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Combining the SCORE with the ectasia risk score system for assessing post LASIK keratectasia risk: the clinical SCORE

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Session Details

Session Title: LASIK and Imaging

Session Date/Time: Tuesday 10/10/2017 | 14:00-15:20

Paper Time: 14:18

Venue: Room 4.1

First Author: : A.Saad FRANCE

Co Author(s): :    C. Chan   D. Salik   M. Dagher   D. Gatinel           

Abstract Details


To create a new algorithm combining the Ectasia Risk Score System (ERSS) with an objective and automated topographical evaluation (SCORE) to detect corneas at risk for iatrogenic ectasia.


Rothschild Foundation, Paris, France SNEC, Singapour


Preoperative data of 111 eyes that underwent uncomplicated LASIK with 3 years of follow-up and 31 unpublished post LASIK ectasia cases were analyzed. A discriminant function was created combining the SCORE (an objective topographical evaluation of corneas) with all the original individual parameters included in the ERSS (age, residual stromal bed thickness, intended correction, central pachymetry) except the subjective topographical score of the ERSS. 'At risk' of ectasia was defined as SCORE > -0.5 and/or ERSS ≥ 3


The sensitivity and specificity of the combined scoring system were 94% and 96% respectively, exceeding the sensitivity and specificity of each individual scoring system (64 and 90% respectively for the ERSS alone, 81 and 97% respectively for the SCORE alone). Twenty nine out of 31 eyes with ectasia were correctly classified by the combined algorithm and all but 3 normal cases were correctly classified as normal.


The efficacy of the ERSS in predicting ectasia risk is limited by the absence of an objective topographical evaluation in its scoring parameters. Combining the SCORE with the ERSS helped to create a more accurate and objective clinical scoring system for the detection of ectasia susceptible corneas.

Financial Disclosure:

travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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