To the Editor.
—We appreciate the interest that Drs Perlstein and Chubak1 showed in our article2 on posterior keratoconus and their point is well taken. The rationale for doing a penetrating keratoplasty on our 16-year-old patient with 20/70 vision in each eye due to posterior keratoconus was not fully explained in our article. The history was given from the time of referral to one of us (K.H.S.), but records were available to us from a previous visit to an ophthalmologist in the same office, suggesting an excellent potential for vision. These included the information that in 1970, at the age of 10 years, the patient's visual acuity was 20/50 in each eye without correction, improving to 20/30 with pinhole in each eye. She read J 1 print with difficulty. No treatment was recommended at that time.The patient was next seen for keratoplasty in 1976 at the age
Streeten BW, Spitzer KH, Karpik AG. Keratoplasty for Posterior Keratoconus. Arch Ophthalmol. 1984;102(9):1268–1270. doi:10.1001/archopht.1984.01040031028015
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