63
EW REFRACTIVE
January 2019
Contact information
Durrie: ddurrie@durrievision.com
Kugler: lkugler@kuglervision.com
Editor's notes: Dr. Durrie has financial
interests with Visiometrics and Tracey
Technologies. Dr. Kugler has no finan-
cial interests related to his comments.
about the visual system," Dr. Kugler
said. EW
irregularity that's coming from the
cornea and from inside the eye. It
doesn't directly measure the image
on the retina, but it does measure
how the light is affected by the
anterior cornea. It also measures the
entire optical system in a wavefront
map. Then you can subtract the
cornea from the wavefront map,
and that tells you what's coming
from the inside of the eye. It's useful
in patients who have higher-order
aberrations and unusual visual
symptoms because it can analyze
what's going on optically. It also
has a lot of nice views that you can
show patients, so they have a clearer
understanding of what's going on
with their eyes," he said.
Dr. Durrie explained that the
iTrace has a dysfunctional lens
syndrome index. "It provides a
metric number depicting the lens
scatter that is measured through
the device. It's a more broad-based
device, which is an advantage and a
disadvantage. It's a little more com-
plicated to explain to patients what
it means," he said.
Pentacam
This is a Scheimpflug device that
provides an image of the eye so
that surgeons can see the cornea in
cross-section. "You can see the lens
and look for lens density changes,"
Dr. Durrie said. "I use the Pentacam
to explain changes in the lens to
patients. The graphics are helpful. I
can point to their cornea and show
them where their contact lenses
are and where laser surgery is done.
It also provides a side view of the
lens, so I can show them the density
of their lens. I can show them the
difference between their lens and a
full-blown cataract."
Dr. Kugler said that there is a
device similar to the iTrace called
the OPD-Scan III (Nidek, Gamagori,
Japan), and there are devices similar
to the Pentacam, such as the Galilei
device (Ziemer Ophthalmic Systems,
Port, Switzerland), which has similar
functionality. He noted that the HD
Analyzer is unique.
"Of course, a good quality slit
lamp exam is essential. Let's not
forget that the red reflex we can use
from a direct ophthalmoscope can
also give us a lot of information
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