Which combination of procedures would be your best choice to provide vision improvement in patients with progressive keratoconus?

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Cross-linking combined with excimer laser partial PRK may offer stable, reliable, improved visual rehabilitation, in addition to potentially increased biomechanical strengthening.
We have shown that same-session partial topo-guided PRK with CXL is more effective than sequential PRK after earlier CXL in a large comparative case series. The refractive effects of the combined, same-day treatment were impressive: The majority of patients obtained a corrected distance visual acuity of 20/40.
This procedure, known today as the Athens protocol,

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