Topography-guided corneal surface laser ablation combined wi
Researchers aimed to study the outcomes of topography-guided customized excimer laser subepithelial ablation combined with accelerated CXL for progressive keratoconus.

31 eyes of 30 patients with progressive keratoconus were included in this prospective study. Topography-guided excimer laser ablation without refractive correction was performed. Simultaneous accelerated collagen cross-linking with ultraviolet light of 30 mW/cm2 for 4 min was followed. Uncorrected distance visual acuity (UCVA), manifest refraction, corrected distance visual acuity (CDVA), tomograghy were examined at postoperative 1, 6, and 12 months.

--UDVA improved slightly after surgery. BSCDVA improved significantly from 0.32±0.20 logMAR to 0.15±0.14 logMAR at postoperative 12 months.

--During 12-month follow-ups, there were no significant differences in manifest refraction and corneal keratometry except for maximal keratometry value of the anterior surface (Kapex), which decreased significantly from 57.23±5.09D to 53.13±4.47D.

--Even though the thinnest corneal thickness decreased from 465±24 microm to 414±35 microm, curvature asymmetry index front (SIf), keratoconus vertex front (KVf) and Baiocchi Calossi Versaci index front (BCVf) decreased significantly till postoperative 12 months.

--Corneal higher-order aberrations and coma also decreased significantly till 12 months after surgery.

It was concluded that topography-guided surface ablation without refractive correction paired with simultaneous rapid collagen cross-linking produced good stability in refraction and corneal curvature, as well as BSCDVA and corneal optical quality improvements.