New Trends in Corneal Topography

Tips on Galileis Optical Pachymetry

Carlos G. Arce, MD
Associate Researcher and Ophthalmologist
Ocular Bioengineering & Refractive Surgery Sectors, Institute of Vision Department of Ophthalmology, Paulista School of Medicine Federal University of So Paulo, Brazil
Financial Disclosure: Carlos G. Arce MD: Territory Manager for Latin America, Vista Optics Limited, Widnes, UK Research & Development Consultant, Ziemer Group AG, Port, Switzerland Speaker, Bausch & Lomb do Brasil
Author does not have financial interest in the commercialization of equipments mentioned

New Trends in Corneal Topography Normal Values with Galilei

Traffic light color distribution gives a meaning to scales of curvature, pachymetry and elevation maps 2nd yellow: 47 D in Curvature (1 D step) 500 m in Thickness (15-20 m step) 15 m in Elevation (5 m step) 2nd green: 44 D in Curvature 530 or 560 m in Thickness Zero m in elevation RED = STEEP, THIN or HIGH STOP! YELLOW = BORDER LINE CAUTION! GREEN = NORMAL GO AHEAD! BLUE BLUE = = FLAT, FLAT, THICK THICK or or DEEP DEEP WHY? WHY?

New Trends in Corneal Topography Corneal Pachymetry is not only one value

Normal distribution pattern: Central warmer zone with concentric rings Normal difference between peripheral and central average seems to be 150-200 m

New Trends in Corneal Topography Corneal Pachymetry is not only one value

Galilei default distribution of colors is better because have 6 instead of only 3 green steps for normal range

New Trends in Corneal Topography Corneal Pachymetry is not only one value

Galilei default distribution of colors is better because have 6 instead of only 3 green steps for normal range

New Trends in Corneal Topography Thickness Progression Profile Normal Slope Number of steps using scales of 15 m or 20 m

1 2 3 4

5 6 7 8 9

Steep Slope
1 2 34 5 6 7 8 9 10 11 12

Simple and practical No need of graphics or curves

New Trends in Corneal Topography Thickness Progression Profile

High astigmatism with KPI = 0% Normal slope: <10 steps of 20 m

New Trends in Corneal Topography Thickness Progression Profile

Assymetric curvature with KPI = 14% Border line slope: 10 steps of 20 m

New Trends in Corneal Topography Thickness Progression Profile

Keratoconus with KPI = 76% Steep slope: 13 steps of 20 m

New Trends in Corneal Topography Thickness progression may be assymetric 12 steps of 20 m

TPI: Thickness Progression Index derived from overall linear regression y = Ax + B TP = (TPI) d + T0

TPI = TP T0
d Examples: TPIA = (647-501)/5.2 = 28.07 m/mm TPIB = (690-501)/2.4 = 78.75 m/mm Future: Color maps made from TPI

New Trends in Corneal Topography Thinnest Point and Pupil Centroid

Thinnest point thinner than 500 m AND located beyond 1 mm from the pupil centroid is KCN until demonstrate against
Alzamora JB, Stillitano I, Maidana EJ, Arce CG, Schor P, Campos M, Chalita MR, Sartori M. Variao espacial da espessura da cnrea medida por paquimetria quantitativa de rea. In: Arce C, Francesconi M, Nose W Editors. Concenso Orbscan. Cultura Medica. RJ. In press

New Trends in Corneal Topography Pachymetry Map

New Trends in Corneal Topography Clinic correlation with Topography

Thinning Healing

New Trends in Corneal Topography Deepness of opacities

Horizontal Slit

Vertical Slit

New Trends in Corneal Topography Deepness of corneal layers

Courtesy of Sonia Yoo, MD Bascom Palmer Eye Institute

Incongruency of anterior & posterior curvature Thick cornea with asymetric and uncommon pattern KCN Report: KPI = 40.6 %

590-610 m CCT 654 m

Inferior KCN in Epithelium Fuchs Densitometry Maxthick 31 % with

691-714 m

cornea