Related Experiment Video
Updated: May 30, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Simultaneous topography-guided photorefractive keratectomy followed by corneal collagen cross-linking for keratoconus
George D Kymionis1, Dimitra M Portaliou, George A Kounis
1Institute of Vision and Optics University of Crete, Medical School, Heraklion, Crete, Greece. kymionis@med.uoc.gr
Purpose:
To present the long-term results after simultaneous photorefractive keratectomy followed by corneal collagen cross-linking for keratoconus.
Design:
Prospective, interventional, consecutive case series.
Methods:
In this study, 26 patients (31 eyes) with progressive keratoconus were included. All patients underwent customized topography-guided photorefractive keratectomy immediately followed by corneal collagen cross-linking with the use of riboflavin and ultraviolet A irradiation. Epithelium was removed by transepithelial phototherapeutic keratectomy in all cases.
Results:
Mean follow-up was 19.53 ± 3.97 months (range, 12 to 25 months). Mean preoperative spherical equivalent was -2.3 ± 2.8 diopters (D), whereas at the last follow-up examination, it was significantly (P < .001) reduced to -1.08 ± 2.41 D. Logarithm of the minimal angle of resolution uncorrected and best-corrected visual acuity were reduced significantly by 0.46 and 0.084 (P < .001), respectively, at the last follow-up examination. Finally, mean steep and flat keratometry readings were reduced by 2.35 (P < .001) and 1.18 (P = .013) at the last follow-up examination.
Conclusions:
Simultaneous photorefractive keratectomy followed by corneal collagen cross-linking seems to be a promising treatment alternative in our series of keratoconic patients.
