A candidate for refractive surgery presented with classic (type I) Ehlers-Danlos syndrome (EDS). Clinical examination revealed blue sclera, limbus-to-limbus corneal thinning, myopia, and astigmatism.

Orbscan® (Bausch & Lomb) pachymetry mapping provided a striking demonstration of the limbus-to-limbus thinning with a central corneal thickness of 360 µm in the right eye and 383 µm in the left eye and midperipheral corneal thickness ranging from 370 to 438 µm and 376 to 434 µm, respectively. Despite the theoretical biomechanical weakness from the thin cornea and defective collagen, regular surface topography was maintained without the development of keratoconus.

Although all types of EDS remain a contraindication to laser refractive surgery, Orbscan mapping provides a valuable insight into corneal shape and thickness in this condition.

J Cataract Refract Surg 2004; 30:1795-1798 . 2004 ASCRS and ESCRS

Konrad Pesudovs, PhD
University of Bradford, Bradford BD7 1DP, United Kingdom

Accepted for publication: 26 November 2003