Abstract
To report cases of progressive keratoconus (KC) in patients aged ≥48years and the successful arrest of progression using corneal cross-linking (CXL) with riboflavin and ultraviolet-A light. Five eyes from four patients with progressive KC aged 48, 48, 51 and 54years are reported in this case series. All eyes were followed regularly after initial diagnosis. Kmax was used as an indicator of progression and KC progressed at a rate of 1.4 diopters in 6months and 14.6 diopters in 14months. All patients eventually received CXL, and all were aged ≥50years at the time of the procedure. One eye required two CXL procedures to successfully stabilize the patient's cornea. Despite the probability of KC progression strongly declining after the age of 40years, it never becomes zero. It is therefore advisable to continue regular follow-up corneal tomography examinations in patients with KC, even in their fifth and sixth decades of life.
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