Tailored stromal expansion with a refractive lenticule for crosslinking the ultrathin cornea.

We describe a technique for stromal expansion of thin and ultrathin corneas in keratoconus patients that uses refractive stromal lenticules of patients having small-incision lenticule extraction for myopic correction. The stromal lenticule is placed and spread over the host cornea following epithelial debridement so the thickest area of the 6.2 mm diameter lenticule corresponds to the thinnest area of the cone. The remaining collagen crosslinking (CXL) procedure is carried out in a routine manner. We believe tailored stromal expansion is a safe and effective technique for performing CXL in patients with thin corneas.