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Financial Disclosure: Financial Disclosure: Carlos G. Carlos G. ArceArce MD:MD:
Territory Manager for Latin America, Vista Optics Limited, Territory Manager for Latin America, Vista Optics Limited, WidnesWidnes, UK, UKResearch & Development Consultant, Research & Development Consultant, ZiemerZiemer Group AG, Port, SwitzerlandGroup AG, Port, Switzerland
Speaker, Bausch & Lomb do Speaker, Bausch & Lomb do BrasilBrasilAuthor does not have financial interest in the commercializationAuthor does not have financial interest in the commercialization of equipments mentionedof equipments mentioned
CarlosCarlos G. G. Arce,Arce, MDMD
Tips on Galilei’s Optical PachymetryTips on Galilei’s Optical Pachymetry
Associate Researcher and Ophthalmologist Ocular Bioengineering & Refractive Surgery Sectors, Institute of Vision
Department of Ophthalmology, Paulista School of MedicineFederal University of São Paulo, Brazil
New Trends in Corneal TopographyNew Trends in Corneal Topography
Normal Values with GalileiNormal Values with Galilei
New Trends in Corneal TopographyNew Trends in Corneal Topography
Traffic light color distribution gives a meaning to scales of curvature, pachymetry and
elevation maps
2nd yellow:2nd yellow:47 D in Curvature (1 D step)
500 500 μμmm in Thickness (15in Thickness (15--20 20 μμm step)m step)15 μm in Elevation (5 μm step)
2nd green:2nd green:44 D in Curvature
530 or 560 530 or 560 μμmm in Thickness in Thickness Zero μm in elevation
RED = STEEP, THIN or HIGH RED = STEEP, THIN or HIGH STOP!STOP!YELLOW = BORDER LINE YELLOW = BORDER LINE CAUTION!CAUTION!
GREEN = NORMAL GREEN = NORMAL GO AHEAD!GO AHEAD!BLUE = FLAT, THICK or DEEP BLUE = FLAT, THICK or DEEP BLUE = FLAT, THICK or DEEP WHY?WHY?WHY?
Corneal Pachymetry is not only one value Corneal Pachymetry is not only one value
New Trends in Corneal TopographyNew Trends in Corneal Topography
Normal distribution pattern: • Central warmer zone with concentric rings• Normal difference between peripheral and central average seems to be 150-200 μm
Corneal Pachymetry is not only one value Corneal Pachymetry is not only one value
New Trends in Corneal TopographyNew Trends in Corneal Topography
Galilei default distribution of colorsis better because have 6 instead of only 3 green steps for normal range
Corneal Pachymetry is not only one value Corneal Pachymetry is not only one value
New Trends in Corneal TopographyNew Trends in Corneal Topography
Galilei default distribution of colorsis better because have 6 instead of only 3 green steps for normal range
New Trends in Corneal TopographyNew Trends in Corneal Topography
12
12
3
3
4
4
5
5
6
6
7
7
8
89
9
101112
Normal Slope
Steep Slope
Thickness Progression Profile Thickness Progression Profile
Number of steps using scales of 15 μm or 20 μm
• Simple and practical• No need of graphics or curves
New Trends in Corneal TopographyNew Trends in Corneal Topography
High astigmatism with KPI = 0%Normal slope: <10 steps of 20 μm
Thickness Progression Profile Thickness Progression Profile
New Trends in Corneal TopographyNew Trends in Corneal Topography
Thickness Progression Profile Thickness Progression Profile
Assymetric curvature with KPI = 14%Border line slope: 10 steps of 20 μm
New Trends in Corneal TopographyNew Trends in Corneal Topography
Thickness Progression Profile Thickness Progression Profile
Keratoconus with KPI = 76%Steep slope: 13 steps of 20 μm
ThicknessThickness progression may be assymetricprogression may be assymetric
TPI: TThickness PProgression IIndex derived from overall linear regression
y = Ax + B TP = (TPI) d + T0
TPI = TP – T0d
New Trends in Corneal TopographyNew Trends in Corneal Topography
12 steps of 20 μm
A
B
Examples:TPIA = (647-501)/5.2 = 28.07 μm/mmTPIB = (690-501)/2.4 = 78.75 μm/mm
Future: Color maps made from TPI
Thinnest Point and Pupil Thinnest Point and Pupil CentroidCentroid
• Alzamora JB, Stillitano I, Maidana EJ, Arce CG, Schor P, Campos M, Chalita MR, Sartori M.Variação espacial da espessura da cónrea medida por paquimetria quantitativa de área.
In: Arce C, Francesconi M, Nose W Editors. Concenso Orbscan. Cultura Medica. RJ. In press
TN
New Trends in Corneal TopographyNew Trends in Corneal Topography
Thinnest point thinner than 500 μm AND located beyond 1 mm from the pupil centroid is KCN until demonstrate against
PachymetryPachymetry MapMap
New Trends in Corneal TopographyNew Trends in Corneal Topography
Clinic correlation with TopographyClinic correlation with Topography
New Trends in Corneal TopographyNew Trends in Corneal Topography
ThinningThinning
HealingHealing
Deepness of opacitiesDeepness of opacities
Horizontal Slit
Vertical Slit
New Trends in Corneal TopographyNew Trends in Corneal Topography
Deepness of corneal layersDeepness of corneal layers
New Trends in Corneal TopographyNew Trends in Corneal Topography
Courtesy of Sonia Yoo, MD Courtesy of Sonia Yoo, MD ––Bascom Palmer Eye InstituteBascom Palmer Eye Institute
• Incongruency of anterior & posterior curvature
• Thick cornea with asymetric and uncommon pattern
≈ 590-610 μm
CCT 654 μm
≈ 691-714 μmInferiorEpithelium
Densitometry Max 31 %
KCN in Fuchs
with thick cornea
• KCN Report: KPI = 40.6 %
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