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Topographers are very important in laser eye surgery, both for patient screening before surgery (to detect abnormalities such as keratoconus, which is a contraindication for laser eye surgery) and for evaluating results after surgery. Topography should be the first test of choice to attempt to identify the cause of vision defects reported by patients for which no cause can be found in slit-lamp examination or refraction.
Ablation defects such as central islands, decentration, small optical zones or irregular astigmatism will be readily visible on topography though they may not be accurately assessed with wavefront aberrometry. Patients considering additional surgery with wavefront-guided procedures should have expert review of their topographies before attempting treatment.
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