title: Excessive Corneal Flattening and Thinning After Corneal Cross-linking: Single-Case Report With 5-Year Follow-up.
abstract: OBJECTIVE
  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 μm to 243 μm) 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.
authors: *Vardinoyiannion Eye Institute of Crete (VEIC), Department of Ophthalmology, Faculty of Medicine, University of Crete, Heraklion, Greece; and †Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miller School of Medicine, Miami, FL.
authors: George D
authors: GD
authors: Kymionis
authors: Konstantinos I
authors: KI
authors: Tsoulnaras
authors: Dimitrios A
authors: DA
authors: Liakopoulos
authors: Theodoros A
authors: TA
authors: Paraskevopoulos
authors: Anna I
authors: AI
authors: Kouroupaki
authors: Miltiadis K
authors: MK
authors: Tsilimbaris
mesh_terms: D003094:Collagen / Q000378:metabolism; D003315:Cornea / Q000473:pathology*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000209:etiology*; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D009929:Organ Size; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011183:Postoperative Complications; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen