Case 3 - Refractive

Modesto / Stockton / Merced Laser Eye Surgery Specialist – Dr. Ash
Case Study

23 year old male seeking laser eye surgery in Modesto. Patient has had poor vision for years with little change in the prescription.

OD -5.50 - 2.25 x 005 --> 20/25
OS Plano -4.50 x 175 --> 20/25

Ultrasound Pachymetry:
OD 563 sd 5.3
OS 560 sd 2.7

Here is a case of a younger individual (23) with a large anisometropia that has been stable a number of years. K's as seen on the topo are 42.50 and 44.75 in the right eye and 40.75 and 45.00 in the left eye – relatively flat. The central corneal ultrasound pachymetry is decent (560's)

What would you do?
a) No surgery / Wait
b) PRK
c) Blade LASIK
d) FemtoSecond LASIK

Do you need more information? On the Visante omni, I did the global pachymetric maps and merged them with the ATLAS topographies to create the Holladay report and the posterior elevation maps of the cornea.

As you can see in the Holladay reports above, the anterior axial curvature is in the top left corner. That gets merged with the top center pachymetric map from the Visante to create the bottom right corner posterior elevation map. The posterior elevation maps are fitted to the best ellipsoid. As seen, both the right and left eye demonstrate a perfectly normal posterior elevation map.

Patient underwent an IntraLase LASIK surgery (100 micron flaps). What would you have done? Email me at

In addition to performing sophisticated laser eye surgery procedures, Dr. Ash specializes in cataract surgery with premium IOLs. Over the course of his distinguished career, he has helped many cataract surgery Stockton / Modesto patients achieve their best possible vision.

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