade-offs. A corneal surgeon picks with you, not for you.
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Is CXL alone the goal?
For some eyes, a ring segment or topography-guided PRK belongs alongside CXL. We say so before you book.
The journey
From topography to healing — what happens, in order.
One corneal surgeon from first scan to twelve-month review — including the quiet months of remodelling that follow.
Phase 1 · Before your treatment
Topography, OCT, plan
Phase 2 · On the day
A morning at the clinic
Phase 3 · After
Healing and reviews
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, previous topography or scans, whether your vision has changed and how quickly.
- 02
Before
Corneal topography and OCT
Scheimpflug topography (Pentacam or similar) and anterior-segment OCT confirm progression and measure corneal thickness — critical before CXL.
- 03
Before
We come back with a recommendation
Within one working day: epi-off, epi-on or accelerated CXL — or, if a ring segment or topography-guided PRK belongs alongside it, we say so.
- 04
On the day
Arrival at the day-case unit
Consent, drops to soften the eye, and a chat with the corneal surgeon. Topical anaesthesia only — you are awake throughout.
- 05
On the day
The procedure itself
30 to 60 minutes. Epithelium removed (epi-off) or left on (epi-on), riboflavin drops applied, then UV-A light for the treatment time.
- 06
On the day
Bandage lens and home
A bandage contact lens is placed to help the surface heal. Topical antibiotic and steroid drops start the same day. Home within a couple of hours.
- 07
After
Healing and review
Epi-off: 3–7 days for the surface to close, weeks of blurred vision, months of quiet remodelling. Topography is repeated at 6 and 12 months.
Typical end-to-end: 2–4 weeks from enquiry to treatment. Surface healing: 3–7 days. Full stabilisation confirmed at 12 months.
When it helps
When corneal crosslinking is the right step.
The situations where CXL earns its place, plus the one red flag that means emergency ophthalmology rather than a clinic booking.
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Progressive keratoconus
Documented steepening on topography, or worsening astigmatism — the classic indication for CXL, and the one it works best for.
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Pellucid marginal degeneration
A rarer ectatic disorder with an inferior band of thinning. CXL is used to halt progression here too.
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Post-LASIK or post-refractive ectasia
When the cornea weakens and bulges after laser refractive surgery — CXL is the accepted treatment to stabilise it.
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PACK-CXL for corneal infection
Photoactivated chromophore CXL is used for infectious keratitis with melting — an emerging, specialist indication.
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Young eyes with new keratoconus
Teenagers and young adults progress fastest. Early CXL after diagnosis is often the right call, even without a second scan yet.
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Contact-lens intolerance developing
Increasing difficulty tolerating rigid lenses may signal ongoing change worth investigating and, if progressive, treating.
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Family history plus early signs
A first-degree relative with keratoconus and any topographic asymmetry warrants close monitoring — and CXL if it moves.
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Red flag: acute hydrops
Sudden vision loss with pain in a keratoconic eye — a break in Descemet’s membrane. Same-day ophthalmology, not a clinic booking.
Treatment options
CXL is not a single procedure.
What each protocol actually involves — Dresden, accelerated, epi-on, and the "CXL plus" combinations that improve vision as well as halt change.
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Epi-off CXL (Dresden protocol)
The gold standard: epithelium removed, riboflavin loaded, UV-A for 30 minutes. Best evidence base, slower recovery.
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Accelerated CXL
Higher UV-A intensity for less time (typically 9 minutes). Similar mechanical effect in most eyes, shorter treatment.
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Epi-on (transepithelial) CXL
Epithelium kept intact — faster recovery, less pain. Evidence is weaker and progression may not be halted as reliably.
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CXL plus intracorneal ring segments
Ring segments reshape the cornea; CXL stabilises it. Combined in selected eyes to improve vision as well as halt change.
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CXL plus topography-guided PRK
Custom laser reshaping combined with CXL — "CXL plus" — to reduce irregular astigmatism in stable, thick-enough corneas.
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PACK-CXL for infection
Photoactivated chromophore CXL for bacterial or fungal keratitis with corneal melting — an off-label, specialist use.
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Bilateral (both eyes) planning
Usually done one eye at a time, weeks apart, so the fellow eye can see while the first heals.
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Consultation and monitoring only
If keratoconus is stable, the honest answer is to watch, not treat. We say so and rescan in 6–12 months.
Our vetted London network
A small panel of corneal surgeons, we picked them.
Consultant corneal and refractive surgeons across central London. Not listed publicly — introductions are made privately, once we understand your case and see your topography.
Selection criteria
How we choose every corneal surgeon in our network.
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Consultant corneal and refractive surgeons, not general ophthalmologists
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Scheimpflug topography and anterior-segment OCT before every treatment
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Both epi-off (Dresden) and accelerated protocols available
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Combined CXL plus ring-segment or topography-guided PRK where clinically appropriate
Safety and recovery
What to expect afterwards — honestly.
Crosslinking is a well-studied, generally safe procedure. The things worth planning are the sore first few days, the weeks of blurred vision, and the small but real risks worth knowing.
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Pain for 2–3 days after epi-off
Removing the epithelium hurts as it heals. Oral painkillers, cool compresses and the bandage lens get you through the worst of it.
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Blurred vision for weeks
Vision is worse before it is better. Most eyes take 4–12 weeks to return to baseline, sometimes longer.
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Corneal haze is common, usually fades
A mild central haze appears in the first months in most eyes and typically settles by 6–12 months.
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Sterile infiltrates
Small white spots in the cornea from an immune reaction, not infection. Uncommon, treated with drops, usually resolve fully.
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Infection is rare but serious
Any red, painful, worsening eye in the first weeks needs same-day review — bacterial or herpetic keratitis can occur.
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Thin corneas need caution
A stromal thickness under 400 microns risks endothelial damage. We either avoid CXL or use protocols designed for thin corneas.
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HSV can reactivate
Anyone with a history of herpes simplex keratitis needs antiviral cover — CXL can wake dormant virus.
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Treatment failure is possible
A minority of eyes continue to progress despite CXL. Repeat treatment is sometimes offered; a small number go on to need a graft.
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Red flags after CXL
Worsening pain after day three, spreading redness, sudden vision drop or discharge — call the clinic or A&E the same day.
Reading your operation note
Your CXL note in four parts. Read the last one first.
Whichever protocol was used, the note the corneal surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note or your topography before the next review, just ask.
- 01 Header
Diagnosis and eye treated
Progressive keratoconus, pellucid marginal degeneration or post-LASIK ectasia — and which eye was treated on the day.
- 02 Technique
Protocol and UV parameters
Epi-off Dresden, accelerated or epi-on; riboflavin type; UV-A intensity and duration; minimum corneal thickness recorded.
- 03 Findings
Topography before and planned reviews
Baseline Kmax, thinnest point and astigmatism. When topography and OCT will be repeated — usually 1, 3, 6 and 12 months.
- 04 Impression
Aftercare, drops and when to worry
Read this first: drop schedule, when the bandage lens comes out, activities to avoid, and the symptoms that mean call the clinic.
Recognised by major UK insurers
Most UK insurers fund CXL for documented progressive keratoconus (NICE IPG466). Cover varies for accelerated or combined "CXL plus" procedures. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about corneal crosslinking.
Quick answers on pain, recovery, cost, protocols, and when CXL is — and is not — the right call.
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Will corneal crosslinking actually fix my keratoconus or just stop it getting worse?
It stops it getting worse — that’s the goal. Riboflavin drops and UV-A light create new collagen bonds that stiffen the cornea and halt progression of keratoconus and other ectatic disorders, but they don’t reverse the shape change already there. The earlier it’s done the better, and London cornea specialists can typically offer an epi-off or epi-on CXL within 2–4 weeks of a confirming tomography scan.
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Do I need CXL if my keratoconus is stable?
Usually not. CXL is treatment for progressive keratoconus. If topography is unchanged over 6–12 months and vision is stable, the right answer is to monitor. A good corneal surgeon says so.
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Epi-off or epi-on — which is better?
Epi-off (Dresden protocol) has the strongest evidence and is the gold standard. Epi-on is faster and less painful but the evidence is weaker and progression may not be halted as reliably. We help you decide with your surgeon.
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What is accelerated CXL?
Accelerated CXL uses higher-intensity UV-A for a shorter time — often 9 minutes rather than 30. In most eyes the biomechanical effect is similar. It saves time on the day but is not automatically better.
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How long does recovery take?
For epi-off CXL: 3–7 days for the surface to heal with pain and blurred vision, then 4–12 weeks for vision to return to baseline. Corneal haze settles over 6–12 months. Epi-on recovery is faster — days rather than weeks.
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How much does private CXL cost?
Roughly £2,200–£3,800 per eye for standard CXL. Combined procedures — CXL plus ring segments or CXL plus topography-guided PRK — are £4,500–£7,800 per eye. We confirm a firm figure within one working day.
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Is CXL covered by NICE and insurers?
NICE recommends CXL for progressive keratoconus (interventional procedure guidance IPG466). Most major UK insurers fund it when medically indicated and progression is documented. We check cover before booking.
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When can I go back to work and exercise?
Most people take a week off for epi-off CXL — screens are hard for the first few days. Exercise resumes at 2 weeks, swimming and eye rubbing avoided for a month. Contact lenses restart once the surgeon confirms healing.
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Will CXL improve my vision?
The main aim is to halt progression, not improve vision. Some eyes flatten a little and see better; some stay the same; a few see slightly worse due to haze. Combined CXL plus PRK or ring segments is the route when improving vision is the goal.
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What are the serious risks?
Infection, sterile infiltrates, persistent haze, treatment failure with continued progression, and — in thin corneas — endothelial damage. Herpes simplex can reactivate. Most complications are manageable if caught early.
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When should I seek urgent help?
Worsening pain after day three, a red painful eye with discharge, a sudden drop in vision, or a bandage contact lens that has fallen out — call the clinic or attend eye A&E the same day.
Related tests and treatments
Looking for something else?
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Cornea transplant
When CXL is not enough — DALK, DMEK and full-thickness grafts.
Learn more -
Optical coherence tomography
Anterior-segment OCT to measure the cornea before treatment.
Learn more -
Ophthalmic diagnostic testing
Topography, tomography and the full imaging workup.
Learn more -
All tests and treatments
Every test and procedure we arrange.
Learn more -
Cataracts
Related condition guide.
Learn more -
Glaucoma
Related condition guide.
Learn more -
Eye Test
Related diagnostic test.
Learn more
In practice, in London
The honest picture around corneal crosslinking in London
For corneal crosslinking, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The wait for corneal crosslinking on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For corneal crosslinking in particular, we bias towards consultants who do this every week rather than every month.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see corneal crosslinking — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.