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    Thinking outside the cone: Over, above standard approach

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



    Figures 11 and 12 

    There are always cases in which surgeons should not maintain a low threshold to perform surgical acrobatics. Refraction is the most important driving force in the quest for emmetropia. This patient showcases that concept. This patient was referred to me after breakage of his Ferrara rings (Ferrara Ophthalmics); these rings had been implanted outside of the US. The refractive examination showed that, despite the appearance of the rings, the patient was still best corrected to emmetropia. Because the previous surgeon had done an excellent job, I opted to laser the cornea and correct the astigmatism to reach 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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