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17 Holladay Report & Holladay EKR65 Detail Report
17.5 Case 3: Holladay Report & Holladay EKR65 Detail Report
of a post LASIK exam
Figure 163: Holladay Report of a post LASIK exam
The mean value of the color scale (green) is 39.0 D, which is 4.5 D flatter than normal, and the semi-
meridian lines are extremely segmented, demonstrating a large amount of irregular astigmatism. The
EKR65 mean is 35.63 D, which is ~ 8 D flatter than normal
(Figure
163). The corneal thickness map
shows that the TP, pupillary center and vertex normal are almost coincident and at the center of
the almost circular color rings. The RP map is also circular, 35.8% thinner than normal at the center
and gradually returning to normal (green) at the 6 mm diameter. The center has a front elevation
(front) is -8 μm at the center and on the elevation (back) is + 14 μm. This elevation on the back is
suggestive of ectasia.
The steepened radius on the back surface of the cornea from the ectasia results in a 63.7% radii
ratio (back/front) and results in the program determining the estimated refractive change to have
been -11.4 D, with a pre-op mean K = 49.1 D. The actual measured pre-op K mean before surgery
was 45.5 D, and the actual refractive change was -7.8 D. The ectasia has thus caused the program to
overestimate the change. In normal refractive surgery the estimated refractive change and estimated
pre-op mean K are much more accurate.
135
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