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Topographic patterns in refractive surgery candidates.

David Varssano1, Igor Kaiserman, Rossen Hazarbassanov

  • 1Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv University, Israel. varssano@tasmc.health.gov.il

Cornea
|July 17, 2004
PubMed
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Many refractive surgery candidates exhibit non-standard corneal topography, with over half showing patterns beyond simple spherical or spherocylindrical. This prevalence of irregular patterns, including suspected keratoconus, challenges standard screening and rejection criteria.

Area of Science:

  • Ophthalmology
  • Corneal topography
  • Refractive surgery

Background:

  • Corneal topography is crucial for refractive surgery screening.
  • Standard topographic patterns are assumed for suitability.
  • Prevalence of non-standard patterns requires evaluation.

Purpose of the Study:

  • Evaluate topographic pattern prevalence in refractive surgery candidates.
  • Estimate candidate rejection rates based solely on topography.
  • Analyze the diagnostic utility of topographic indices.

Main Methods:

  • Retrospective analysis of 100 refractive surgery candidates' videokeratographies.
  • Classification of corneal topographic patterns.
  • Evaluation of software-computed topographic indices.

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Main Results:

  • Over 50% of eyes displayed patterns other than spherical or spherocylindrical.
  • Lower steep patterns (43 eyes) and suspected/probable keratoconus (17 eyes) were common.
  • Topography alone led to rejection in 27 of 200 eyes; lower steep patterns also resulted in rejection.
  • Only the 'keratoconus index' differentiated between spherocylindrical and lower steep patterns.

Conclusions:

  • A significant portion of refractive surgery candidates have non-standard corneal topographies.
  • The continuum from normal to suspected keratoconus, including lower steep patterns, complicates surgical candidacy decisions.
  • Clearer guidelines are needed for managing borderline topographic findings in refractive surgery.