Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Bowman roughness index: new index to quantify Bowman's layer changes in keratorefractive practice and procedures

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Session Details

Session Title: Presented Poster Session: Anterior Segment Imaging

Session Date/Time: Monday 12/09/2016 | 09:30-11:00

Paper Time: 09:40

Venue: Poster Village: Pod 4

First Author: : R.Shroff INDIA

Co Author(s): :    R. Shetty   A. Agrawal   N. Pahuja        

Abstract Details


To study and quantify the impact of changes in Bowmans layer (BL) in keratoconus and Small Incision Lenticule Extraction (SMILE) surgery using Bowmans Roughness Index (BRI) and assess the effect of these changes on clinical parameters


Narayana Nethralaya, a tertiary eyecare hospital in India


High resolution SD-OCT (Bioptigen) was used to scan corneas of subjects of keratoconus and those undergoing SMILE before and at 1 day, 1 week and 1 month after surgery. This index (BRI) for area under undulations was calculated with inbuilt inhouse software. The anterior edge of the BL was segmented from OCT images. After segmentation, a 3rd order polynomial was curve fit to the segmented pixels of the BL edge. The area between the microdistortions and curve fit was evaluated. Visual acuity, refraction and biomechanics were evaluated. BRI was calculated for normals and in different grades of keratoconus.


In SMILE BRI was found to have significant change (P < 0.001) towards varying time points, which was maximum at 1 week and then decreased in a month and beyond. Correlation was also found between refractive error and BRI. In keratoconus mean BRI was 2.15, 1.87 and 1.7 mm2 in normal, FFKC and KC eyes, respectively (p=0.001). BRI had an area under the ROC curve of (0.7) and sensitivity of (93.3%) for detection of FFKC.


BRI quantifies changes in BL following SMILE and is dependent on refractive error. BRI is significantly altered in FFKC eyes, indicating morphological changes may occur before topographic manifestations In keratoconus BRI can be used as a screening tool for FFKC. BRI highlights the importance of the BL in keratorefractive practice.

Financial Disclosure:


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