A pathophysiologic model for Stage 4 DLK that challenges current dogma in refractive surgery and simultaneously refutes four (4) broadly held paradigms in Ophthalmology including:

¿ The etiology and pathophysiology of DLK
¿ The etiology and pathophysiology of CTK
¿ The mechanism that defines control of interstitial fluid pressures in the cornea
¿ The primary etiology and control of corneal biomechanics.

The profoundly revolutionary concepts articulated in this textbook redefine nearly everything we 'know' about control of fluid dynamics and the biomechanical forces that shape in the cornea. This is particularly true with respect to understanding how and why the cornea responds to laser refractive surgery, collagen crosslinking and femtosecond laser photodisruption and the etiology of disorders such as keratoconus.