Wavefront Analysis, Aberrometers & Corneal Topography

442 Pages·2003·80.5 MB·English

by  Benjamin F. Boyd

Editor-in-Chief:
Benjamin F. Boyd, M.D., FACS
Associate Editor-in-Chief:
Amar Agarwal M.S.; F.R.C.S.; F.R.C.Ophth.
Editors
Jorge L. Alio, M.D., PhD
Ronald R. Krueger, M.D., MSE
Steven E. Wilson, M.D.
PUBLISHING © Copyright, English Edition, 2003 for Highlights of
Ophthalmology
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copyright owner.
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Boyd, Benjamin F.; M.D., F.A.C.S.; Agarwal, Amar, M.D.
“Wavefront Analysis, Aberrometers & Corneal Topography”
ISBN Nº. 9962-613-18-3
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ii
EDITOR IN CHIEF
BENJAMIN F. BOYD, M.D., D.SC. (HON), F.A.C.S.
DoctorHonoris Causa
Immediate Past President, Academia Ophthalmologica Internationalis
Honorary Life Member, International Council of Ophthalmology
Designated “Illustrious Citizen of the Republic of Panama”
Editor-in-Chief and Author, HIGHLIGHTS OF OPHTHALMOLOGY, 28 Hard Cover Volumes and
17 million copies of HIGHLIGHTS OF OPHTHALMOLOGY(Journal) in six major languages.
Recipient of the Duke-Elder International Gold Medal Award (International Council of
Ophthalmology), the Barraquer Gold Medal (Barcelona), “for major influence of his publications worldwide”,
“the First Benjamin F. Boyd Humanitarian Award and Gold Medal for the Americas (Pan American) for
“Contributions to Humanity”; the Leslie Dana Gold Medal (St. Louis Society for the Blind) and the National
Society for Prevention of Blindness Gold Medal (United States), Moacyr Alvaro Gold Medal (Brazil), the
Jorge Malbran Gold Medal (Argentina), Colombia Ophthalmological Foundation Alvaro Rodriguez Medal, the
Favaloro Gold Medal (Italy). the “You Made a Difference Award”, Singapore.
First Professor of Ophthalmology and Former Dean, University of Panama School of Medicine.
Recipient of The Great Cross Vasco Nuñez de Balboa, Panama's Highest National Award.
ASSOCIATE EDITOR IN CHIEF
AMAR AGARWAL M.S.;F.R.C.S.;F.R.C.Ophth
Developer of “No Anesthesia Cataract Surgery”, “Phakonit” (cataract removal through a 0.9 mm inci-
sion)" and "Favit" a new technique to remove dropped nuclei. Co-Head, Dr.Agarwal’s Eye Hospital, Chennai
(Madras), India.
(Dr. Agarwal’s Eye Hospital at Chennai is the only eye hospital in the world built in the shape of an
eye and has been included in Ripley’s Believe it or not Series).
EDITORS
JORGE L. ALIO, M.D.
Research, Development and Innovation Department, Ophthalmologic Institute of Alicante and the
School of Medicine, University Miguel Hernández, Spain.
RONALD R. KRUEGER, M.D.
Medical Director, Department of Refractive Surgery, The Cleveland Clinic Foundation, Cole Eye
Institute, Cleveland, Ohio.
STEPHEN WILSON, M.D.
Professor and Chair, Department of Ophthalmology, Grace E. Hill Chair in Vision Research,
University of Washington, Seattle, Washington.
iii
CONTRIBUTING
AUTHORS
Agarwal, Amar, MD. M.S.; F.R.C.S.; F.R.C.Ophth Ambrósio Jr, Renato, MD
Eye Research Centre & Dr. Agarwal's Department of Ophthalmology,
Group of Eye Hospitals University of Washington, Seattle, WA.
Chennai (India), Bangalore (India), Department of Ophthalmology;
Trichy (India) And Dubai (UAE) University of São Paulo, São Paulo, Brazil.
Clínica e Microcirugia Oftalmológica Renato
Agarwal, Athiya, M.D, F.R.S.H, D.O. Ambrósio,
Dr. Agarwal’s Eye Hospital, Rio de Janeiro, Brazil
Chennai-600 086, Tamilnadu, India
Apple, David J., M.D.
Agarwal, J., MD, F.I.C.S., D.O.M.S., F.O.R.C.E. Professor of Ophthalmology and Pathology,
Dr. Agarwal’s Eye Hospital, David J. Apple, MD. Laboratories for
Chennai-600 086, Tamilnadu, India Ophthalmic Devices Research,
John A. Moran Eye Center,
Agarwal, Sunita, MD, M.S., F.S.V.H., F.R.S.H., D.O. Department of Ophthalmology and Visual Sciences,
Dr. Agarwal’s Eye Hospital, University of Utah,
Chennai-600 086, Tamilnadu, India Salt Lake City, Utah
Agarwal, T., MD, F.I.C.S., D.O, F.O.R.C.E. Border, Andrea D., O.D.
Dr. Agarwal’s Eye Hospital, Discover Vision Centers
Chennai-600 086, Tamilnadu, India Kansas City, Missouri, U.S.A.
Alió, Jorge L., MD, PhD Boyd, Benjamin F., M.D., F.A.C.S.
Research, Development and Innovation Department, Editor in Chief
Ophthalmologic Institute of Alicante, Spain. Highlights of Ophthalmology
School of Medicine, Panama, Rep. of Panama
University Miguel Hernández,
Spain Boyd, Samuel, MD.
Associate Editor
Alpins, Noel, MD. FRACO. FRCOphth. FACS. Highlights of Ophthalmology
Medical Director NewVision Clinics Melbourne Director, Laser Section and
Founding Member, Melbourne University Associate Director, Retina and
Excimer Laser Group; Protocol and Ethics Vitreous Department,
Committee. Clinica Boyd Ophthalmology Center
Panama, Rep. of Panama.
iv
Contributing Authors
Carvalho, L. A., MD. Fujieda, Masanao, MA,
Instituto de Física de São Carlos Nidek Ltd., Co.,
(IFSC - USP), Brazil Japan
Carvalho, L. A. V., Ph.D. Ginis, Harilaos S, BSc,
Instituto de Ciências Matemáticas e de Physicist
Computação de São Carlos (ICMC-USP), Brazil Department of Ophthalmology
School of Medicine
Castro, J. C., MD. University of Crete
Instituto de Física de São Carlos Heraklion, Crete
(IFSC - USP), Brazil Greece
Centurion, Virgilio, MD Goes, Frank Jozef, MD
Chief of the Institute for Eye Diseases, Refractive Surgery-Cataract Surgery
Sao Paulo, Brazil Eye Centre Antwerp Belgium.
Honorary Academic Consultant
Cigales, Melania, M.D. University Ghent, Belgium.
Instituto Oftalmologico Hoyos International Belgian representative at ISRS “The
Sabadell, Spain International Society of Refractive Surgery”
Chamon, W., MD. Hamam, Habib, MD.
Escola Paulista de Medicina (EPM), Associate Professor
Universidade Federal de São Paulo, Brazil Faculty of Engineering
Dept. of Electrical Ingineering
Denning, James A., B.A., B.S. University of Moncton
Discover Vision Centers Moncton, New Brunswick
Kansas City, Missouri, U.S.A. Canada
Doane, John F., M.D. Hardten, David R., MD
Discover Vision Centers Director of Refractive Surgery,
Kansas City, Missouri, U.S.A. Minnesota Eye Consultants,
Associate Clinical Professor of Ophthalmology,
Doshi, Ashish, MD, M.S, F.E.R.C. University of Minnesota,
Dr. Agarwal’s Eye Hospital, Minneapolis, Minnesota
Chennai, Tamilnadu, India Director of Refractive Surgery and
Residency Programs
Doshi, Sonika, MD, M.S., F.E.R.C. Regions Medical Center
Dr. Agarwal’s Eye Hospital, St. Paul, Minnesota
Chennai, Tamilnadu, India
Hoyos, Jairo E., M.D.
EuDaly, Lon S., O.D. Medical Director
Discover Vision Centers Instituto Oftalmologico Hoyos
Kansas City, Missouri, U.S.A. Sabadell, Spain
Feinerman, Gregg, M.D., F.A.C.S. Hoyos-Chacon, Jairo, M.D.
Feinerman Vision Center Instituto Oftalmologico Hoyos
Newport Beach, California Sabadell, Spain
v
Contributing Authors
Jacob, Soosan, MD, MS, DNB, FERC Montés-Micó, Robert, OD, MPhil
Dr. Agarwal’s Eye Hospital & Research, Development and Innovation
Eye Research Centre, Department, Ophthalmologic
Chennai-. Tamil Nadu, India. Institute of Alicante and the
School of Medicine,
Jain, Mukesh, PhD University Miguel Hernández,
Nidek Ltd., Co., Spain
Japan
Morris, Scot, O.D.
Kanjani, Nilesh, MD, M.B.B.S. D.O. F.E.R.C. Discover Vision Centers
Dr. Agarwal’s Eye Hospital, Kansas City, Missouri, U.S.A.
Chennai-600 086, Tamilnadu, India
Netto, Marcelo V., MD
Katsanevaki, Vikentia J., MD, Department of Ophthalmology,
Department of Ophthalmology University of Washington,
School of Medicine Seattle, WA
University of Crete
Heraklion, Crete Pallikaris, Ioannis G, MD, PhD.
Greece Professor in Ophthalmology,
Department of Ophthalmology
Keller, Peter, PhD, School of Medicine
Department of Optometry & University of Crete
Vision Sciences Heraklion, Crete
University of Melbourne, Greece
Australia
Panagopoulou, Sophia I, BSc,
Krueger, Ronald R., M.D. Physicist
Medical Director, Department of Ophthalmology
Department of Refractive Surgery School of Medicine
The Cleveland Clinic Foundation University of Crete
Cole Eye Institute Heraklion, Crete
Cleveland, Ohio Greece
Lindstrom, Richard L., MD Pandey, Suresh K., M.D.
Medical Director, Instructor,
Phillips Eye Center for Teaching and Research David J. Apple, MD Laboratories for
Clinical Professor, Ophthalmic Devices Research,
University of Minnesota, John A. Moran Eye Center,
Minneapolis, Minnesota University of Utah,
Salt Lake City, UT,
Martiz, Jaime R., MD.
Refractive Surgery Consultant
The Laser Center, Houston, Texas;
Course Director & President
International LASIK Course
Houston, Texas
vi
Contributing Authors
Plainis, Sotiris, PhD, Simón, Jr., José Mª , MD.
Vision Scientist Anterior Segment Unit
Department of Ophthalmology Simon Eye Clinic
School of Medicine Barcelona, Spain
University of Crete
Heraklion, Crete Simón, Sarabel, MD.
Greece Chief Posterior Segment Unit
Simon Eye Clinic
Probst, Louis E. MD Barcelona, Spain
Medical Director
The Laser Eye Centers, Slade, Stephen G., MD.
Chicago, Illinois The Laser Center,
Houston, Texas
Schor, P., MD.
Escola Paulista de Medicina (EPM), Walsh, Gemma, B.Optom.
Universidade Federal de São Paulo, Brazil University of Melbourne;
Senior Optometrist
Sharma, Vidushi, M.D., F.R.C.S. (Edin). New Vision Clinics, Melbourne, Australia.
Senior Resident, Postgraduate Diploma in Advanced
Dr. Rajendra Prasad Center for Clinical Optometry.
Ophthalmic Sciences, All India Institute of
Medical Sciences, New Delhi, India; Werner, Liliana, M.D., PhD
Assistant Professor,
Simón, Cristina, MD. David J. Apple, MD Laboratories for
Contact Lens Service Ophthalmic Devices Research,
Simon Eye Clinic John A. Moran Eye Center,
Barcelona, Spain University of Utah,
Salt Lake City, UT
Simón, Guillermo L., MD.
Chief Anterior Segment and Wilson, Steven E., MD
Refractive Surgery Unit Professor and Chair
Simon Eye Clinic Department of Ophthalmology,
Barcelona, Spain Grace E. Hill Chair in Vision Research
University of Washington,
Simón, José Mª, MD. Seattle, WA
Chairman
Glaucoma Senior Consultant
Simon Eye Clinic
Barcelona, Spain
vii
CONTENTS
SECTION I
FUNDAMENTALCONCEPTS AND DEVELOPMENTS
CHAPTER 1 CHAPTER 2
THE REFRACTIVE MEDIAOF PREOPERATIVE CONSIDERATIONS
THE HUMAN EYE:
Benjamin F. Boyd, MD., FACS
Optical Properties, Relevant
Samuel Boyd, MD.
Anatomico-physiological
Consideration and Clinical Application Important Preoperative Assessments 15
Biomicroscopy 15
Vidushi Sharma, MD, FRCS (Edin)
Detection of Corneal Problems 15
Suresh K. Pandey, MD
Dry Eye Patients 16
Liliana Werner, MD, PhD
IMPORTANT CONTRIBUTIONS OF
David J. Apple, MD
COMPUTARIZED CORNEAL
TOPOGRAPHY 18
THE REFRACTIVE MEDIAOF THE EYE 5
How Computerized Corneal
The Human Cornea 5
Topography Works 19
Applied Anatomy and Histology
Importance of the Tear Film
of the Human Cornea 6
During Computerized Corneal
The Aqueous and Vitreous Humor 9
Topography 19
The Human Crystalline Lens 10
The Role of Contact Lenses 19
Refractive Properties and Relevant
Types of Computerized Topography
Anatomy-Histology 10
Systems 20
Lens Capsule 11
The Most Important Developments 21
Lens Epithelial Cells 11
SECTION II
TOPOGRAPHY
CHAPTER 3 3- Computerized Videokeratoscopy:
FUNDAMENTALS ON CORNEAL Modern Corneal Topographers 27
TOPOGRAPHY Causes of Artefacts of the Corneal
Topography Map 30
Guillermo L. Simón, MD., Sarabel Simón, MD.,
Understanding and Reading Corneal
José Mª Simón, MD., José Mª Simón, Jr., MD.,
Topography 31
Cristina Simón, MD.
Topographic Scales 32
Computer Displays: Presentation of
Human Optics and the Normal Cornea 25
Topographic Information 32
Instruments to Measure the Corneal Surface 26
Common Corneal Maps 36
1- Keratometry 26
Special Software Applications and Displays 39
2- Keratoscopy or Photokeratoscopy 26
viii
Contents
Topography Maps of the Normal Cornea 43 CHAPTER 4
Comparing Displays 46 TOPOGRAPHY SYSTEMS
Brief Atlas of CornealTopography
Part 1
Special Topographic Conditions 47
Brief Atlas of Corneal Topography Orbscan
Special Cases 59 (Bausch & Lomb)
TOPOGRAPHERS CURRENTLY
Amar Agarwal, MD. M.S.; F.R.C.S.; F.R.C.Ophth
AVAILABLE 63
Nilesh Kanjani, MD. D.O; Dip N B; FE R C
ASTRAMAX™ 3-D Stereo
Athiya Agarwal, MD. M.D.; F.R.S.H. ; D.O.
Topographer (Lasersight®) 64
Sunita Agarwal, MD. M.S.; F.S.V.H.; D.O.
Zeiss Humphrey Systems®ATLAS™
Corneal Topography System
Paraxial Optics 98
Models 993 and Eclipse 995 65
Raytrace or Geometric Optics 98
Color Ellipsoid Topometer,
Elevation 98
by Technomed® 67
ORBSCAN I AND II 99
MEDMONT E-300 67
Specular vs Back-Scattered Reflection 99
DICON® CT200 by Dicon Vismed Inc.-
IMAGING IN THE ORBSCAN 100
PARADIGM, USA 68
Map Colours Conventions 101
KERATRON™ Corneal Topographer
Analysis of the Normal Eye by the
(Optikon 2000® S.p.A, Italy -Europe) 72
Orbscan Map 102
EYE SYS® 2000 74
Clinical Applications 103
ET-800 Corneal Topography System 74
EYE MAPEH-290 ALCON® Corneal
Part 2
Topography System 75
TOMEY® Autotopographer TMS-3 76 The Alcon EyeMap® EH-290 Corneal
OCULUS® Keratograph™ and Topography System (Placido Disc Pattern)
HAAG-STREIT® Keratograph CTK 922 77
Samuel Boyd, MD
ORBSCAN IIz™ - Bausch & Lomb®
Surgical, Inc. (USA) 82
Optical Properties of the Cornea 108
Nidek OPD-SCAN 10000 90
Corneal Topography – Principles 109
THE FUTURE OF CORNEAL
INTERPRETATION OF TOPOGRAPHIC
TOPOGRAPHYIN EVERYDAY
MAPS 109
PRACTICE 90
Surface Curvature Measurements in
The Future of Refraction 91
Topography 110
Elevation Map 110
Relative vs. Absolute Scales 111
Other Topography Systems 112
Most Important Clinical Applications of
Corneal Topography 112
ix
Contents
SECTION III
CLINICALAPPLICATIONS
OF TOPOGRAPHY
CHAPTER 5 CHAPTER 7
THE USE OFTOPOGRAPHYIN ANTERIOR KERATOCONUS
DIAGNOSING CORNEALDISORDERS
J. Agarwal, MD, FICS; DO;FORCE
Renato Ambrósio Jr, MD.; Marcelo V. Netto, MD T. Agarwal, MD, FICS;DOMS;FORCE
Steven E. Wilson, MD Amar Agarwal, MD, M.S., F.R.C.S., F.R.C.OPHTH.
Nilesh Kanjani, MD, M.B.B.S. D.O. F.E.R.C.
Ashish Doshi, MD, M.S, F.E.R.C.
COLOR-CODED MAPS
Sonika Doshi, MD, M.S., F.E.R.C.
AND THE IMPORTANCE OF
Sunita Agarwal, MD, M.S., F.S.V.H., F.R.S.H., D.O.
STANDARIZED COLOR SCALES 117
Athiya Agarwal, M.D, F.R.S.H, D.O.
Quantitative Descriptors and Artificial
Intelligence Programs 119
Orbscan Topography 139
The Normal Prolate Cornea 120
ANTERIOR KERATOCONUS 140
Ectatic Diseases of The Cornea and
Contact Lens-Induced Warpage 122
CHAPTER 8
KERATOCONUS AND PELLUCID
CORNEALTOPOGRAPHYIN IRREGULAR
MARGINALCORNEALDEGENERATION 122
ASTIGMATISM: DIAGNOSTIC TOOLIN
Other Corneal Disorders 127
THE EVALUATION OFTHE QUALITYOF
Terrien's Marginal Degeneration 127
VISION
Pterygium 127
Jorge L. Alió, MD, PhD
CHAPTER 6 Robert Montés-Micó, OD, MPhil
PRIMARYPOSTERIOR CORNEAL
ELEVATION Introduction to Irregular Astigmatism 145
CORNEALTOPOGRAPHYPATTERNS
Amar Agarwal, M.D, M.S., F.R.C.S., F.R.C.OPHTH
OF IRREGULAR ASTIGMATISM 145
Nilesh Kanjani, M.D, M.B.B.S. D.O. F.E.R.C.
A.- Irregular Astigmatism with
Ashish Doshi, M.D, M.S, F.E.R.C.
Sonika Doshi, M.D, M.S., F.E.R.C. Defined Pattern 146
Sunita Agarwal, M.D, M.S., F.S.V.H., F.R.S.H., D.O. B.- Irregular Astigmatism with
Athiya Agarwal, M.D, F.R.S.H, D.O. Undefined Pattern 146
J. Agarwal, M.D, F.I.C.S., D.O.M.S., F.O.R.C.E. Quantitative Analysis of Irregular
T. Agarwal, M.D, F.I.C.S., D.O, F.O.R.C.E. Astigmatism from Topography 149
Fourier Analysis applied to
Orbscan Corneal Topography System 131 Corneal Topography 150
PRIMARYPOSTERIOR CORNEAL Corneal Aberration Identification
ELEVATION 132 from Topography 152
x