Photorefractive keratectomy with collagen cross-linking in grade 2 progressive keratoconus

A 24-year-old male with slowly progressing vision loss over six months came to our hospital. On clinical evaluation, his unaided visual acuity was 3/60, which improved to 6/60 with spherocylindrical correction. His lenticular status and posterior segment were within normal limits. On Pentacam evaluation, there was gross evidence of keratoconus. Over the next two months, his Pentacam scan showed a progressive increase in keratoconic parameters. Hence, he was scheduled for topography-guided photorefractive keratectomy (PRK) with full-threshold collagen cross-linking (CXL). After PRK with CXL, the inferior cone was obliterated, providing a stable corneal surface. His unaided visual acuity at three and six months was 6/12 and 6/9p, respectively. His visual acuity remained at 6/9p at the end of 2 years.