Simultaneous topography-guided PRK followed by corneal collagen cross-linking for keratoconus

PURPOSE: To present the results after simultaneous photorefractive keratectomy (PRK) followed by corneal collagen cross-linking (CXL) for progressive keratoconus. METHODS: Twelve patients (14 eyes) with progressive keratoconus were prospectively treated with customized topography-guided PRK with the Pulzar Z1 (wavelength 213 nm, CustomVis) immediately followed by corneal collagen CXL with the use of riboflavin and ultraviolet A irradiation. RESULTS: Mean follow-up was 10.69±5.95 months (range: 3 to 16 months). Mean preoperative spherical equivalent refraction (SE) was -3.03±3.23 diopters (D) and defocus was 4.67±3.29 D; at last follow-up SE and defocus were statistically signifi cantly reduced to -1.29±2.05 D and 3.04±2.53 D, respectively (P<.01). Preoperative mean (logMAR) uncorrected visual acuity was 0.99±0.81 and best spectacle-corrected visual acuity was 0.21±0.19, which improved postoperatively to 0.16±0.15 and 0.11±0.15, respectively. The mean steepest keratometry was reduced from 48.20±3.40 D preoperatively to 45.13±1.80 D at last follow-up. CONCLUSIONS: Simultaneous PRK followed by CXL seems to be a promising treatment capable of offering functional vision in patients with keratoconus.