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    Keratoconus: Thinking outside the cone

    Cases highlight various scenarios ranging from highly complex to simple


    Case Scenarios

    Fgure 1. This is the case of a 40-year-old man who was referred to me following CXL performed twice by two different surgeons and implantable collamer lens (ICL) surgery by a third surgeon in his keratoconic eye. The patient was left with hyperopic astigmatism. 

    On reviewing his options, I reiterated to him that all three of his surgeons had done an excellent job and actually made it easy for me to take him to his end zone.

    I performed laser ASA surgery to bring him to emmetropia and unaided 20/20 vision. (Surgeons involved in this case included 

    Collaborating surgeons in this case included William B. Trattler, MD, Center for Excellence in Eye Care, Miami; Brian Boxer Wachler, MD, Boxer Wachler Institute, Los Angeles, and Raymond Stein, MD, Bochner Eye Institute, Toronto.)

    This case also underscores the fact that the number of surgeries a patient has had in the past is immaterial and should not be a roadblock in the unrelenting quest for emmetropia.

    Case 2

    Arun C. Gulani, MD
    Dr. Gulani is director of refractive surgery and chief, cornea & external disease, as well as assistant professor, department of ...

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