11 May, 2021

Guidance published: Corneal cross-linking (CXL)

Health Technology Wales has today published national Guidance on corneal Cross-linking (CXL).

We appraised the clinical and cost effectiveness of CXL for the treatment of adults and children with keratoconus.

The evidence supports the routine adoption of corneal cross-linking (CXL) for children and adults with progressive keratoconus.

Compared to standard care, CXL slows disease progression and may improve visual acuity. It may also reduce or delay the need for corneal transplantation.  Economic modelling suggests that CXL is cost effective on the basis of an assumed sustained clinical benefit for at least 14 years.

HTW recommends the acquisition of real word data to capture long-term outcomes (including patient-reported outcomes measures) in people who have CXL for keratoconus.

The status of our Guidance is that NHS Wales should adopt this guidance or justify why it has not been followed. We will evaluate the adoption and impact of our Guidance.

We’ve published Guidance, an Evidence Appraisal Report (EAR), a Topic Exploration Report and a plain language summary for this topic. Click here to read about this topic.

HTW Appraisal Panel considers appraisal evidence within the context of NHS Wales and produces the HTW Guidance. The panel also helps us to identify important topics, evaluates the uptake of guidance and facilitates stakeholder engagement. It has pan-Wales and multi-disciplinary representation. Learn more about our Appraisal Process.