Purpose: To highlight two cases of keratoconus with significant variations of corneal curvature during pregnancy that reversed several months after delivery.

Methods: Case reports and literature review.

Results: Two women experienced a significant decrease of corrected distance visual acuity during pregnancy. Evaluation of corneal topography by Scheimpflug imaging revealed transitory variations of the keratometric values in both patients during the gestational period. These topographical alterations were evident not only during pregnancy, but also in the postpartum period, with stabilization of corneal topography several months after delivery.

Conclusions: These clinical cases indicate that hormonal changes occurring regularly during gestation may have a severe impact on the progression of keratoconus. However, these changes are transient and fully reversible. Therefore, physicians should be reluctant to perform cross-linking during or directly after pregnancy and should wait until the corneal curvature has been stabilized.