Impacto da análise do "wavefront" na refratometria de pacientes com ceratocone

Ambrósio, Renato; Caldas, Diogo Leitão; Silva, Renata Siqueira da; Pimentel, Leonardo Nogueira; Valbon, Bruno de Freitas

doi:10.1590/s0034-72802010000500004

Cited by 13 publications

(1 citation statement)

References 55 publications

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“…Different studies involving eyes with typically “innocent” topography, from patients with clinical ectasia identified in the fellow eye, confirmed the capacity of corneal tomography to improve the accuracy of detecting mild or subclinical ectatic disease [ 4 , 15 , 16 , 17 , 18 , 19 , 20 ]. Corneal tomographic parameters revealed an excellent ability to identify susceptibility to developing ectasia after LASIK (Laser-Assisted in Situ Keratomileusis) in retrospective studies involving patients with such complications [ 13 , 21 , 22 ]. The need to go beyond corneal shape evaluation for describing ectasia risk within the biomechanical domain was supported and promoted [ 23 , 24 ].…”

Section: Multimodal Imagingmentioning

confidence: 99%

Enhanced Diagnostics for Corneal Ectatic Diseases: The Whats, the Whys, and the Hows

Esporcatte

Salomão

Neto³

et al. 2022

Diagnostics

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There are different fundamental diagnostic strategies for patients with ectatic corneal diseases (ECDs): screening, confirmation of the diagnosis, classification of the type of ECD, severity staging, prognostic assessment, and clinical follow-up. The conscious application of such strategies enables individualized treatments. The need for improved diagnostics of ECD is related to the advent of therapeutic refractive procedures that are considered prior to keratoplasty. Among such less invasive procedures, we include corneal crosslinking, customized ablations, and intracorneal ring segment implantation. Besides the paradigm shift in managing patients with ECD, enhancing the sensitivity to detect very mild forms of disease, and characterizing the inherent susceptibility for ectasia progression, became relevant for identifying patients at higher risk for progressive iatrogenic ectasia after laser vision correction (LVC). Moreover, the hypothesis that mild keratoconus is a risk factor for delivering a baby with Down’s syndrome potentially augments the relevance of the diagnostics of ECD. Multimodal refractive imaging involves different technologies, including Placido-disk corneal topography, Scheimpflug 3-D tomography, segmental or layered tomography with layered epithelial thickness using OCT (optical coherence tomography), and digital very high-frequency ultrasound (VHF-US), and ocular wavefront. Corneal biomechanical assessments and genetic and molecular biology tests have translated to clinical measurements. Artificial intelligence allows for the integration of a plethora of clinical data and has proven its relevance in facilitating clinical decisions, allowing personalized or individualized treatments.

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