Comparing outcomes of Tel-Aviv Protocol vs Athens Protocol in the treatment of progressive keratoconus
Bibliographic record
Abstract
PURPOSE: To compare outcomes of accelerated crosslinking combined with either epithelial photorefractive keratectomy (Tel-Aviv Protocol) or topography-guided photorefractive keratectomy (Athens Protocol) for keratoconus. SETTING: Bochner Eye Institute, Toronto, Canada, and Care Vision Laser Center, Tel Aviv, Israel. DESIGN: Multicenter retrospective comparative study. METHODS: Consecutive progressive keratoconus eyes treated with either Tel-Aviv or Athens Protocol were included. Preoperative and 1-year posttreatment uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalence (SEQ), astigmatism, maximal keratometry (Kmax), and minimal corneal thickness (MCT) were assessed. Propensity score matching (PSM) was used to adjust for differences in baseline characteristics. RESULTS: 35 eyes of 35 patients were treated with Tel-Aviv Protocol and 60 eyes of 60 patients with Athens Protocol. At baseline, the Tel-Aviv Protocol group was younger ( P = .03) and had worse UDVA ( P < .001), better CDVA ( P = .005), and lower MCT ( P < .001). At 1 year, both groups improved in UDVA, CDVA, astigmatism, and Kmax ( P < .05 for all). The Tel-Aviv Protocol group demonstrated significant improvement in SEQ ( P < .001). PSM revealed that Athens Protocol had a 1.84 D greater reduction in Kmax ( P = .02) and 19.44 μm greater MCT reduction ( P = .02) compared with Tel-Aviv Protocol ( P = .02). The Tel-Aviv Protocol group had 3.4-line greater improvement in UDVA ( P = .03) compared with Athens Protocol. CONCLUSIONS: Both protocols improve visual and topographic outcomes. Tel-Aviv Protocol provides better visual gains, and Athens Protocol offers greater corneal flattening. Tel-Aviv Protocol may be preferred in patients with thinner corneas due to its reduced stromal tissue ablation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".