• Written By: Jennifer Li, MD
    Cornea/External Disease

    This article reports two cases of keratoconus progression four and five years after corneal collagen crosslinking (CXL) treatment. This appears to be the first time in which keratoconus progression after a period of stability post-CXL has been reported in the literature.

    In the first case, the patient had been stable up to three years post-CXL. At postoperative year four, he was noted to have more than a diopter increase in the keratometric values. In the second case, the patient also was noted to be stable three years post-CXL treatment. By postoperative year five, however, he was noted to have a significant increase in the keratometric values in one eye. In both cases, the patients’ visual acuity remained stable despite the increasing keratometric values.

    The authors say that neither patient had received any medication or seemed to have had another possible factor that can be considered a trigger for keratoconus progression.

    They speculate that corneal stromal regeneration may explain the recurrence of disease despite treatment. They recommend repeated post-CXL topographic evaluation of keratoconic patients for several years after treatment.

    As our collective experience with CXL grows and the duration of follow-up for these patients increases, we may find more such cases of disease progression requiring further treatment.