2025/11/25 by Knezović, Igor, Jovanović, Nina, Djurić, Sara
Medicine · #Athens protocol #Corneal surgery and disorders #DISC protocol #Glaucoma and retinal disorders #Medicine and health #Ophthalmology and Visual Impairment Studies #PRK #corneal cross-linking #keratoconus #topo-guided
paper · doi:10.3205/oc000261
openalex publication_date 2025/11/25 · openalex created_date 2025/11/27 · openalex updated_date 2026/07/01
Purpose: To present the results of two different surgical procedures, decentered individualized sphero-cylindrical protocol (DISC protocol) and Athens protocol, performed on a 34-year-old patient after being diagnosed with keratoconus in both eyes. Observation: CXL (CSO VEGA CMB X Linker, Florence, Italy) application. 36 months postoperative uncorrected visual acuity (UCVA) of the left eye remained the same as preoperatively, while the best corrected visual acuity (BCVA) was -3.5 Dsph=20/30. In the right eye, UCVA and BCVA were both 20/22. Results of Fourier's analysis of the right eye imply a 52% decrease in corneal irregularity, while in the left eye, corneal irregularity decreased by 12.8%. Values of spheric aberration in Zernike analysis 36 months postoperatively showed a lower increase in Athens protocol than DISC protocol. The index of vertical asymmetry and the index of surface variance showed lower values in both procedures during the whole postoperative period, while the index of height decentration showed a more significant decline in Athens protocol 36 months postoperatively. Conclusion and importance: DISC protocol is a novel approach, with the potential to become a promising strategy for slowing the progression of keratoconus and recovering uncorrected visual abilities.