Financial Disclosure: Medical Director–Galilei R&D Consultant, Ziemer Group AG, Port, Switzerland Consultant & Territory Manager for.

Slides:



Advertisements
Similar presentations
Spherical Aberration Post Bilateral Implantation of Two Prevalent Aspheric IOLs DR. ROBERT A. KAUFER, MD MARTINEZ, BUENOS AIRES ARGENTINA
Advertisements

Theoretical Optical Performance of an Equal Conic Intraocular Lens and Comparison to Spherical and Aspheric IOLs Edwin J. Sarver, PhD.
Dr H. Razmjoo Isfahan University of Medical Sciences Multifocal IOLs
Swept Source Optical Coherence Tomography for Evaluation of Posterior Corneal Changes after Refractive Surgery Dr. Tommy Chung Yan Chan Dr. Vishal Jhanji.
Comparison of corneal astigmatism measured with 3 devices Mariko Shirayama, M.D, Li Wang, M.D, PhD, Mitchell P. Weikert, M.D, Douglas D. Koch, M.D. Cullen.
Correlation Of Corneal Contour With Higher Order Ocular Aberrations (HOA) In Indian Eyes Manish Chaudhary MS Amit Gupta MS Advanced Eye Centre, Postgraduate.
Long-Term Follow-Up of Toric Intraocular Lens Implantation for Keratoconus Alejandro Navas, MD, MSc, Martha Jaimes, MD, Jesús Cabral, MD, Arturo Ramirez.
Visual outcome & subjective visual symptoms of the Tecnis ZM900 multifocal intraocular lens in Asian eyes Dr Colin S.H. Tan MBBS, MMed (Ophth), FRCSEd.
Aspheric IOL’s: clinical benefits and customizing cataract surgery Bojan Pajic, MD, PhD, FEBO Swiss Eye Research Foundation, ORASIS, Reinach, Switzerland.
Ocular Aberrations and Quality of Vision with Aspheric Single-Piece and Spherical Multi- Piece IOL: Contra lateral Comparative Study Ahmed Assaf MD, FRCSEd.
Cataract Surgery Using Biaspheric IOLs in Patients With Corneal Irregularities James P. Gills, MD St. Luke’s Cataract & Laser Institute Tarpon Springs.
Managing the Refractive “Surprise” After Toric IOL Placement Managing the Refractive “Surprise” After Toric IOL Placement Brad H Feldman, MD Derek DelMonte,
Repeatability of Anterior and Posterior Corneal Higher- Order Aberrations in 4 mm, 6 mm and 8 mm diameters measured by Pentacam System Jadwiga Wojtowicz.
W. A. Maxwell, MD, PhD ASCRS 2008 Comparison of the Optical Image Quality for Presbyopia Correcting IOLs using Modulation Transfer Function Testing W.
Financial Disclosure: Authors do not have financial or commercial interest in mentioned equipments Dr Arce is Consultant & Territory Manager for Latin.
Medical Director - R & D Consultant, Ziemer Group AG, Port, Switzerland Speaker, Bausch & Lomb do Brasil Territory Manager.
1 Cataract Surgery Stephen G. Slade MD, FACS. 2 Financial Disclosure Alcon, AMO, B&L Consultant, Clarity, NuLens, RVO, Technolas 2 This presentation represents.
Evaluation of Corneal Parameters and Spherical Aberration After DSAEK Measured with Pentacam System Orkun Muftuoglu, Pawan Prasher, R. Wayne Bowman, Steven.
W. Maxwell, MD, PhD California Eye Institute Fresno, California
Phacoemulsification in eyes with previous anterior chamber phakic IOL surgery Walton Nosé, MD, PhD 1,2 Adriana dos Santos Forseto, MD 1 Mariana Ávila,
Correlation Between Corneal Biomechanics and Wavefront Aberrations Alejandro Rivera, MD Private Practice Mexico City The author has no financial interest.
Evaluation of Interface Reflectivity and Corneal Aberrations following DSAEK Hamid Khakshoor, MD Professor of Ophthalmology Mashhad University of Medical.
Neeti Parikh, MD Fuxiang Zhang, MD Department of Ophthalmology Henry Ford Hospital A Comparison Of Patient Satisfaction With Modified Monovision Versus.
A Fellow Eye Comparison of Aberrations, Modulation Transfer Function and Contrast Sensitivity After AcrySof IQ and AcrySof Natural IOL Implantation. Mayank.
ASCRS 08 Changes Of Higher Order Aberrations After Excimer Laser Treatment For Moderate Myopia by Means of Preoperative Wavefront Aberration Levels using.
The authors have no financial interest in the subject matter of this poster Yinfei Xu, Peter S. Hersh, MD, David S. Chu, MD Institutional Affiliations.
ROTATING SCHEIMPFLUG TOPOGRAPHIC PARAMETERS IMPORTANT IN DISTINGUISHING NORMAL FROM KERATOCONIC CORNEAL MORPHOLOGICAL FEATURES Clayton Falknor, MD, Orkun.
P91: Clinical Performance of Phakic Angle-Supported Investigational IOL in Prospective Global Trials, ASCRS 2010, Boston P91: Clinical performance of phakic.
ELEVATION AND PACHYMETRY VALUES IN NORMAL CORNEAS OBTAINED BY GALILEI ASCRS Boston April Vision Sana Research Group Vision Sana Research Group.
Comparison of Central Corneal Thickness and Peripheral Corneal Thickness using Sheimpflug system, Optical Coherence Tomography and Ultrasound Pachymetry.
Analysis of Ocular Wavefront Aberrations in Post Penetrating Keratoplasty Eyes with Two Different Hartmann-Shack Aberrometers Adriana S. Forseto 1, MD;
The Effect of Corneal Anterior Surface Eccentricity on Astigmatism after Cataract Surgery Choul Yong Park MD 1 Sung Jun Lee MD 1 Prabjot Channa MD 2 Roy.
Adriana S. Forseto1, MD Walton Nosé1,2, MD
Simple Presbyopic Correction Technique Mahmoud M. Ismail, M.D Ph.D. Professor of Ophthalmology Al-Azhar University Medical Director Nour El Hayat Eye Center.
DGII 2008 Comparison of Aspheric ReSTOR and Tecnis multifocal IOL Dongho Lee MD, PhD Yonsei eye center, Seoul, South Korea No Financial Interest.
Abdulrahman Al-Muammar, MD, FRCSC
Futoshi Taketani, MD,PhD,
Sherman W. Reeves, MD, MPH 1,3,4 ; Jacob A. Kozisek, OD 1,2 ; Noumia Cloutier-Gill, OD 1,2 ; David R. Hardten, MD 1,2,3,4 Accuracy of Scheimpflug Imaging.
Ocular functional optical zone following hyperopic LASIK/PRK: Analysis based on polychromatic retinal image quality Mitchell P. Weikert, MD Li Wang, MD,
Comparative Study of the Aspheric Akreos Adapt AO IOL Versus the Spherical Akreos Adapt IOL Maghizh Anandan Martin Leyland.
Comparison of Central Corneal Thickness, Anterior Chamber Depth, and Central Corneal Power Measurements between Two Scheimpflug Imaging Systems Yuichi.
Post-LASIK Intraocular Lens Power Adjustment Nomogram Joseph Diehl Kevin Miller, MD Jules Stein Eye Institute, David Geffen School of Medicine.
Jay Fiore MD, Eric Donnenfeld MD, Hank Perry MD, Dana Morschauser OD
Investigation of Multifocal Toric IOLs to Compensate for Corneal Astigmatism and to Provide Near, Intermediate, and Distance Vision José L. Rincón, MD.
Inadvertent Insertion of an Opposite- Side Tecnis ZM900 Multifocal IOL Wilson Takashi Hida, M.D. Celso Takashi Nakano; Jonathan Lake;
Minimizing Risk in Visian ICL Implantation.
Corneal shape and corneal aberrations after MicroIncision Cataract Surgery (MICS) NOCHEZ Y, BUREL B, MAJZOUB S, PISELLA PJ C.H.U.
Dissatisfication After Multifocal Intraocular Lens Implantation in Taiwan Yu Wei Lin, MD (Presenting Author); Ching-Ju Hsieh; Lin-Chung Woung The authors.
Outcomes Update for an Aspheric Accommodating IOL John A. Hovanesian, M.D. Clinical Instructor, UCLA Jules Stein Eye Institute Harvard Eye Associates,
Vinohrady Teaching Hospital, Prague, Czech Republic Vinohrady Teaching Hospital, Prague, Czech Republic M. Vokrojova MD, M. Vokrojova MD, D. Sivekova MD,
Department of Ophthalmology, University of Ulsan College of Medicine,
Multifocal Corneal Excimer Ablations for Presbyopia
Postoperative Refraction and Patient Satisfaction after Bilateral Implantation of Presbyopia-Correcting Intraocular Lenses Robert Cionni, MD Financial.
Management of Corneal Astigmatism with Toric IOLs: Optimizing Outcomes
Charlotte ROHART1, Gilles Chaine1, Damien GATINEL2
Source: Figure 1. Image of colors with their different wavelengths refracted at different angles.
Wavefront Optimized Retreatment after Prior Wavefront
Corneal High-Order Aberrations in Keratoconus
Eye clinic of the 3rd Faculty of Medicine, Prague, Czech Republic
MP Weikert, M Shirayama, L Wang, DD Koch
University of Florence Oto-Neuro-Ophthalmological Department
Carlos G. Arce, MD Associate Researcher and Ophthalmologist
Mohamed A Guenena, MD Helga P Sandoval, MD, MSCR Kerry D Solomon, MD
Comparison of vision with an accommodating IOL versus a multifocal IOL
Introduction and Overview
Sun Woong Kim, M.D.1, Hae Jung Sun, M.D.1,
Aspherical ablation profiles in excimer laser treatments
The authors have no financial interest
Age-related difference in Lasik Treatment
Michael Goodman, Alexandra Paul and Andrew Hsu
Presentation transcript:

Financial Disclosure: Medical Director–Galilei R&D Consultant, Ziemer Group AG, Port, Switzerland Consultant & Territory Manager for Latin America, Vista Optics Limited, Widnes, UK Consultant, Mark’Ennovy Personalized Care, Madrid, Spain Author does not have financial interest in the commercialization of equipments or IOLs mentioned Carlos G. Arce, MD Carlos G. Arce, MD Ophthalmologist, Private Eye Clinic, Campinas, SP, Brazil Volunteer Ophthalmologist and Researcher, Ocular Bioengineer and Refractive Surgery Sectors, Institute of Vision, Department of Ophthalmology, Paulista School of Medicine, Federal University of São Paulo, SP, Brazil Spherical Aberration and Eccentricity Factor of Normal Corneas and Corneas That Had Underwent Refractive Surgery

Results: Normal corneas had SA=+0.24 ±0.07 µm (-0.18 ±0.08 D), anterior Є 2 =+0.20 ±0.16 and posterior Є 2 =+0.25 ±0.16. Corneas that underwent myopic LASIK had SA =+0.67 ±0.19 µm (-0.50 ±0.14 D) (P<0.005); anterior Є 2 = ±0.33 (P<0.0005), and posterior Є 2 =+0.39 ±0.18 (P<0.05). Corneas with hyperopic LASIK had SA ±0.13 µm (0.40 ±0.11 D) (P<0.005); anterior Є 2 = ±0.22 (P<0.0005) and posterior Є 2 =+0.41 ±0.13 (P<0.05), Purpose: To study the spherical aberration (SA) and shape profile of normal corneas and that underwent myopic or hyperopic corneal LASIK. Setting: Private Eye Clinic, Campinas, SP, Brazil Methods: Total corneal SA and eccentricity (Є 2 ) index were assessed with the Galilei (Ziemer Ophthalmic Systems AG, Port, Switzerland) dual Scheimpflug- Placido integrated system were assessed in 39 normal corneas (24 patients) that underwent myopic or hyperopic LASIK. Preoperative spherical equivalent range was to D in 29 eyes/19 patients, and +2.0 to D in 10 eyes/5 patients, respectively. Myopic LASIK Spherical Aberration Anterior Є 2 Posterior Є 2 Spherical Aberration Anterior Є 2 Posterior Є 2 Hyperopic LASIK

Normal Cornea Without Refractive Surgery SA = 0.28 μm SA = D Normal corneal surface is from sphere (Є 2 =0) to elliptical prolate (0<Є 2 <1) Total corneal SA is positive (µm) or negative (D): SA=+0.24 ±0.07 µm (-0.18 ±0.08 D) Final total eye SA depends on SA of IOL chosen. Target Rx for IOL calculation may be plano or little negative Example: Є 2 = 0.10

Anterior surface becomes oblate with negative Є 2 Total corneal SA is high positive (µm) or negative (D): SA=+0.67 ±0.19 µm (-0.50 ±0.14 D) IOL implanted should not be spherical with positive SA (µm) Target Rx may be plano or negative. Monovision is better accepted Cornea with Post-Myopic Refractive Surgery SA = 0.94 μm SA = D Example: Є 2 = -1.44

Cornea with Post-Hyperopic Refractive Surgery Anterior surface becomes hyper-prolate with high positive Є 2 Total corneal SA becomes more negative (µm) or positive (D): SA= ±0.13 µm (0.40 ±0.11 D) IOL implanted should not be aspheric hyper-prolate with negative SA (µm) Target Rx may be plano or little positive. Traditional monovision is less tolerated SA = μm SA = 0.62 D Example: Є 2 = 1.83

Galilei measures the total corneal wave front Spherical aberration (SA) is linked to contrast sensitivity SA=0 gives sharpness of vision Larger SA gives depth of focus (multifocal cornea) Reasoning for Custom Selection of IOL When the cornea becomes more prolate When the cornea becomes more prolate Q factor and Є 2 increase Q factor and Є 2 increase Positive SA reduces Positive SA reduces Around Є 2 = 0.55 then SA = 0 Around Є 2 = 0.55 then SA = 0 Є 2 > 0.60 then SA is already negative Є 2 > 0.60 then SA is already negative When cornea becomes less prolate or oblate When cornea becomes less prolate or oblate Q factor and Є 2 reduce Q factor and Є 2 reduce Positive SA increases Positive SA increases

IOL SA + Total Corneal SA = Total eye SA after cataract extraction SphericalAberration V. & H. Coma H. Trefoil H. Quatrefoil V. Trefoil V. Quatrefoil Glasser & Campbell. Vision Res, 1998: 38 (2); 209 Artal et al. J. Opt. Soc. Am. A. Feb 2002 Total SA of the eye increases with Total SA of the eye increases with age due to lens changes age due to lens changes Total corneal SA maintains a stable Total corneal SA maintains a stable value with age in normal corneas value with age in normal corneas that do not change shape that do not change shape Total corneal SA becomes less positive or negative in typical Total corneal SA becomes less positive or negative in typical keratoconus keratoconus Total corneal SA becomes some Total corneal SA becomes some more positive in typical initial pellucid more positive in typical initial pellucid marginal degeneration marginal degeneration Total corneal SA after myopic Total corneal SA after myopic refractive surgery is more positive refractive surgery is more positive Flatter and more oblate corneas Flatter and more oblate corneas seem to have larger positive SA seem to have larger positive SA value value Total corneal SA after hyperopic refractive surgery is more negative Total corneal SA after hyperopic refractive surgery is more negative Steeper and more prolate corneas Steeper and more prolate corneas seem to have larger negative SA seem to have larger negative SA value value

Conclusions Conclusions SA and eccentricity factor Є 2 have an inverse SA and eccentricity factor Є 2 have an inverse correlation correlation Normal corneas and those that underwent refractive Normal corneas and those that underwent refractive surgery have not the same SA surgery have not the same SA Our results suggest that rational IOL selection and the Our results suggest that rational IOL selection and the target refraction expected in IOL calculation may be target refraction expected in IOL calculation may be optimized with preoperative data from total corneal optimized with preoperative data from total corneal wavefront derived by dual Scheimpflug –Placido wavefront derived by dual Scheimpflug –Placido tomographic system tomographic system Spherical IOLs with positive SA seem a good option for Spherical IOLs with positive SA seem a good option for eyes that underwent hyperopic refractive surgery or eyes that underwent hyperopic refractive surgery or with typical keratoconus. Aspheric IOLs with negative with typical keratoconus. Aspheric IOLs with negative SA seem a worst option SA seem a worst option In these eyes a plano or little positive target would be In these eyes a plano or little positive target would be ideal and classic monovision would not be recommended ideal and classic monovision would not be recommended Aspheric IOLs with negative SA seem a good option for Aspheric IOLs with negative SA seem a good option for eyes with normal corneas and that underwent myopic eyes with normal corneas and that underwent myopic surgery surgery Spherical IOLs are also an option in normal corneas Spherical IOLs are also an option in normal corneas when a small negative refractive target is expected when a small negative refractive target is expected Eyes that underwent myopic LASIK seem to be ideal for Eyes that underwent myopic LASIK seem to be ideal for classic monovision with myopic residual refraction classic monovision with myopic residual refraction Standard Sph (SA = μm)Standard Sph (SA = μm) PhysIOL (SA = μm)PhysIOL (SA = μm) AcrySof IQ (SA = μm)AcrySof IQ (SA = μm) Tecnis (SA = μm)Tecnis (SA = μm) SofPort AO (SA = 0 μm)SofPort AO (SA = 0 μm) Crystalens (SA =0 μm)Crystalens (SA =0 μm) Rayner (SA = 0 μm)Rayner (SA = 0 μm) Mediphacos (SA= 0)Mediphacos (SA= 0) central rays focus beyond outer rays central rays focus in front of outer rays All rays are focused at focused at same point Modified from Koch et al 2009