الفهرس 
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Abstract
The aim of this study was to evaluate and compare the outcome of simultaneous and successive corneal collagen cross linking (CXL) and Femtosecond laser assisted intrastromal corneal keraring segments in keratoconus.
Twenty patients were enrolled in this a prospective comparative interventional case series. The study was conducted in Minia university hospital and Roaa Laser Vision Correction Center from June 2015 to May 2016.
All patients had keratoconus grade I to III according to the Amsler-Krumeich classification with clear corneal center and Corneal thickness of at least 400 µm at the thinnest corneal point, and at least 450 µm at the incision site. Pediatric patients, patients with grade IV keratoconus, acute hydrops, keratometric readings greater than 65 Dioptre, history of herpetic keratitis, corneal dystrophies, opacities or scarring, autoimmune or systemic connective tissue disease were excluded. Patients with Any other ocular diseases such as cataract, glucoma, retinopathies,…. etc, corneal or intraocular surgeries, and one-eyed patients were also excluded.
The patients were equally divided into 2 groups: group A; underwent corneal cross linking (epithelium off) 2 months after Femtosecond laser assisted intrastromal corneal keraring segments , and group B; underwent simultaneous corneal cross linking (epithelium off) with Femtosecond laser assisted intrastromal corneal keraring segments. group A included 3 males and 3 females, and age ranged from 17 to 40 years. group B included 5 males and 3 females. Age ranged from 20 to 36 years.
Surgeries were performed between June 2015 and May 2016. Pentacam scan was done for all patients preoperatively, 3 and 6 months postoperatively.
Improvement of the visual outcome in each group was obvious regarding BSCVA, K readings (decreased, indicating corneal flattening) and spherical and cylindrical refractions.
We found a statistically insignificant differences (P value <0.05) between the 2 groups after 6 months regarding all data concerning with visual outcome (BSCVA, K readings (K1, K2, meanK), pachymetry and spherical and cylindrical refractions).