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Corneal collagen cross-linking with riboflavin/ultraviolet A (CXL) is a method for the treatment of progressive keratectasia.1 2 In 60% of patients, CXL leads to arrest of progression, and in 40%, even a regression of Kmax values is observed.2 Here, we report three cases that did not display regression but rather displayed a massive remodelling with Kmax reduction of up to 9.5 dioptres (D), accompanied by formation of a deep stromal opacity and a distinct increase in best spectacle-corrected visual acuity (BSCVA).
Three eyes of three patients with progressive keratoconus were included in this interventional case series. Progression was defined as an increase in Kmax>1.0 D within 12 months.3 Pre- and postoperative examinations included corneal topography (Keratograph C, Oculus, Wetzlar, Germany), Scheimpflug imaging (Pentacam, Oculus, Wetzlar, Germany) and slit-lamp examination. CXL was performed as published previously.4
For an overview of corneal characteristics, please refer to table 1.
A 27-year-old man (case 1) was referred to us for bilateral keratoconus in April 2007. Previous topographies …