Safety and Efficacy of Corneal Crosslinking Combined With Phototherapeutic Keratectomy With or Without Topography-Guided Photorefractive Keratectomy

PTK-CXL and TG-PRK plus CXL protocols are safe and effective both at arresting the disease progression and providing visual improvement. The latter brings further corneal flattening, greater visual improvement, and less corneal aberrations. For patients with progressive keratoconus with adequate corneal thickness, we recommend combined TG-PRK plus CXL, with the PTK-CXL protocol reserved for patients with better visual acuity or thinner corneas.