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Prof. Dr. Efekan Coşkunseven

keratoconus

Keratoconus Athens Protocol

The Athens Protocol involves performing topography-guided laser (PRK) and cross-linking (CXL) in the same session for keratoconus treatment. It both corrects the cornea and halts the progression of the disease.

keratoconus
Prof. Dr. Efekan Coşkunseven

Prof. Dr. Efekan Coşkunseven

Ophthalmology · Istanbul

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The Athens Protocol is a combined keratoconus treatment that corrects the corneal surface with topography-guided laser and strengthens the corneal structure with cross-linking (CXL) in the same session. It reduces irregular astigmatism and halts progression.

Contents5 sections
  1. 01 What Is the Athens Protocol?
  2. 02 What Does It Do?
  3. 03 Who Is It Suitable For?
  4. 04 Procedure Process
  5. 05 Results

What Is the Athens Protocol?

The Athens Protocol involves performing topography-guided laser (PRK) together with cross-linking in the same session for the treatment of keratoconus. This method is a combined approach aimed at halting the progression of the disease and correcting the corneal surface.

What Does It Do?

The procedure takes place in two stages:

  1. Topography-guided laser: Surface correction is performed according to the corneal map, reducing irregular astigmatism.
  2. Cross-Linking (CXL): The corneal structure is strengthened with UV-A light, halting progression.

As a result, it both corrects the cornea and halts the progression of the disease.

Who Is It Suitable For?

  • Early and moderate-stage keratoconus (Stage 1–2, selected Stage 3)
  • Patients with sufficient corneal thickness
  • Patients with high irregular astigmatism
  • Patients who cannot see clearly with glasses

Procedure Process

The procedure takes approximately 45–60 minutes:

  • Removal of the epithelial layer
  • Application of topography-guided laser
  • Instillation of riboflavin drops
  • UV-A light (approximately 30 minutes)
  • Fitting of a bandage contact lens

Results

Within the first 3–6 months:

  • Irregular astigmatism decreases
  • Night vision improves
  • Double/shadowed vision decreases significantly
  • Glasses prescription may decrease
  • An improvement of at least 1–3 lines of vision may be observed

The results of any surgical or invasive procedure may vary from person to person.

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Frequently Asked Questions

Short answers to the questions patients ask most about this treatment. Your personal situation is assessed during the examination.

  1. 01 Who is the Athens Protocol suitable for?

    It is suitable for early and moderate-stage keratoconus (Stage 1–2, selected Stage 3), patients with sufficient corneal thickness, those with high irregular astigmatism, and patients who cannot see clearly with glasses.

  2. 02 How is the procedure performed?

    The epithelial layer is removed, topography-guided laser is applied, riboflavin drops are instilled, and UV-A light is administered for approximately 30 minutes; a bandage contact lens is then fitted. The procedure takes approximately 45–60 minutes.

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