keratoconus. yellow rings
DESCRIPTION
TRANSCRIPT
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YELLOW RINGS
PAULO FERRARA EYE CLINICBELO HORIZONTE – MG
PAULO FERRARA, MD, PhD
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Material PMMA
YELLOW FILTER
Apical Diameter 5mm
Triangular cross section= prismatic
effect
Hole in each extremity
FLAT BASIS WIDTH 0,6 MM
Variable arch lengh segments
Ferrara Ring Characteristics
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Flat basis responds for astigmatism induction
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PRISMATIC EFFECT
LESS HALOS
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VISIBLE LIGHT ESPECTRUM
Wavelength Range
(nanometers)Perceived Color
340-400 Near Ultraviolet (UV; Invisible)
400-430 Violet
430-500 Blue
500-570 Green
570-620 Yellow to Orange
620-670 Bright Red
670-750 Dark Red
Over 750 Near Infrared (IR; Invisible)
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COMPLEMENTARY COLORS
Cyan = White - Red
Magenta = White - Green
Yellow = White - Blue
The complementary colors (cyan, yellow, and magenta) are also commonly
referred to as the primary subtractive colors because each can be formed by
subtracting one of the primary additives (red, green, and blue) from white light.
PRIMARY COLORS
Red + Green + Blue = White
COLOR PERCEPTION
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ABSORPTION FILTERS
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DAY AND NIGHT VISION – COLOR SENSIBILITY
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The cornea is 100% transparent and is YELLOW.
It is responsible for the absorption of radiations bellow 300
nm
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Cristaline lens = YELLOW , responsible for the
absorption of 50% of the incident light, increases
with age and can simulate tritanopy in advanced
cataracts
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METHODS TO EVALUATE
LIGHT SCATTERING AFTER FERRARARING Y/W
IMPLANTATION
C QUANT
PSF COMPARATIVE STUDY
CLINICAL EVIDENCE
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MEASUREMENT OF THE RETINAL STRAYLIGHT
The amount of straylight in an eye is expressed in one
number called the STRAYLIGHT PARAMETERS. This
parameter determines the ratio between the unawanted
scattered light which causes retinal contrast reduction and
the wanted NON scattered light which forms the retinal
image
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COMPARATIVE MEASUREMENTS OF
THE STRAYLIGHT
C-QUANT
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J.L.S.N. male 26 y.o
KC II LE
Type 2
PRE-OP DATA 08/07/2008
MANIFEST REFRACTION
LE: +3.00 – 5.00 x 135
BSCVA
LE: 20/80
SURGICAL STRATEGY
01 AFR 160/25
Incision axis 75
Incision depth 470 micra
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J.L.S.N. male 26 y.o
KC II LE
Type 2
POST-OP DATA 08/08/2008
MANIFEST REFRACTION
LE: +0.50 – 2.00 X 113
BSCVA
LE: 20/40
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R.L.M. female 17 y.O
KC II RE
Type 2
PRE-OP DATA 04/22/2008
MANIFEST REFRACTION
RE: +1.00 -5.00 X 80
BSCVA
LE: 20/50
SURGICAL STRATEGY
01 AFR 160/25
Incision axis 90
Incision depth 450 micra
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R.L.M. female 17 y.O
KC II RE
Type 2
POST OP DATA 06/17/2008
MANIFEST REFRACTION
RE: +2.00 -3.50 X 90
BSCVA
LE: 20/40
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R.P.S.J. male 28 Y.O
KC II LE
Type 2
PRE-OP DATA 08/04/2008
MANIFEST REFRACTION
LE: -4.50 X 115
BSCVA
LE: 20/60
SURGICAL STRATEGY
01 AFR 160/25
Incision axis 135
Incision depth 520 micra
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R.P.S.J. male 28 Y.O
KC II LE
Type 2
POST OP DATA 11/08/2008
MANIFEST REFRACTION
LE: -4.50 X 110
BSCVA
LE: 20/40
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M.M.C. female 36 y.O
KC III LE
Type 2
PRE-OP DATA 24/03/2008
MANIFEST REFRACTION
LE: -1.00 -3.50 X 125
BSCVA
LE: 20/80
SURGICAL STRATEGY
02 AFR 160/20-20
Incision axis 90
Incision depth 480 micra
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M.M.C. female 36 y.O
KC III LE
Type 2
POST OP DATA 08/08/2008
MANIFEST REFRACTION
LE: -2.00
BSCVA
LE: 20/40
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C.C.J. male 24 y.O
KC III LE
Type BOW-TIE
PRE-OP DATA 27/09/2007
MANIFEST REFRACTION
LE: -3.00 -3.50 X 150
BSCVA
LE: 20/80
SURGICAL STRATEGY
02 AFR 160/15-20
Incision axis 75
Incision depth 520 micra
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C.C.J. male 24 y.O
KC III LE
Type BOW-TIE
POST OP DATA 27/06/2008
MANIFEST REFRACTION
LE: -1.50 X 60
BSCVA
LE: 20/40
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C.C.J. male 24 y.O
KC III RE
Type BOW-TIE
PRE-OP DATA 07/07/2008
MANIFEST REFRACTION
LE: -1.50 X 45
BSCVA
LE: 20/80
SURGICAL STRATEGY
02 AFR 160/15-15
Incision axis 90
Incision depth 480 micra
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C.C.J. male 24 y.O
KC III LE
Type BOW-TIE
POST OP DATA 07/08/2008
MANIFEST REFRACTION
LE: PLANO
BSCVA
LE: 20/25
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B.S.N.A. female 17 y.O
KC II RE
Type 2
PRE-OP DATA 02/26/2008
MANIFEST REFRACTION
LE: +1.00 -5.00 X 80
BSCVA
LE: 20/50
SURGICAL STRATEGY
01 AFR 160/25
Incision axis 90
Incision depth 450 micra
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B.S.N.A. female 17 y.O
KC II RE
Type 2
POST OP DATA 08/08/2008
MANIFEST REFRACTION
LE: +2.00 -3.50 X 90
BSCVA
LE: 20/40
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R.R.S. male 19 y.O
KC II LE
Type 2
PRE-OP DATA 11/22/2006
MANIFEST REFRACTION
LE: +2.00 -4.00 X 100
BSCVA
LE: 20/40
SURGICAL STRATEGY
01 AFR 160/20
Incision axis 90
Incision depth 450 micra
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R.R.S. male 19 y.O
KC II LE
Type 2
POST OP DATA 08/08/2008
MANIFEST REFRACTION
LE: -2.25 -1.50 X 130
BSCVA
LE: 20/40
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COMPARATIVE STUDY OF
THE PSF
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MCU 26a Fem Wavefront total Pré e Pós
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AC 26a Fem Coma Pré e Pós
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AC 26a Fem Mapa de Zernike Pré e Pós
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MCH 26 Fem
Refração +0.50DE<>-
4.25DCx30
Acuidade visual sem
correção 20/400
Acuidade visual com
correção 20/200
Diâmetro pupilar 6.30mm
Planejamento 1 arco de
anel 160°/250µ
Refração –0.50DE<>-
2.50x60
Acuidade visual sem
correção 20/100
Acuidade visual com
correção 20/70
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MCU 26a Fem Topo Pré e Pós
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MCU 26a Fem OPD (mapa
refracional) Pré e Pós
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MCU PSF Pré e Pós
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MCU 26a Fem Wavefront HO Pré e
Pós
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MCU 26a Fem Coma Pré e Pós
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MCU 26a Fem Aberração Esférica Pré
e Pós
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MCU 26a Fem Mapa de Zernike Pré e
Pós
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NSSJ 25A Masc
Refração pré operatoria
+ 1.00DE<>-6.00x150
Av s/c 20/400
Av c/c 20/60
Planejamento 1 arco de
anel de 160°/250µ
Refração pós operatória
–0.50DE<>-1.00x150
Av s/c 20/40
Av c/c 20/25
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NSSJ 25 Masc Topo Pré e Pós
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NSSJ 25a Masc OPD (mapa
refracional) Pré e Pós
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NSSJ 25a Mas Wavefront Total Pré e
Pós
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NSSJ 25a Masc Coma Pré e Pós
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NSSJ 25a Masc Aberração Esférica
Pré e Pós
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NSSJ 25a Masc PSF Pré e Pós
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NSSJ 25a Masc Wavefront HO Pré e
Pós
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NSSJ 25a Masc Mapa de Zernike Pré
e Pós
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CLINICAL EVIDENCE
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D.N.B, MALE, 03/07/1952
ICLRGPKP
BSCVA RE 20/50
MANIFEST REFRACTION: -8,00 SPH
KONUS EVOLUTIVE STAGE III
Surgery date: 15/06/2005
Surgical strategy:
01 FR 210/25 incision 90 depth 470 micra
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HALOS COMPLAINT
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HALOS COMPLAINT
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HALOS COMPLAINT
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HALOS COMPLAINT
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HALOS COMPLAINT
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DECEMBER 2007
EXCHANGING THE W
FERRARARING FOR A YELLOW
ONE
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DISAPPEARENCE OF
HALOS COMPLAINT
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WHY PIGMENTED RING IS BETTER?
LIGHT SOURCES SPECTRA