Abstract: Keratoconus is a chronic progressive disease without inflammation. It is characterized by the gradual thinning and slow expansion of normal cornea into a cone. Corneal collagen crosslinking has become an important treatment and one of the effective methods to prevent the progress of keratoconus by improving the biomechanical properties of cornea. 400 μm corneal thickness limits many ultra-thin keratoconus from the corneal cross-linking treatment. In view of the good therapeutic effect of corneal crosslinking on corneal dilation diseases, many scholars have tried various new treatment schemes on the basis of the original standard scheme in recent years. For example, the improvement of surgical methods such as transepithelial and epithelial island preservation, the use of low permeability riboflavin, corneal contact lens and lens removed from small incision lenticule extraction to increase the total corneal thickness, and personalized adjustment of intraoperative energy use, personalized adjustment of intraoperative energy use and other improved treatment methods. These technologies are designed to break through the 400 μm limitation of corneal cross-linking surgery, so as to achieve safe and effective corneal cross-linking treatment for ultra-thin keratoconus. (Int Rev Ophthalmol, 2022, 46: 242-246)

Key words: keratoconus, ultra-thin cornea, corneal dilation, corneal collagen crosslinking