Long-term Tomographic, Refractive, and Visual Analysis of Keratoconus Eyes With Extreme Corneal Flattening After Corneal Cross-linking

Progressive extreme corneal flattening when accompanied with a decrease of CDVA was a late complication of CXL that may have required corneal transplantation for visual rehabilitation. Preoperative steeper corneas and keratometric flattening greater than 2 D at the first year postoperative period were risk factors associated with long-term extreme postoperative corneal flattening.