In the article below, Raymond Stein, MD, discusses the importance of testing patients for keratoconus prior to their LASIK surgery. As a member of the distinguished Bochner Eye Institute team, Dr. Raymond Stein works closely with his colleagues to help ensure the highest levels of patient safety and satisfaction.
Keratoconus is a well-recognized contraindication to LASIK. The creation of a corneal flap and removal of tissue by an excimer laser can weaken the cornea. This can lead to corneal instability with progressive ectasia. Although there are a variety of clinical signs of keratoconus, the use of computerized topography usually detects the earliest stage of keratoconus. The most advanced topography units measure both curvature and elevation. At Bochner, the Pentacam is our unit of choice.
We typically make the diagnosis of keratoconus when one or more indications are present:
1. Inferior steepening of greater than 1.5 Diopters compared to superior cornea.
2. Elevation of the posterior cornea of greater than 17 microns compared to a best-fit sphere.
3. Elevation of the anterior cornea of greater than 21 microns compared to a best-fit sphere.
4. Central steepening of greater than 49 Diopters.
5. Steepest corneal location associated with thinning of less than 500 microns.
6. Advanced clinical signs include Vogt’s striae and apical scarring.
In addition to the clinical findings above, we are reluctant to perform LASIK if there is an immediate family history of keratoconus.
Careful preoperative evaluation prior to laser vision correction can greatly reduce the risk of corneal ectasia.
To learn more about the Bochner Eye Institute and Raymond Stein, please call 416-960-2020 or visit www.bochner.com.
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