Stockton / Modesto / Merced LASIK Surgeon – Dr. Ash
Pellucid Marginal Degeneration

A 52 year-old female patient with history of very high astigmatism for years presented for evaluation. Her refraction prescription have remained challenging in that the physical production of workable glasses were difficult.

In the image above the anterior axial curvature from the ATLAS Corneal Topographer is presented in the top left corner. This map presents the classic "kissing bird beaks" or the "crab claw" pattern classic of the pellucid marginal degeneration. The anterior mean curvature is in the bottom left corner showing significant steepening of the inferior cornea. The anterior elevation assuming the best fit sphere is also presented in the top right showing a forward bulge 47 microns above the best fit sphere. All the above are directly obtained from the ATLAS corneal Topographer.

The Visante Anterior Segment OCT provides the Pachymetric Map in the top center showing a moderate thinning of the cornea in the inferior temporal position. The relative pachymetry map is derived from a comparison to "normal" population.

Visante omni 3.0 Link provides the posterior surface date on the bottom right map. The Posterior Elevation map assuming the best fit sphere shows a 78 micron forward bulge. These maps confirm the diagnosis of the pellucid marginal degeneration in a clinically obvious case.

In the same patient with an assumed best fit ellipsoid, one can clearly note that the pellucid marginal degeneration. The posterior bulge is even more pronounced at 86 microns. Additionally in this format of Holladay report, the map in the bottom left side, the anterior tangential curvature map replaced the anterior mean curvature.

08/23/09

Dr. Ash is a highly experienced Modesto / Stockton / Tracy LASIK and cataracts surgeon who treats all of his patients with the utmost dedication and attentiveness. This approach, combined with Dr. Ash's advanced surgical skill, attracts numerous Modesto, Merced, Tracy, Manteca and Stockton cataracts and LASIK patients every year.

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