Through this interesting case from our daily office evaluations here a 47-year-old male who has undergone a cornea transplant for keratoconus in his left eye about 20 years ago, we will discuss with the help of Pentacam corneal Tomography as well as anterior segment OCT thickness and epithelial maps the treatment options for both the eye with untreated keratoconus: no vision change from a dim 20/100 CDVA, apparent progression in pentacam and the left eye that has a good cornea transplant 20 years now with very significant astigmatism intolerance to contact lens use and CDVA 20/200
poor visual rehabilitation currently negates action: we will reccend to start with a therapeutic PTK forbthe high cylinder in the OS and maybe later Athens Protocol CXL in the OS
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