case_images: PMC9022154_01
case_images: Optical coherence tomography (OCT) of the macula: right eye (OD) - normal macular contour; left eye (OS) - epiretinal membrane with traction on the foveal contour and lamellar macular hole
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case_images: F1
case_images: Optical coherence tomography (OCT) of the macula showed the presence of an epiretinal membrane with traction on the foveal contour and lamellar macular hole in the left eye (Fig. 1).
case_images: Epiretinal membrane with traction on the foveal contour and lamellar macular hole before (left image) and after (right image) surgery
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case_images: F2
case_images: The patient underwent posterior vitrectomy, epiretinal membrane peeling and internal gas tamponade with SF6 in the left eye with good anatomical and functional postoperative results, with 20/ 25 (0.1 logMAR) vision without correction (Fig. 2).
case_images: Left column - The keratometric cylinder measured on the auto ref/ kerato/ tono/ pachymeter Tonoref III (Nidek Co., Ltd.); Right column - Optical coherence biometry measured on the Aladdin HW3.0 biometer (Topcon)
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case_images: F3
case_images: Tonoref III (Nidek Co., Ltd., Japan) varied from -01.50 cylindric diopters to -03.75 cylindric diopters (Fig. 3). This also showed variability of the keratometry (Fig. 3), which led to further investigations. The built-in placido disc topography system of the Aladdin biometer showed a topography suggesting corneal ectasia in the inferior half of the cornea on some measurements (Fig. 4).
case_images: Variability of placido disc topography maps
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case_images: F4
case_images: This also showed variability of the keratometry (Fig. 3), which led to further investigations. The built-in placido disc topography system of the Aladdin biometer showed a topography suggesting corneal ectasia in the inferior half of the cornea on some measurements (Fig. 4).
case_images: Irregularities of the rings projected on to the cornea during placido disc topography
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case_images: F5
case_images: However, the rings projected on the cornea were irregular in an unorganized matter, which led to the suspicion of ocular surface disease (Fig. 5).
case_images: Scheimpflug topography
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case_images: F6
case_images: Topographic measurements were repeated after treatment with a Scheimpflug topographer (Pentacam HR, Oculus, Inc., U.S.A), that showed a difference in keratometric values (Fig. 6).
case_images: Refractometric and keratometric values at 1 month and 6 months after surgery
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case_images: F7
case_images: At 6 months, however, the refraction changed to 0 spheric diopters with -00.75 cylindric diopters at 1650, keratometric cylinder of -01.25 diopters and spheric equivalent of -00.50 diopters (Fig. 7).
case_images: Placido disc topography 10 months after cataract surgery
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case_images: F8
case_images: However, 10 months after the surgery, the placido disc topography showed a keratoconus prediction index of 90%, with no ocular surface irregularities that could influence the measurement (Fig. 8).