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Advanced epithelial mapping for refractive surgery.

Pooja Khamar1, Kavita Rao2, Kareeshma Wadia3

  • 1Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, India.

Indian Journal of Ophthalmology
|November 24, 2020
PubMed
Summary
This summary is machine-generated.

Detecting subclinical keratoconus (KC) early is crucial to prevent post-refractive surgery complications. Epithelial mapping using Optical Coherence Tomography offers a promising method to supplement diagnosis and guide treatment decisions for corneal ectatic disorders.

Keywords:
Epithelial mappingkeratoconuspreferred practicesrefractive surgery

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Diagnostic Imaging

Background:

  • Subclinical keratoconus (KC) presents a significant risk for iatrogenic ectasia after refractive surgery.
  • Current diagnostic methods like corneal topography may miss early-stage KC due to epithelial remodeling.
  • Accurate detection of subclinical KC is vital for surgical planning and preventing adverse outcomes.

Purpose of the Study:

  • To review the utility of Optical Coherence Tomography (OCT)-based epithelial mapping devices in diagnosing and managing subclinical keratoconus (KC).
  • To explore how independent analysis of corneal epithelium and stroma can improve understanding of refractive surgery outcomes and KC.
  • To guide clinicians on integrating epithelial mapping into practice for better diagnosis and management of KC and post-refractive surgery complications.

Main Methods:

  • Review of literature on Optical Coherence Tomography (OCT) devices for corneal epithelial mapping.
  • Focus on specific OCT devices like RTVue and MS-39 for their application in KC and refractive surgery.
  • Analysis of how epithelial and stromal data contribute to diagnosing corneal ectatic disorders.

Main Results:

  • Epithelial remodeling can mask stromal irregularities indicative of early keratoconus (KC).
  • OCT-based epithelial mapping provides detailed insights into corneal surface and stromal changes.
  • Devices like RTVue and MS-39 show potential in identifying subclinical cases missed by traditional topography.

Conclusions:

  • Epithelial mapping using OCT is a valuable tool to supplement corneal topography in detecting subclinical keratoconus (KC).
  • Integrating epithelial mapping can enhance diagnostic accuracy, aid in surgical decision-making, and improve management of corneal ectatic disorders.
  • This approach offers a more comprehensive understanding of outcomes in refractive surgery and keratoconus management.