ihab m. osman ass. prof. of ophthalmology alexandria ... · ass. prof. of ophthalmology alexandria...

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Ihab M. Osman

Ass. Prof. of Ophthalmology

Alexandria University

FRCS Glasgow

ESOIRS 2018

Regular Pentacam HR Pentacam

Light source blue LEDs (475 nm UV-free)

Speed50 images in 2 seconds, 500 measuring points

per image

50 images in 2 seconds, 2760 measuring points per

Scheimpflug image

Number of measured

points

max. 25.000 max. 138.000

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Keratoconus Assay

4 Maps Refractive

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Amsler-Krumeich (AK) system

In the AK system, the severity of keratoconus is graded from stage 1–4 using spectacle refraction, central keratometry, presence or absence of scarring, and central corneal thickness.Limited by:• Absent posterior corneal data• Failure to put thinnest location into consideration

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Thickness Indices

Belin/Ambrosio AssayDeviation Indices

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How to Monitor KC Progression

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Fast screening report

Pentacam HR and Cataract

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Calculation of K readings for IOL formulas

1. Holladay report

2. Detailed holladay report


(EKR) that can be used in older version IOL formulas that correct for n=1.3375.

Total corneal refractive power map cannot be used in conventional IOL formulas but can be used for newer versions of IOL calculation formulas

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Holladay Report

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The EKR65 values is optimal to use in IOL power

calculations formulas using the Holladay IOL consultant software.

It needs no additional adjustments are necessary for the back surface in toric IOL calculations.



1. Holladay report


Cataract preoperative report for premium IOL


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Less than 0.3 micron

Evaluation of irregular astigmatismDetection of abnormal corneal shape

Evaluation of corneal spherical aberrations

•0.1 micron( 6 mm) or higher for aspheric IOLs

•Less than 0.1 for spherical IOL

Evaluation of corneal cylinder



1. Holladay report



Grading of nuclear cataract density(PNS)


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It evaluates the optical density of the lens by analyzing the backward scatter.

Examination with the eye is dilated.

The software automatically calculates the density of a central, 3-dimensional reference block, grading it from 0 to 5.

Pentacam®Nucleus Staging (PNS)

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1. Holladay report




Phakic IOLs


Phakic IOLs

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Calculates the required pIOL power using the implanted

calculator.

Allows a simulation of the pIOL position in up to 30 years.

The crystalline lens grows approximately 19 μm per year a with possible consequence of endothelial cell loss.

3D pIOL Simulation Software and Aging Prediction for iris fixated

pIOL

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Normal depth AC

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Shallow AC

Deep AC

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1. Holladay report




Phakic IOLs

Iris details for Toric IOLs


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Iris details for Toric IOL Implantation

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Wavefront

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For following up corneal haze post PRK, or with infectious

keratitis, corneal mucopolusaccharidosis and keratoconus.

Limitations

1. Opaque corneas causes high backscatter and unreliable measurements.

2. Corneal densitometry increases with age in the periphery but remains stable centrally

3. Scleral backscatter can artificially elevate the values near the limbus.

Densitometry Assessment

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Fast Screening Report

ACD

ACA

Pachymetry

IOP-correction

ACV

Cutoff value of 113 mm3 for ACV discriminates narrow angles

Glaucoma Screening

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Pentacam HR and RGP Fitting

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As a UBM

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PENTACAM AXL

ihab m. osman ass. prof. of ophthalmology alexandria ... · ass. prof. of ophthalmology alexandria...

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