Excessive Corneal Flattening and Thinning After Corneal Cross-linking: Single-Case Report With 5-Year Follow-up

Purpose: To present a case of significant progressive corneal flattening and thinning after corneal cross-linking (CXL), with 5 years of follow-up. Methods: Case report. Results: A 23-year-old woman presented with bilateral progressive keratoconus and received CXL treatment (Dresden protocol) for both eyes in March 2009. The patient has demonstrated gradual significant corneal thinning (from a preoperative value of 464 mu m to 243 mu m) and progressive flattening (+11.1-diopter change in spherical equivalent) in her right eye, over a 5-year period. The fellow eye remained stable during the same postoperative period. Conclusions: This is the first case report of significant progressive corneal flattening and thinning after undergoing CXL treatment for progressive keratoconus.