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This Cornea and Refractive Surgery……

Q:

Are there corneal thicknesses below which you would avoid any refractive surgery?

I am considering PRK on this 34 y/o woman. Stable refraction for years. No family history of corneal disease

MR:
-3.00 -1.00 x 180
-3.00 -1.00 x 180

Pachymetry:
460
470

A:

before 2005 or so we mostly worried about RSB, like if they had a RSB over 250 the chance of ectasia would be low

past 2005 (approx) reports started to come out of iatrogenic KC with RSBs well over 250, some even in the 300s
but in cases where STARTING PACHY was low, ie below 500
now i won’t perform a case if LOWEST STARTING PACHY is below 475 ANYWHERE, as i had a case like the above:(
admittedly, there is no firm cut-off #, the 475 is as arbitrary as the 250–but it does help, and you need to use something
hope this helps;)

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