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Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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Long-term comparison of simultaneous topography-guided photorefractive keratectomy followed by corneal cross-linking vs corneal cross-linking alone

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Session Details

Session Title: Cross-Linking Protocols

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 14:00

Venue: Room A3, Podium 3

First Author: : V.Kankariya INDIA

Co Author(s): :    G. Kontadakis   G. Kymionis   I. Pallikaris   A. Plaka           

Abstract Details


To compare the results of corneal collagen cross-linking (CXL) alone with combined simultaneous topography-guided photorefractive keratectomy plus CXL (tPRK-CXL) for progressive keratoconus for a 3-year interval.


University Of Crete


DESIGN: Prospective, comparative interventional case series. PARTICIPANTS: Forty-eight patients (60 eyes) with progressive keratoconus.


Thirty eyes underwent combined tPRK with a solid-state laser (maximum ablation depth, 50 μm) followed by CXL, and 30 eyes underwent CXL alone. Groups were matched in terms of age and keratoconus stage. MAIN OUTCOME MEASURES: Corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), keratometry, and corneal confocal microscopy.


Pre-op CDVA in the tPRK-CXL group was 0.26±0.17 logMAR, and in the CXL group was 0.24±0.18. At last follow-up, CDVA was 0.09±0.10 logMAR in the tPRK-CXL and 0.15±0.12 logMAR in the CXL (P < 0.05). 19 eyes and 8 eyes in the tPRK-CXL group and in the CXL group, respectively, gained 2 or more lines of CDVA. Pre-op, UDVA was 0.83±0.54 logMAR in the tPRK-CXL and 0.86±0.62 logMAR in the CXL group (P = 0.79). At last follow-up, UDVA was 0.27±0.25 logMAR in the tPRK-CXL group and 0.69±0.58 logMAR in the CXL (P < 0.001).



Simultaneous tPRK followed by CXL in this series of keratoconus patients offered significantly improved vision to treated patients in comparison with CXL alone, and similar results regarding postoperative stability. Safety concerns regarding corneal thickness were taken into account in treatment planning.

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