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    Thinking outside the cone: Over, above standard approach

    Scenarios of keratoconus, management highlight ways to devise treatment ‘recipes’


    Figure 4

    The Intacs can be used directionally to decrease the astigmatism. In this patient, the astigmatism is reduced from a preoperative value of 7.4 to 0.6 D, with a resultant immediate improvement in the vision. There is also the potential for more visual improvement later if laser ASA needs to be performed.

    Figure 5


    Intacs segments can be implanted not only to decrease the keratometry values to a more normal range but also can be followed by laser ASA surgery to bring the eye to emmetropia.

    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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