Corneal volume, pachymetry, and correlation of anterior and posterior corneal shape in subclinical and different stages of clinical keratoconus.
ABSTRACT To evaluate the corneal volume, pachymetry, and correlation of anterior and posterior corneal shape in subclinical and clinical keratoconus.
Vissum Corporation, Alicante, Spain.
Eyes were placed into 1 of 4 groups as follows: keratoconus 2 (grade II), keratoconus 1 (grade I), subclinical (subclinical keratoconus), and control (normal eyes). All eyes had an ophthalmologic examination including corneal evaluation (curvature, elevation, asphericity, pachymetry, corneal volume) by rotating Scheimpflug imaging (Pentacam). The posterior-anterior corneal power ratio was also calculated.
Seventy-one eyes (51 patients; aged 16 to 64 years) were evaluated. Astigmatism and keratometry of both corneal surfaces were statistically significantly higher in the keratoconus 1 and 2 groups (P<or=.02). Posterior astigmatism was statistically significantly higher in the subclinical group than in the control group (P = .01). A strong correlation (r>or=-0.81) was found between anterior and posterior curvature in the normal and subclinical groups; the correlation was weaker in clinical keratoconus cases (r<or=-0.56). The correlation in astigmatism between the anterior and posterior surface was good in all keratoconus groups (r>or=0.81). The posterior-anterior corneal power ratio was significantly higher in the keratoconus 2 group than in the other groups (P<or=.01). Pachymetric readings were progressively lower in eyes with subclinical, early, or moderate keratoconus (P<.01). The corneal volume was statistically significantly lower in the keratoconus 2 group than in the other groups (P = .04).
The correlation between anterior and posterior corneal curvature was lower in keratoconus, although the correlation between anterior and posterior astigmatism was maintained.
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ABSTRACT: To quantitatively evaluate the changes in anterior and posterior corneal curvatures of eyes with keratoconus. Case-control retrospective and observational study. Thirty-one patients who were clinically diagnosed to have unilateral or bilateral keratoconus and 18 normal subjects. The anterior and posterior topographies were obtained using scanning-slit videokeratography and assessed by Fourier series harmonic analysis. Quantitative descriptors of the topography data, spherical power, regular astigmatism, and irregular astigmatism (asymmetry and higher order irregularity) components were compared between the anterior and posterior surfaces and among groups of clinically diagnosed keratoconus (33 eyes), keratoconus suspect (13 eyes), and normal subjects (36 eyes). Spherical power (P = 0.0003, Mann-Whitney U test with Bonferroni's correction of P values), regular astigmatism (P = 0.0166), and asymmetry (P = 0.0031) of the anterior surface were significantly greater in the keratoconus eyes than in the normal controls. For the posterior surface, spherical power (P<0.0001), regular astigmatism (P = 0.0143), asymmetry (P< 0.0001), and higher order irregularity (P = 0.0032) of the keratoconus group were significantly greater than those of the control group. The keratoconus suspect eyes, when compared with the normal controls, showed a significantly greater amount of spherical power (P = 0. 0166) and asymmetry (P<0.0001) in the anterior surface and spherical power (P <0.0001), regular astigmatism (P = 0.0244), asymmetry (P<0.0001), and higher order irregularity (P = 0.0276) in the posterior surface. All refractive components demonstrated statistically significant correlations between the anterior and posterior surfaces (P<0.0001, Spearman's rank correlation). Not only the anterior but also the posterior corneal curvature is affected in keratoconus. These changes are observed from the early stage of this disorder.Ophthalmology 08/2000; 107(7):1328-32. · 5.56 Impact Factor
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ABSTRACT: 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. Private practice, New York, New York, USA. 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. 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. 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.Journal of Cataract [?] Refractive Surgery 05/2008; 34(4):623-31. · 2.53 Impact Factor
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ABSTRACT: To determine the shape and astigmatism of the posterior corneal surface in a healthy population with age, using Scheimpflug photography corrected for distortion due to the geometry of the Scheimpflug imaging system and the refraction of the anterior corneal surface. Scheimpflug imaging was used to measure in six meridians the cornea of the right eye of 114 subjects, ranging in age from 18 to 65 years. The average radius of the anterior corneal surface was 7.79+/-0.27 (SD) mm and the average radius of the posterior corneal surface was 6.53+/-0.25 (SD) mm. Both surfaces were found to be flatter horizontally than vertically. The cylindrical component of the posterior surface of 0.33 mm is twice that of the anterior surface (0.16 mm). The asphericity of both the anterior and the posterior surface was independent of the radius of curvature at the vertex, refractive error and gender. In contrast with that of the anterior corneal surface, the asphericity of the posterior corneal surface varied significantly between meridians. With age, the asphericity of both the anterior and the posterior corneal surface changes significantly, which results in a slight peripheral thinning of the cornea. On average, the astigmatism of the posterior corneal surface (-0.305 D) compensates the astigmatism of the anterior corneal surface (0.99 D) with 31%. The results show that the effective refractive index is 1.329, which is lower than values commonly used. There is no correlation between the asphericity of the anterior and the posterior corneal surface. As a result, the shape of the anterior corneal surface provides no definitive basis for knowing the asphericity of the posterior surface.Vision Research 04/2006; 46(6-7):993-1001. · 2.14 Impact Factor