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Enhanced ectasia susceptibility screening based on clinical and tomographic data

Poster Details

First Author: I.Ramos BRAZIL

Co Author(s):    B. Lopes   M. Salomão   L. Jordao   A. Luz   R. Correa   R. Ambrósio

Abstract Details



Purpose:

To test a previously presented criteria based on clinical and corneal tomography data to identify pre-operative risk (susceptibility) for ectasia.

Setting:

Instituto de Olhos Renato Ambrósio, Rio de Janeiro-RJ, Brazil; Hospital de Olhos Santa Luzia, Maceió-AL, Brazil; Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro-RJ, Brazil.

Methods:

The pre-operative clinical and tomographic data from forty-six eyes from 38 patients that developed ectasia after LASIK (Group 1), and 266 control eyes from 141 patients with stable LASIK (Group 2) were analyzed. The 'Enhanced Ectasia Susceptibility Screening' (EESS), a combined parameter based logistic regression analysis of clinical and corneal tomography data was previously described to identify pre-operative risk for ectasia. The EESS was used to distinguish the groups. The Mann-Whitney U test and the area under the ROC curve (AUC) were used to verify the diferences between the groups, and test the performance of this criteria in this series.

Results:

Statistically significant difference was found among the groups for EESS (p<0.0001, Mann-Whitney test). EESS obtained 90.5% of sensitivity and 92.1% of specificity, with AUC = 0.936 (95% Confidence Interval = 0.902 to 0.960; Standard Error = 0.0318; Cut-off = -2.31; Z statistic = 13.722; Significance level p < 0.001) to distinguish ectasia susceptibility after LASIK from stable LASIK cases.

Conclusions:

The EESS is a valid and effective method for detecting eyes at risk for ectasia after LASIK. Although it represents a significant improvement over previously utilized screening strategies, other artificial intelligence strategies may be applied to optimize accuracy. Also, novel diagnostic criteria, such as corneal biomechanics should be considered. FINANCIAL INTEREST: NONE

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