International Journal of Keratoconus and Ectatic Corneal Diseases

Register      Login

VOLUME 4 , ISSUE 2 ( May-August, 2015 ) > List of Articles


Long-term Stability of Ectasia in a Young Patient with Asymmetric Keratoconus

Rosane de Oliveira Corrêa, Ana Laura Caiado Canedo, Rozalia Beildeck, Marcella Quaresma Salomão, Penelope Burle de Politis

Citation Information : Corrêa RD, Canedo AL, Beildeck R, Salomão MQ, Politis PB. Long-term Stability of Ectasia in a Young Patient with Asymmetric Keratoconus. Int J Kerat Ect Cor Dis 2015; 4 (2):66-68.

DOI: 10.5005/jp-journals-10025-1102

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2015; The Author(s).



To report the clinical course of a typical young patient presenting with asymmetric keratoconus (KC), that demonstrates that stabilization of the ectatic process is possible without cross-linking (CXL) procedure.


Case report and review of the literature.


A 17-year-old male patient was referred due to the diagnosis of keratoconus. Patient complained of loss of vision in the left eye (OS). Uncorrected distance visual acuity (UDVA) was 20/25+ in the right eye (OD) and 20/80 in the left eye; wavefront-assisted manifest refraction gave best corrected distance visual acuity (CDVA) of 20/20 in OD and 20/40 in OS. The diagnosis of keratoconus was confirmed with Placido disk-based topography (Oculus Keratograph 4), and Pentacam HR corneal tomography (Oculus Optikgeräte GmbH, Wetzlar, Germany). Femtosecond laser-assisted intracorneal ring segment (ICRS) implantation was performed in the left eye and treatment for allergy was prescribed for both eyes, along with patient education and advice not to rub the eyes. After 3 months, significant improvement was observed on UDVA (20/30) and CDVA (20/20) in the left eye. Topometric and tomographic stability of ectasia was observed in the right eye in a 4-year follow-up.


Intracorneal ring segment caused significant regularization of the corneal shape and improvement on visual acuity. Ectasia stability was achieved with no need for CXL, despite the patient's young age. This case raises the point that the indication of CXL for every keratoconic patient should be reconsidered.

How to cite this article

de Oliveira Corrêa R, Canedo ALC, Beildeck R, Salomão MQ, de Politis PB, Ambrósio R Jr. Longterm Stability of Ectasia in a Young Patient with Asymmetric Keratoconus. Int J Kerat Ect Cor Dis 2015;4(2):66-68.

PDF Share
  1. Keratoconus. Surv Ophthalmol 1998 Jan-Feb; 42(4):297-319.
  2. Simplying ectasia screening with Pentacam corneal tomography. Highlights of Ophthalmology 2010; 38(3):12-20.
  3. Management of keratoconus: current scenario. Br J Ophthalmol 2011;95(8):1044-1050.
  4. Induction of cross-links in corneal tissue. Exp Eye Res 1998 Jan;66(1):97-103.
  5. Techniques for stiffening the cornea. J Refract Surg 1999;15:711-713.
  6. Stress-strain measurements of human and porcine cornea after riboflavin/ultraviolet-Ainduced cross-linking. J Refract Surg 2003;29:1780-1785.
  7. Riboflavin/ultraviolet- A-induced collagen cross-linking for the treatment of keratoconus. Am J Ophthalmol 2003;135:620-627.
  8. Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen. J Cataract Refract Surg 2006;32:837-845.
  9. Atopy and Keratoconus: a multivariate analysis. Br J Ophthalmol 2000;84:834-836.
  10. Eye rubbing can cause keratoconus. Cornea 2004;23:539-540.
  11. Biomechanical and histological changes after corneal cross-linking with and without epithelial debridement. J Cataract Refract Surg 2009;35: 540-546.
  12. Long-term followup of intacs in keratoconus. Am J Ophthalmol 2007 Feb;143(2):236-244.
  13. Two-year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus. Am J Ophthalmol 2012 Sep;154(3):520-526.
  14. Corneal cross-linking in teenagers. Presented at the cross-linking congress, Deer Valley, Utah, 2012 July 29.
  15. Complication and failure rates after corneal cross-linking. J Cataract Refract Surg 2009 Aug;35(8):1358-1362.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.