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    Corneal tomography or topography: When to make the clinical decision

    Tomography brings novel abilities, but classic imaging technologies aren't going anywhere



    Case reports

    Published case reports further illustrate the value of including tomography and biomechanical assessments for the diagnostic evaluation of patients in clinical practice.

    One such report described a case of unilateral ectasia identified in a patient who had been referred for treatment of keratoconus in his right eye.14 Unilaterality of the ectatic disease was confirmed by extensive diagnostic evaluation, including Placido disk-based corneal topography, Scheimpflug corneal tomography, ocular wavefront analysis, and corneal segmental tomography with epithelial thickness mapping by very high frequency digital ultrasound and spectral-domain OCT.

    “The patient admitted he was rubbing the right eye,” Dr. Ambrósio said. “We know ectasia can occur in any eye, but as we established in the global consensus, although keratoconus can be asymmetric, it is always bilateral.”

    Another report presented the case of a patient who developed post-LASIK ectasia despite being considered at low risk based on preoperative topographic evaluation.12 Findings from corneal tomographic and biomechanical measurements identified ectasia risk in the fellow unoperated eye.

    “The unoperated eye would be considered a good candidate for LASIK based on findings from standard screening methods, which included a normal front surface topography and central corneal thickness of 542 µm,” he said.

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