Severe corneal flattening and thinning after combined corneal cross-linking and photorefractive keratectomy (CXL Plus): a case report
Marjan Mazouchi1 , Mohammad Mehdi Sadoughi1 *, Mohammad Hasan Alamzadeh Ansari1 , Hamed Esfandiari10
- Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract: To present a case of progressive corneal flattening and thinning after combined corneal cross-linking (CXL) and photorefractive keratectomy (CXL Plus).
Methods: Observation (Case Report)
Results: a 24-year-old man underwent bilateral combined standard CXL and photorefractive keratectomy (PRK) for keratoconus suspect. His baseline rigid gas permeable (RGP_
Corrected vision was 20/25 in both eyes with refractive errors of -5.50 sph, -3.00 cyl *175 in the right eye and -5.50 sph, -2.75 cyl *175 in the left eye. The postoperative course was uneventful with RGP corrected vision of 20/25 up until 4 years postoperatively when the patient returned complaining of bilateral blurred vision. His RGP corrected vision dropped to 20/50 in both eyes. Ophthalmic evaluation revealed a significant corneal thinning (more than 300 µm in thinnest point) and flattening (more than +10.00 diopters change) in both eyes.
Conclusion: significant corneal thinning and flattening could occur years after combined CXL and PRK.
This report calls for studies with long term follow-up on the safety and efficacy of combined CXL and PRK procedures (CXL Plus).
