conclusion: surprisingly, standard CXL showed close results to CXL-plus at the 24 th follow-up month. Standard CXL acted as a stabilizing procedure associated with a late myopic component reduction. CXL-plus acted as a refractive and stabilizing procedure with an early effect on both the myopic and the astigmatic component but no later improvement. Standard CXL seems to be more powerful than AXL in its long-term effect. Therefore, in the future, we want to test the combination of PRK with standard CXL.