Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance
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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Defining ectasia susceptibility

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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: 10:10

Venue: Poster Village: Pod 4

First Author: : R.Ambrosio Jr BRAZIL

Co Author(s): :                  

Abstract Details

Purpose:

To prospectively define ectasia susceptibility, which is fundamental for evaluating candidates for laser vision correction, as well as patients with keratoconus.

Setting:

Rio de Janeiro Corneal Tomography and Biomechanics Study Group

Methods:

Considering Global consensus definitions and the two-hit hypothesis, keratoconus is a bilateral but often asymmetric disease. However, corneal ectasia may occur in any cornea due to mechanical process. A comprehensive evaluation of ectasia susceptibility considers general clinical data, along with complementary exams such as topometric (front surface curvature) and tomographic (3D corneal shape) and corneal biomechanical data. The preoperative state of 439 eyes with stable LASIK (minimal follow-up of 24 months), and from 72 eyes that developed ectasia after LASIK were compared. 241 eyes with normal topography from patients with clinical ectasia in the fellow eye were also analyzed.

Results:

85.06% of the eyes with normal topography from patients with clinical ectasia in the fellow eye were identified as with high ectasia susceptibility. All eyes that developed ectasia were identified with moderate to high ectasia susceptibility by an enhanced approach that combines uses artificial intelligence methods based on geometric data and the impact if surgery, with less than 7% of false positives among stable LASIK cases. Bilateral presentation of ectasia suspeptibility was presented in an identical twin sister with bilateral normal topography, whose sister had clinical keratoconus in one eye and fellow eye with forme fruste disease.

Conclusions:

Ectasia susceptibility is best defined among cases that developed ectasia after laser vision correction or on the retrospective evaluation of cases that had natural progression to keratoconus. Any cornea may undergo ectatic progression considering the innate biomechanical or structural predisposition and the environmental factors. This is consistent with the 'two-hit hypothesis', which consists on a genetic predisposition to biomechanical failure and a second hit by the environment. This is possible to characterize the susceptibility considering tomography data, however biomechanical data and possible genetics are needed.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a competing company

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