It is believed that today more than 50,000 individuals in 40 countries world-wide have benefited from the relatively new LASIK Xtra eye surgery. The surgery is approved in Europe, the Middle East, Australia, Asia and Canada and is expected to get the go-ahead in the United States soon. That’s because surgeons performing LASIK in combination with cross-linking are achieving extremely promising results.

The goal of cross-linking in combination with LASIK (i.e. LASIK XTRA) is to improve LASIK outcomes in general, that is to ensure corneal stability from a biomechanical point of view and avoid corneal ectasia from a safety point of view.

The stability issue is important since London researcher and ophthalmologist John Marshall, PhD, has shown that basic LASIK treatment may well weaken the cornea by 15%t to 25%. Although this doesn’t cause any clinical difficulties, it could lead to the necessity to repeat laser eye surgery further down the line. Cross-linking (LASIK Xtra) can do a lot to prevent this.


Why LASIK Xtra is Important

As its name implies LASIK Xtra is an enhanced form of standard LASIK surgery. It doesn’t just enhance the power of the LASIK surgery by making it last longer but also opens it up to more candidates such as those with corneas which are too thin for standard LASIK treatment or those with the degenerative eye conditions such as Keratoconus (which causes a bulging of the eye).

How does LASIK Xtra work?

The procedure involves a combination of Ultraviolet A (UVA) light and riboflavin (vitamin B). The former is an invisible light ray normally provided by the sun and responsible for the body’s tanning process. Riboflavin, meanwhile, is a vitamin which the body uses in order to produce red blood cells and to turn carbohydrates into energy. It is found throughout the body, including the eye. It’s also a familiar component in a wide variety of foods such as dairy products, green leafy vegetables, nuts and beans. Today bread and cereal manufacturers routinely add this non-toxic vitamin to their products.



The patient first undergoes the original LASIK operation where an anaesthetic is applied to the eye and a flap cut into the cornea in one of two ways – either using a femtosecond laser or a microkeratome tool. The flap is lifted and the excimer laser reshapes the cornea to correct the way in which light reaches the eye. In doing so the patient’s short or long-sightedness is much improved.

The next step , when the LASIK Xtra is included, involves riboflavin eye-drops being dropped onto the cornea. The eye drops are then allowed to soak for a couple of minutes after which the cornea is rinsed clean and its flap restored. A minute’s worth of ultra violet light is then directed on the eye. This has the effect of binding chemicals between the collagen molecules.

Benefits of LASIK Xtra

By far the largest benefit from LASIK Xtra surgery is the fact it lengthens the effectiveness of the surgery. In other words there is less likelihood of follow-up laser eye surgery being requred 10 or 20 years down the line. One surgeon, Dr. Christoph Kranemann of Clearview Institute in Toronoto refers to this as the “stabilizing effect” where the Xtra technique “locks-in a prescription following surgery.” In LASIK without the Xtra surgery, he said, the cornea often attempted to revert to its original shape resulting in the necessity for follow-up surgery some years later.

Eye patients whose short or long-sightedness was so severe that it excluded them from the LASIK procedure, may now be able to benefit when LASIK Xtra is used. Dr John Blaylock of British Columbia said that it provided not just long-term stability, but also “enhanced safety” for patients that he treated with LASIK.

The surgery can also be used to treat degenerative eye conditions such as keratoconus which causes a bulging of the eye due to the cornea thinning over time.

Does LASIK Xtra work with other laser eye surgery procedures?

LASIK Xtra is not restricted to LASIK surgery but is also effective when used in conjunction with LASEK, PRK and AK. The procedure can also be undergone years after the original LASIK surgery has taken place. In other words, the two treatments don’t have to be taken together.

Negative effects of LASIK Xtra

There is a higher risk of infection in the eye due to a contamination of the riboflavin but this can be prevented with a sterile environment. The surgery is also more expensive than standard LASIK but the cost must be weighted against the possible need for further laser eye surgery at a later date.