Short-term bilateral keratoconus progression after deep anterior lamellar keratoplasty in one eye and intracorneal ring segments and corneal crosslinking in the other due to eye rubbing

A 15-year-old boy had deep anterior lamellar keratoplasty in the right eye and intracorneal ring segments/corneal crosslinking in the left eye for the treatment of progressive keratoconus due to eye rubbing. He achieved a good surgical results, and 6 months later, the uncorrected distance visual acuity (UDVA) was 0.30 logarithm of the minimum angle of resolution (logMAR) in each eye, the refraction in the right eye was plano-2.75 × 135 = 0.30 logMAR and in the left eye was-0.75-2.50 × 45 = 0.18 logMAR. Twelve months postoperatively, there was recurrence of intense eye rubbing. UDVA dropped, and bilateral corneal steepening was noted. Bilateral corneal crosslinking was performed along with an allergist consultation for eye rubbing control. Ten years later, his UDVA was 1.3 logMAR and 0.40 logMAR and corrected distance visual acuity was 0.10 logMAR and 0.18 logMAR in the right and left eyes, respectively.