Continued Long-term Flattening After Corneal Cross-linking for Keratoconus.

PURPOSE To report 3 cases with continued long-term flattening after corneal cross-linking (CXL) for keratoconus and to determine its prevalence. METHODS Case series. RESULTS Three eyes of three patients presented with an ongoing corneal flattening over 10 years after CXL in the absence of corneal opacities. Of the initial 433 eyes treated with CXL between 2005 to 2007, only 45 eyes completed the 10-year follow-up period, indicating a prevalence of 6.7%. CONCLUSIONS Besides continuous flattening due to scars and intense early flattening, a third entity of continuous flattening can be observed after CXL. Continuous long-term flattening after CXL seems to affect more patients than initially anticipated and should be considered as a late-onset complication of CXL. [J Refract Surg. 2018;34(8):567-570.].

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