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    Why single-instrument screening for keratoconus remains a dream


    “The final message is that you cannot rely solely on machine-based metrics at this time,” Dr. Randleman said. “The goal is to transform the subjective nature of screening into an objective evaluation, but we’re not there yet. When you are screening for refractive surgery, until we have one metric that is fully reliable, you still have to err on the side of caution. When we see patients who are not good candidates for LASIK, we need to be extremely cautious.”

    Patients with any identifiable predisposition for keratoconus should not have surgery in either eye, Dr. Randleman said.

    “We know what full blown keratoconus looks like, but the subtler forms are the ones that make screening challenging,” he said. “That is why we are looking at these highly asymmetric patients—we want to see what metrics we can apply for screening in those eyes to other patients with no obvious findings in either eye.” 


    This article was adapted from Dr. Randleman’s presentation at the 2016 American Society of Cataract and Refractive Surgery Symposium & Congress.

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