analyze the outcomes of therapeutic photorefractive keratectomy combined with prophylactic accelerated cross-linking (PRK-Plus), for treatment of thin suspicious cornea

Inclusion Criteria:

1. CCT less than 490 microns

2. K mean more than 46 and/or K max more than 47.

3. Astigmatism cylinder >1.5 D.

4. D value of Belin/Ambrósio Module > 1.6

5. inferior- superior asymmetry or bow-tie pattern with skewed radial axes on tangential maps and abnormal changes on (BAD).

6. Asymmetry topography between 2 eyes, even if neither eye"s topographic pattern is in itself decidedly abnormal.

7. Any significant skewed radial axis with or without inferior steepening, or one diopter or more of inferior steepening in some areas but an I-S value of ,1.4,7.

8. young patients with against-the-rule astigmatic patterns.

9. a PTA value 40% if calculated.

10. Abnormal Topographic Patterns

11. K2 reading of corneal back surface less than [-7].

12. D Value of CSTP > 2.5 in Belin/Ambrósio curve

13. We look at values within the central 5 mm circle; the map should be displayed in the BFTE float mode with an estimated area of 8 mm of diameter:

    • Elevation values on the front surface values > +12 μ
    • Elevation values on the back surface values >+15 μ.
    • If there is any isolated island on either front or back surfaces (in the BFS float mode)

Exclusion Criteria:

1. Eyes diagnosed with KC.
2. CCT less than 450 microns