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Detection of postlaser vision correction ectasia with a new combined biomechanical index

Authors
 Riccardo Vinciguerra  ;  Renato Ambrósio Jr  ;  Ahmed Elsheikh  ;  Farhad Hafezi  ;  David Sung Yong Kang  ;  Omid Kermani  ;  Shizuka Koh  ;  Nanji Lu  ;  Prema Padmanabhan  ;  Cynthia J Roberts  ;  Suphi Taneri  ;  William Trattler  ;  Ashkan Eliasy  ;  Ikhyun Jum  ;  Bernardo Lopes  ;  Vasanthi Padmanaban  ;  Pietro Rosetta  ;  Anika Rost  ;  Emilio A Torres-Netto  ;  Paolo Vinciguerra 
Citation
 JOURNAL OF CATARACT AND REFRACTIVE SURGERY, Vol.47(10) : 1314-1318, 2021-10 
Journal Title
JOURNAL OF CATARACT AND REFRACTIVE SURGERY
ISSN
 0886-3350 
Issue Date
2021-10
MeSH
Biomechanical Phenomena ; Cornea ; Corneal Topography ; Dilatation, Pathologic ; Elasticity ; Humans ; Keratoconus* ; Retrospective Studies
Abstract
Purpose: To validate and evaluate the use of a new biomechanical index known as the Corvis biomechanical index-laser vision correction (CBI-LVC) as a method for separating stable post-LVC eyes from post-LVC eyes with ectasia.

Setting: 10 clinics from 9 countries.

Design: Retrospective, multicenter, clinical study.

Methods: The study was designed with 2 purposes: to develop the CBI-LVC, which combines dynamic corneal response (DCR) parameters provided by a high-speed dynamic Scheimpflug camera (CorVis ST; OCULUS Optikgeräte GmbH) and then to evaluate its ability to detect post-LVC ectasia. The CBI-LVC includes integrated inverse radius, applanation 1 (A1) velocity, A1 deflection amplitude, highest concavity and arclength, deformation amplitude ratio of 2 mm, and A1 arclength in millimeters. Logistic regression with Wald forward stepwise approach was used to identify the optimal combination of DCRs to create the CBI-LVC and then separate stable from LVC-induced ectasia. Eighty percentage of the database was used for training the software and 20% for validation.

Results: 736 eyes of 736 patients were included (685 stable LVC and 51 post-LVC ectasia). The receiver operating characteristic curve analysis showed an area under the curve of 0.991 when applying CBI-LVC in the validation dataset and 0.998 in the training dataset. A cutoff of 0.2 was able to separate stable LVC from ectasia with a sensitivity of 93.3% and a specificity of 97.8%.

Conclusions: The CBI-LVC was highly sensitive and specific in distinguishing stable from ectatic post-LVC eyes. Using CBI-LVC in routine practice, along with topography and tomography, can aid the early diagnosis of post-LVC ectasia and allow intervention prior to visually compromising progression.
Full Text
https://journals.lww.com/jcrs/fulltext/2021/10000/detection_of_postlaser_vision_correction_ectasia.13.aspx
DOI
10.1097/j.jcrs.0000000000000629
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Jun, Ik Hyun(전익현) ORCID logo https://orcid.org/0000-0002-2160-1679
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190721
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