Corneal tomography under general anesthesia in the lateral decubitus position

Corneal tomography, a common in-office procedure, is essential for assessing keratoconus, planning refractive surgeries, and diagnosing corneal and ocular surface conditions. However, it can be challenging to perform on young children and individuals with intellectual and developmental disabilities (IDD) on account of poor cooperation during image acquisition. We present a novel technique for conducting corneal tomography under general anesthesia in the lateral decubitus position using the Pentacam system. Following induction of anesthesia in the supine position, the patient is transitioned to a lateral decubitus position with their eyes aligned with the Pentacam apparatus. Our procedure, performed without complications, has been successfully implemented in 22 eyes of 13 patients with IDD. Of these, 5 eyes were diagnosed with keratoconus and subsequently underwent collagen cross-linking. This approach not only addresses the challenges posed by patients with IDD but also underscores the adaptability of existing technology in accommodating diverse patient populations.