Comparative evaluation of refractive surgery candidates with Placido topography, Orbscan II, Pentacam, and wavefront analysis.
OBJECTIVE
To study the role of the Pentacam (Oculus), Orbscan II (Bausch & Lomb), and WaveScan (Visx) in evaluating topographic features identified as risk factors for ectasia after laser in situ keratomileusis to identify parameters that may be important in interpreting elevation topography and wavefront data when screening refractive surgery candidates.


METHODS
Private practice, New York, New York, USA.


METHODS
One hundred forty-five eyes of 75 consecutive patients were evaluated for refractive surgery by ultrasound pachymetry (Humphrey Atlas), videokeratography, WaveScan, Orbscan II, and Pentacam. Eyes were classified as normal or suspect based on the Rabinowitz criteria for keratoconus suspect on Placido disk-based videokeratography. Forty-six parameters were evaluated in a comparison of topographically normal eyes and eyes that met the criteria for keratoconus suspect.


RESULTS
The suspect group had thinner pachymetry, multiple distinguishing characteristics on the anterior and posterior corneal surfaces by elevation topography, and larger amounts of coma by wavefront analysis. Multivariable regression analysis identified the following as the strongest predictors of a suspect Placido topography: Pentacam, thinner pachymetry and larger differences between the highest and lowest points on the posterior elevation; Orbscan II, higher anterior maximum elevation, horizontal location of the thinnest point on the pachymetry map, and larger differences between the highest and lowest points on the posterior elevation.


CONCLUSIONS
Several parameters provided by the Pentacam, Orbscan II, WaveScan, and pachymetry were statistically correlated with keratoconus suspect, defined by higher asymmetry and steeper curvature on Placido topography.
Nilforoushan
Mohammad-Reza
MR
New York Eye and Ear Infirmary, New York, NY, USA. mreza04@yahoo.com
Speaker
Mark
M
Marmor
Michael
M
Abramson
Jodi
J
Tullo
William
W
Morschauser
Dana
D
Latkany
Robert
R
D000328:Adult; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology*; D019781:Corneal Topography / Q000379:methods*; D004108:Dilatation, Pathologic / Q000175:diagnosis; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D010781:Photography; D012030:Refractive Errors / Q000175:diagnosis*; D054140:Refractive Surgical Procedures; D012307:Risk Factors