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We initially treated the patient with a conjunctival flap to prevent perforation. Three months later, we performed DALK to restore vision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Conjunctival flap surgery allowed us to avoid corneal perforation and penetrating keratoplasty (PK) \u00e0 chaud. Once the inflammation had resolved, we recessed the conjunctiva and performed DALK for optical purposes. Twelve months later, the graft was clear and the corrected visual acuity was 20\/25 (Snellen). No complications occurred after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although CXL is considered a safe procedure, in rare cases it can lead to serious complications, such as corneal haze, infectious and non-infectious keratitis, stromal melting and perforation. Corneal melting and perforation are usually managed by emergency PK. Herein we suggest a staged approach involving an emergency conjunctival flap followed by DALK at a later time that allowed us to avoid PK \u00e0 chaud.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12886-024-03400-1","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T05:01:59Z","timestamp":1711342919000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of corneal melting after collagen cross-linking for keratoconus: a case report and a review of the literature"],"prefix":"10.1186","volume":"24","author":[{"given":"Antonio","family":"Moramarco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"di Geronimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Gardini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Grendele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Fontana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"3400_CR1","doi-asserted-by":"crossref","unstructured":"Gomes JAP, Donald T, Rapuano C, Belin MW, Ambr\u00f2sio R, Guell JL, et al. 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This study was approved by the Institutional Review Board and performed in accordance with the tenets of Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s parents for the publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"131"}}