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We thank Saad and Gatinel for their interesting observation. We agree that a quantitative definition might have been useful for both suspect keratoconus and forme fruste keratoconus (FFKC). Unfortunately, these definitions, such as those by Rabinowitz and Rasheed or Maeda et al, rely only on front corneal topography indexes, that is, on abnormalities of the anterior corneal curvature and shape. On the contrary, we also included cases with suspect abnormalities of the posterior corneal surface and the pachymetric map. At this moment, there are no standardized and scientifically accepted indexes for (Read more...)

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