Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking

Gitansha Shreyas Sachdev, Shreyas Ramamurthy, Ramamurthy Dandapani Refractive Services, The Eye Foundation, Coimbatore, India Purpose: To assess the safety, efficacy, and refractive predictability of half-fluence accelerated corneal collagen crosslinking (CXL) applied concurrently with photorefractive keratectomy (PRK), and compare the results to standard PRK.Setting: Refractive Services, The Eye Foundation, Coimbatore, India.Design: Interventional comparative case series.Methods: Patients seeking refractive correction for myopia or myopic astigmatism were included in the study. Photorefractive keratectomy with concurrent half-fluence crosslinking (PRK Xtra) was performed in eyes with borderline suspicious tomography (not amounting to forme fruste keratoconus) or low pachymetry between 450 and 474 µm with an otherwise unremarkable corneal tomography. Eyes with normal corneal tomography and thickness between 475 and 500 µm underwent standard PRK. The minimum follow-up period was 1 year. Results: In total, 109 eyes underwent PRK Xtra (Group A) and 118 eyes underwent PRK alone (Group B). The preoperative MRSE was −3.64 D and −3.38 D in Groups A and B, respectively (P=0.28). Group A had a significantly higher number of eyes with thinner corneas (P