Efficacy and Safety of Phototherapeutic Keratectomy and Corneal Collagen Cross-Linking Combined Therapy on Primary Keratoconus

Objective: To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) and corneal collagen cross-linking (CXL) combined therapy on primary keratoconus. Methods: In this prospective, self-controlled clinical study, 11 patients (11 eyes) underwent treatment with combined PTK and CXL. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, topography, corneal thickness, and endothelial cell density were evaluated preoperatively and at 12 months postoperatively. Data were analyzed using paired t-tests. Results: At 12 months postoperatively, UCVA, sphere, and spherical equivalent improved significantly (t=3.692, P=0.008; t=-1.397, P=0.039; t=-2.363, P=0.040 respectively). Maximum K-value (Kmax) and corneal thinnest thickness decreased significantly (t=2.941, P=0.007; t=3.839; P=0.003). There were no significant changes in endothelial cell density (t=-1.615, P=0.172). Conclusions: PTK and CXL combined therapy was effective and safe in the treatment of progressive primary keratoconus. Key words: phototherapeutic keratectomy; corneal collagen cross-linking; keratoconus