To evaluate outcomes of Corneal collagen crosslinking after implantation of a punched contact lens into stromal pocket in keratoconic patients with thin cornea.

This study is a prospective, consecutive case series. Seven eyes with progressive keratoconus entered the study. All the participants presented with reduced visual acuity, spectacle-corrected visual acuity less than 20/20, no corneal scar and thinnest corneal thickness less than 450 microns. After creation of an intrastromal corneal pocket at the depth of 300 microns and diameter of 9 milimeters using femtosecond laser a contact lens was punched with a 9mm corneal punch and was entered into the stromal pocket. Contact lens was explanted after standard 30 minute epithelium off crosslinking was performed. Visual acuity, refraction, specular microscopy and corneal topography were evaluated before operation and in each postoperative visit during one year follow-up period.

Uncorrected and corrected visual acuity, cylindrical refractive errors and endothelial cell count did not change during the one year follow up period. Spherical refraction and keratometery improved significantly after one year compared to preoperative values.

Corneal crosslinking can be performed after implantation of intrastromal contact lens in patients with thin cornea.