Alió et al. 16 as a visual limitation-based KC classification.Recently, Belin and Duncan 18 proposed the ABCD system, which incorporates anterior/posterior corneal curvature data, thinnest point (TP) on pachymetry, and corrected distance visual acuity (CDVA) for progression follow-up in eyes with KC.The ABCD system has been also integrated into the Pentacam HR