Both progressive keratoconus treated with either transepithelial phototherapeutic keratectomy (PTK) and topography-guided photorefractive keratectomy (TG-PRK) are safe and effective for treating progressive keratoconus, but TG-PRK-CXL offers greater visual improvement, more corneal flattening, and better correction of aberrations, according to a study.
Researchers analyzed 120 eyes over a follow-up period ranging from 1 to 3 years. Both groups experienced improved corrected distance visual acuity, but the TG-PRK group showed greater visual gains and more significant corneal flattening. In addition, spherical aberration and coma improvements were observed only in the TG-PRK group.
For patients with progressive keratoconus with adequate corneal thickness, the researchers recommend combined TG-PRK plus CXL, with the PTK-CXL protocol reserved for patients with better visual acuity or thinner corneas.
Reference
Gil P, Gil JQ, Dias M, et al. Safety and Efficacy of Corneal Crosslinking Combined With Phototherapeutic Keratectomy With or Without Topography-Guided Photorefractive Keratectomy. Cornea. 2025;doi: 10.1097/ICO.0000000000003921. Epub ahead of print. PMID: 40492632.
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