Corneal Topographic and Pachymetric Screening of Keratorefractive Patients

PURPOSE: To review the incidence of corneal abnormalities detected in the preoperative examination, using videokeratography and pachymetry that excluded patients from laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). METHODS: We conducted a chart review of consecutive patients who had a preoperative examination and were excluded from refractive surgery. RESULTS: Eighteen patients from 1,392 refractive candidates (1.3%) were designated as poor candidates for LASIK or PRK based on corneal topography and/or pachymetry. Thirteen patients (0.9%) were identified as having keratoconus suspect, keratoconus, or pellucid marginal degeneration. Five patients (0.4%) were excluded due to thin corneas (<490 microm) despite normal corneal topography. CONCLUSIONS: Corneal topography and pachymetry are indispensable tools in the preoperative screening of refractive surgery candidates.