Eyeworld

123 EW CORNEA October 2015 Contact information Ambrósio: dr.renatoambrósio@gmail.com undergo biomechanical decompen- sation and ectasia progression." This will depend on preoperative charac- teristics and the impact from corneal surgery or the environment. Dr. Ambrósio added that it's important to clearly define "suspicious topog- raphy," as he mentioned earlier that this can often be incorrectly used. "Forme fruste" is still an important term in the characterization of kera- toconus. Best ways to distinguish keratoconus from similar- appearing conditions Dr. Ambrósio said it is necessary to go beyond front surface curvature to figure out if the condition is really keratoconus. "Corneal tomogra- phy refers to the 3D evaluation of corneal shape with front and back elevation and thickness mapping," he said. "This is fundamental, and we already have very accurate meth- ods to enhance the sensitivity and specificity." He added that segmental tomography allows the surgeon to evaluate the thickness map of the epithelial layer of the cornea. "This is possible with Scheimpflug, OCT and high frequency US," he said. "I also use ocular aberrometry (wave- front analysis) to characterize optical properties." In terms of corneal biomechanical characterization, the analysis of the deformation response to the non-contact air puff has been used with good results, Dr. Ambrósio said, but these measurements do not replace corneal shape analysis yet. Brillouin spectroscopy is also promising, but still under research, he said. Best tools to stage and diagnose ectasia Dr. Ambrósio thinks that corne- al tomography with Scheimpflug imaging is the best method today for staging and diagnosing ectasia. "However, it is important for the cli- nician to understand the exam and what he aims to detect," he said. This can be challenging to interpret the profound amount of data, he said. "This is why we need to con- sciously use artificial intelligence to enhance the ability to detect ectasia and its susceptibility." EW Editors' note: Dr. Ambrósio has financial interests with Alcon (Fort Worth, Texas), Allergan (Dublin, Ireland), Carl Zeiss Meditec (Jena, Germany), Genom (São Paulo, Brazil), Mediphacos (Belo Horizonte, Brazil), and Oculus (Arlington, Wash.). Explore our innovative world of diagnostics. AAO Booth #4045 • 11.14.15 www.accutome.com 610-889-0200 • +31 [0] 485-350300 Europe • FAX 610-889-3233 • info@accutome.com

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