A 30-year-old man with bilateral floppy eyelid syndrome (more prominent in the left eye) and progressive keratoconus had corneal collagen crosslinking (CXL) in both eyes. No intraoperative or early postoperative complications were found. Topographic examination after CXL revealed a continuous increase in the keratometric values in the left eye in which the floppy eyelid syndrome was more prominent, indicating keratoconus progression (CXL failure). The fellow eye with the less prominent floppy eyelid syndrome remained stable during the follow-up period. Floppy eyelid syndrome could be a risk factor for CXL failure.
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