Fig. 1.

Surgical algorithm for management of keratoconus. *Age<25 years should be considered as progressive keratoconus. ** Rigid gas permeable (RGP) lenses should be considered in any case if tolerant. *** Photorefractive keratectomy (PRK) is only recommended for age>25 years and in conjunction with corneal cross-linking (CXL). BCVA: Best corrected visual acuity, CCT: Central corneal thickness, RSB: Residual stromal bed, KR: Keratometry reading, D: Diopter, CXL: Cross-linking, PRK: Photorefractive keratectomy, DALK: Deep anterior lamellar keratoplasty, PK: Penetrating keratoplasty.