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    Perforation: The Worst Nightmare

    By Marguerite B. McDonald, MD
    Subspecialty Day 2011: Refractive Surgery
    Refractive Mgmt/Intervention

    Dr. Marguerite McDonald shares her most challenging experience in refractive surgery: a perforated anterior chamber caused by design flaws in the Innovatome microkeratome. As her patient became progressively ectatic, suffered poor quality of vision, and eagerly awaited approval of wavefront-guided treatment, Dr. McDonald sent the patient to Europe where refractive lens exchange with a toric IOL and LRIs was performed. Wavefront-guided ablation was eventually performed in both eyes, resulting in excellent long-term results.