Abstract:AIM: To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal crosslinking. METHODS: This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal crosslinking. The choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d, 1, and 3mo. Choroidal thickness in the four cardinal quadrants and the fovea were evaluated. The choroidal vascularity index was also calculated. RESULTS: There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d, 1mo (P>0.05). There was a significant increase in the 3mo (P=0.034) and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d (P=0.014), there was no statistically significant change in vertical axes and other visits in horizontal sections (P>0.05). CONCLUSION: This study sheds light on choroidal changes in postoperative corneal crosslinking for keratoconus. While it suggests the procedure’s relative safety for submacular choroid, more extensive research is necessary to confirm these findings and their clinical significance.