title: Simultaneous topography-guided PRK followed by corneal collagen cross-linking for keratoconus.
abstract: OBJECTIVE
  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 significantly 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.
authors.affiliation: Institute of Vision and Optics University of Crete, Greece. kymionis@med.uoc.fr
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Georgios A
authors.initials: GA
authors.lastname: Kontadakis
authors.forename: George A
authors.initials: GA
authors.lastname: Kounis
authors.forename: Dimitra M
authors.initials: DM
authors.lastname: Portaliou
authors.forename: Alexandra E
authors.initials: AE
authors.lastname: Karavitaki
authors.forename: Michael
authors.initials: M
authors.lastname: Magarakis
authors.forename: Sonia
authors.initials: S
authors.lastname: Yoo
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Pallikaris
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003315:Cornea / Q000503:physiopathology; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery / Q000628:therapy*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D010778:Photochemotherapy / Q000379:methods*; D018903:Photorefractive Keratectomy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin