A month ago, the day the last issue of I-site was published, a good friend to the (R)GP lens industry unexpectedly passed away. One of the items in the August issue of I-site discussed scleral lenses. For over 10 years, Rob Breece advocated and predicted the potential of this lens design, and he created his own semi-scleral lens design. And he was right. Rob also fitted many, many patients with scleral lenses in his practice in Front Royal (Virginia), near Washington DC (USA). The entries in the online guest registry by some of his patients are heartbreaking. He really changed some people's lives. Rob - you will be missed.

                                                                   Eef van der Worp

 

 

In the current (September) issue of the Journal of Cataract and Refractive Surgery, a study by Li et al covers the early detection of keratoconus, which is obviously of extreme importance to the refractive surgeon. Prior to the study they selected four groups: keratoconus, early keratoconus, keratoconus suspect, or normal based on clinical signs and videokeratography. Subjects were followed for one to eight years. Over a median follow-up of 4.1 years, approximately 28% in the keratoconus-suspect group progressed to early keratoconus or to keratoconus, and 75% in the early keratoconus group progressed to keratoconus. Central keratometry, inferior-superior differences in topography and the KISA index were significantly different among groups. Also, progression of keratoconus varied among the groups.