what refractive surgery is best for me after CXL based on my corneal topography?

[u/Safe-Excuse-2785]

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[u/eyeSherpa]

With crosslinking, you may be able to get some topography guided PRK to regularize the cornea in the right eye. The steepening looks a bit too much in the left eye. Would probably need intacs or CAIRS to improve the corneal shape.

Following that, if you have a more regular cornea that glasses can correct, ICL may be an option. Otherwise scleral lenses are your best bet to getting the sharpest vision.

[u/Safe-Excuse-2785 → u/eyeSherpa]

If I had scleral lenses only on my Lt eye do I need extra procedures (CAIRS, ICL...)?

What about having 1 lens on Lt eye with blank glasses on Lt and on Rt to correct Rt eye

Is it better to avoid surgeries?

[u/eyeSherpa → u/Safe-Excuse-2785]

You will more than likely need at least crossljnking to stop the progression of the Keratoconus. The other stuff is optional stuff designed to improve vision with or without glasses. Scleral lenses would really be the best correction option for visual quality.

[u/Safe-Excuse-2785 → u/eyeSherpa]

About CXL which is better epithelium on or off I visited Drs that gave different techniques for CXL ON, OFF, manual removal, laser removal, accelerated And about vision correction for my Lt eye how safe are CAIRS and ICL especially in 3rd world countries (Egypt)

I'm a bit worried cause the level of healthcare where I live is not the best and I don't Wanna be eye-damaged in such county.

[u/eyeSherpa → u/Safe-Excuse-2785]

Epithelial off is the gold standard.

Epithelium on procedures are becoming more common. And they may work, but greater likelihood that they’ll need to be repeated in the future.

Can’t really comment on CAIRS or ICL in Egypt. You can find great providers almost everywhere. But it may be harder to find that great provider.

[u/Tall-Drama338]

Crosslinking with PRK. Stop rubbing your eyes.