Performance of a new optimized ectasia risk screening index using a comprehensive approach: morphological and biomechanical-based approaches

Session Details

Session Title: Investigations and Complications Management

Session Date/Time: Tuesday 13/09/2016 | 13:30-15:15

Paper Time: 14:04

Venue: Hall C3

First Author: : M.Krauthammer ISRAEL

Co Author(s): :    M. Santhiago   D. Varssano   R. Krueger   D. Smadja           

Abstract Details

Purpose:

To analyze the performance of a new optimized ectasia risk screening index in detecting corneas that were at risk of ectasia.

Setting:

Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Methods:

Preoperative data of 84 eyes that underwent LASIK with at least 3 years of follow-up and 8 post LASIK ectasia were retrospectively submitted to the evaluation of a new optimized screening program for assessing the risk of ectasia: The combination of a topo-tomographic index using a Dual Scheimpflug system for detecting suspect corneas with the magnitude of the percentage of tissue altered (PTA) by the surgery. The performance of this new combined index in predicting the risk of ectasia to occur preoperatively was compared to the performance of the Keratoconus Prediction Index (KPI) and the Ectasia Risk Score System (ERSS).

Results:

One hundred percent (8/8) of the ectasia cases would have been preoperatively labeled as corneas at risk using this new Index compared to 25% using the KPI (2/8) and respectively 37,5% (3/8), 12,5% (1/8) and 50% (4/8) considered at high, moderate and low risk by the ERSS. In contrast, respectively 13,1% and 8,4% of the corneas in the uncomplicated LASIK group would not have been recommended for LASIK procedure, due to suspect pattern recognition or excessive PTA.

Conclusions:

The use of this new index combining a topo-tomographic based approach with an indice that relates to the anticipated biomechanical response may help drastically improving the sensitivity of the detection of cornea at risk of ectasia, although it may in some cases, make reconsider a LASIK indication into a PRK or abstention.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company