PURPOSE To compare 1-year visual and tomographic outcomes of topography-guided photorefractive keratectomy (TGPRK) and topography-assisted phototherapeutic keratectomy (TPTK) with corneal cross-linking (CXL). METHODS TGPRK and TPTK were performed in 72 eyes (68 patients) and 74 eyes (71 patients), respectively. Based on the TGPRK ablation plan, the eyes underwent TPTK where the theoretical minimum corneal thickness (MCT) after surgery was less than 400 µm. In the TGPRK group, the theoretical maximum ablation depth was 50 µm after epithelium removal. In TPTK, a decentered single-step PTK was performed only in the steepest anterior curvature zone and the stromal ablation depth was limited to 25 µm. After ablation, accelerated CXL was performed in the central 8-mm zone (9 mW/cm2 for 10 minutes in "epithelium-off" mode) in both TGPRK and TPTK. The visual acuity and tomography were assessed. RESULTS Improvement in uncorrected (P = .73) and corrected (P = .66) distance visual acuity was similar between the two groups. However, TGPRK eyes had a greater decrease in keratometry, anterior defocus, and spherical aberration (P < .001) at the cost of greater ablation of tissue (P < .001). The median MCT decreased by 27 and 52.5 µm in the TPTK and TGPRK eyes, respectively. Both groups had similar decreases in anterior root mean square of lower (P = .10) and higher (P = .12) order aberrations. CONCLUSIONS Both TGPRK and TPTK improved visual acuity in the keratoconic eyes at 1 year of follow-up. However, TPTK removed less volume of tissue. Further, it could be an alternative to TGPRK if the theoretical stromal ablation exceeds 50 µm in thin keratoconic corneas. [J Refract Surg. 2021;37(8):562-569.].

中文翻译：

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同时地形引导的 PRK/CXL 与地形辅助的 PTK/CXL：圆锥角膜的 1 年预期结果。

目的 比较地形引导光屈光性角膜切除术 (TGPRK) 和地形辅助光治疗性角膜切除术 (TPTK) 与角膜交联 (CXL) 的 1 年视觉和断层扫描结果。方法TGPRK和TPTK分别在72眼（68例）和74眼（71例）中进行。根据 TGPRK 消融计划，眼睛接受了 TPTK，其中手术后的理论最小角膜厚度 (MCT) 小于 400 µm。在 TGPRK 组中，去除上皮后的理论最大消融深度为 50 µm。在 TPTK 中，偏心单步 PTK 仅在最陡峭的前曲率区进行，基质消融深度限制为 25 µm。消融后，在中央 8 毫米区域进行加速 CXL（在“上皮关闭”中 9 mW/cm2 持续 10 分钟）模式）在 TGPRK 和 TPTK 中。评估视力和断层扫描。结果 未矫正 (P = .73) 和矫正 (P = .66) 远距离视力的改善在两组之间相似。然而，TGPRK 眼在角膜曲率、前离焦和球面像差方面有更大的下降 (P < .001)，但代价是组织消融更大 (P < .001)。TPTK 和 TGPRK 眼的中值 MCT 分别降低了 27 和 52.5 µm。两组在较低 (P = .10) 和较高 (P = .12) 阶像差的前均方根方面都有相似的下降。结论 TGPRK 和 TPTK 在随访 1 年时都改善了圆锥角膜的视力。然而，TPTK 去除的组织体积较小。此外，如果在薄的圆锥角膜中理论基质消融超过 50 µm，它可能是 TGPRK 的替代方案。[J 屈光手术。2021;37(8):562-569.]。