{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:34:16Z","timestamp":1787236456499,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100005809","name":"Hyderabad Eye Research Foundation","doi-asserted-by":"publisher","award":["Intramural"],"award-info":[{"award-number":["Intramural"]}],"id":[{"id":"10.13039\/501100005809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,9]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Corneal endothelial toxicity leading to corneal oedema or endothelial decompensation is a potential concern after corneal collagen cross-linking, especially in patients with susceptible corneas, such as in cases of Fuchs endothelial corneal dystrophy (FECD). A 23-year-old patient diagnosed with keratoconus (KC) was noted to have early-onset FECD with central corneal endothelial guttae in both eyes. Since there was a documented progression, the patient was subjected to corneal collagen cross-linking (CXL) in both eyes. Postoperatively, KC was bilaterally stable post-CXL with no corneal oedema in the postoperative period and no corneal decompensation over a 3-year follow-up period. This case shows that CXL may be safely performed in patients with progressive KC and co-existent FECD when the stromal thickness permits. Our patient did not have corneal decompensation or accelerated loss of endothelial cells for 3 years following CXL.<\/jats:p>","DOI":"10.1136\/bcr-2026-274117","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:25:15Z","timestamp":1787232315000},"page":"e274117","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcome of collagen cross-linking (CXL) for progressive keratoconus with coexistent Fuchs endothelial corneal dystrophy"],"prefix":"10.1136","volume":"19","author":[{"given":"Neelima","family":"Balakrishnan","sequence":"first","affiliation":[{"name":"Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-951X","authenticated-orcid":false,"given":"Rashmi","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"2026082006251241000_19.8.e274117.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(02)02220-1"},{"key":"2026082006251241000_19.8.e274117.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(03)00343-2"},{"key":"2026082006251241000_19.8.e274117.3","doi-asserted-by":"publisher","DOI":"10.1159\/000074071"},{"key":"2026082006251241000_19.8.e274117.4","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1111\/aos.15654","article-title":"Phenotype and genotype of concurrent keratoconus and Fuchs endothelial corneal dystrophy","volume":"101","author":"Liu","year":"2023","journal-title":"Acta Ophthalmol"},{"key":"2026082006251241000_19.8.e274117.5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1159\/000505579","article-title":"Comorbidity of Keratoconus and Fuchs\u2019 Corneal Endothelial Dystrophy: A Review of the Literature","volume":"63","author":"Mylona","year":"2020","journal-title":"Ophthalmic Res"},{"key":"2026082006251241000_19.8.e274117.6","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1990.01070090095047"},{"key":"2026082006251241000_19.8.e274117.7","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10792-021-02019-1","article-title":"Adverse events after riboflavin\/UV-A corneal cross-linking: a literature review","volume":"42","author":"Serrao","year":"2022","journal-title":"Int Ophthalmol"},{"key":"2026082006251241000_19.8.e274117.8","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31820687f7"},{"key":"2026082006251241000_19.8.e274117.9","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31823cbeb1"},{"key":"2026082006251241000_19.8.e274117.10","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31826cf32d"},{"key":"2026082006251241000_19.8.e274117.11","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2024.102090","article-title":"Late-onset corneal edema after customized crosslinking for progressive keratoconus","volume":"35","author":"Vandevenne","year":"2024","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2026082006251241000_19.8.e274117.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2012.06.005"},{"key":"2026082006251241000_19.8.e274117.13","doi-asserted-by":"crossref","DOI":"10.1097\/00003226-199010000-00006","article-title":"Keratoconus Associated with Corneal Endothelial Dystrophy","volume":"9","author":"Orlin","year":"1990","journal-title":"Cornea"},{"key":"2026082006251241000_19.8.e274117.14","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1097\/00003226-200111000-00021","article-title":"Anterior keratoconus associated with unilateral cornea guttata","volume":"20","author":"Darlington","year":"2001","journal-title":"Cornea"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-274117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:25:17Z","timestamp":1787232317000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-274117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":14,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,20]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-274117"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-274117","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}