Imaging tools—such as topography, tomography, ray-tracing, and anterior-segment optical coherence tomography (AS-OCT)—are helpful to both plan refractive surgeries and assess any potential complications, said Dr Sonia H. Yoo.
Topography can be helpful for keratoconus screening, surgical planning and astigmatism correction. It also can be used to document the effects of surgery, investigate any poor outcomes and plan for enhancements, added Dr Yoo, professor, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States. “It’s important to recognise pathological patterns to rule out candidates such as the patient with inferior steepening,” Dr Yoo said.
Keratorefractive surgery performed in such cases is associated with a higher risk of keratectasia and postoperative topographic instability.
A decentered myopic ablation and a central island are other complications that can be seen by topography and are associated with poor outcomes. Tomography generates a 3D re-creation and can measure the anterior and posterior surfaces, which can be helpful with assessment of the cornea. Wavefront maps and ray-tracing help surgeons to evaluate higher-order aberrations (HOAs), which can be responsible for reduced quality of vision, Dr Yoo said.
DR SONIA H. YOO, MD
E: [email protected]
This article was adapted from Dr Yoo’s presentation at the 2018 meeting of the American Academy of Ophthalmology. Dr Yoo is an equity partner in Resolve Ophthalmics and a consultant for Avedro.