Low_resolution_Thesis_CDD_221009_public - Visual Optics and ...

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$XXX Congress of the European Society of Cataract and Refractive ...$

CHAPTER 5 Both the ablation algorithm design and the strategy of compensation for the ablation efficiency factors contributed to the optical outcomes. The estimated postoperative corneal asphericity is half with the new generation laser algorithms than with non-optimized algorithms (for -9 D correction), but still not negligible. Plastic artificial eye models allow a systematic evaluation of the ablation profile and of the correction factor for efficiency effects, which is essential to further improve ablation algorithms to avoid increase of corneal asphericity (and spherical aberration), which still occurs from purely physical factors. 5.6. OUTLOOK Chapters 3, 4 and 5 presented the development of an experimental model based on artificial eyes for the study of refractive surgery. Different partial experimental studies and enhancements were performed (material, measurement method, alignment procedure) to improve the model and gain precision and functionality. The methodology was applied to the study of a previous generation laser (inducing a high quantity of spherical aberration), and to three new generation lasers (which induce a reduced amount of spherical aberration). By comparing the outcomes of the surgery in the physical model and in real patients we could establish a baseline for biological effects. We found that much of the increase of spherical aberration previously attributed to biomechanical factor had in fact a physical origin. The contribution of biomechanical factors to the optical response to refractive surgery still needs to be quantified. Biomechanical effects may contribute to the final post-operative corneal shape, but if relevant, they will primarily affect the posterior corneal surface, as this may bulge by effect of intraocular pressure on a thinner cornea and lamellar disruption when cutting the flat. There are methodological problems for the quantitative study of the back surface of the cornea and the results in the literature are controversial, as measurements are subject to geometrical and optical distortions. In Chapter 6, a new experimental model for the validation of measurements of the back surface of the cornea will be presented, and applied to a Pentacam Scheimpflug imaging camera. The validated instrument will be used in Chapter 6 for the study of corneal changes after refractive surgery on real patients, with special emphasis on the posterior surface of the cornea. 154
HYBRID PORCINE/PLASTIC MODEL 6Chapter Chapter 6 - Hybrid Porcine/Plastic Model for the study of the back surface of the cornea This chapter is based on the ARVO 2009 poster presentation by Laura Remón et al. “Validation of Posterior Cornea Quantitative Scheimpflug Imaging Using a Hybrid Porcine/Plastic Model” (Remon et al., 2009). This corneal model can be used for the study of biometric measurements of the cornea. This chapter describes the model itself, and its particular use for the validation of the Pentacam Scheimpflug imaging system in the measurement of the post-corneal surface shape. The main contribution of Carlos Dorronsoro was the design of the Hybrid Porcine/Plastic Model and its experimental development, and participation in the design of the experiments, technical support during the measurements, and analysis of the data. Coauthors of the study are Laura Remón, Sabine Kling, Jesús Merayo-Lloves, and Susana Marcos. 155
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Doctoral thesis Corneal Ablation an
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Contents Corneal Ablation and Conta
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2.2.1. Fitting surfaces............
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5.3.3. Ablation efficiency factors
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10.5. DISCUSSION...................
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We thank José Antonio Sánchez-Gil
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BOZR Back Optic Zone Radius BCVA Be
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INTRODUCTION 1.1. MOTIVATION The fr
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INTRODUCTION 1.2. THE OPTICAL SYSTE
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INTRODUCTION Myopia is a very commo
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INTRODUCTION a point focus: the dif
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INTRODUCTION system, and tilt repre
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INTRODUCTION term Z 0 2 stands for
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INTRODUCTION which image was shadow
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INTRODUCTION The defocus Zernike te
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INTRODUCTION 1.4.6.3. Internal Aber
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INTRODUCTION 1.5.2.3. Alternating v
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INTRODUCTION and further-more, at l
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INTRODUCTION alcohol is used to loo
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INTRODUCTION changes in reflectivit
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INTRODUCTION Marcos et al. (Marcos
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INTRODUCTION 1.7.3. Ablation effici
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INTRODUCTION corneal surface may be
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INTRODUCTION Algorithm design: The
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INTRODUCTION contact lenses the fie
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INTRODUCTION 1.10.1. Tear studies A
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INTRODUCTION there are still many u
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INTRODUCTION 6. Evaluation and unde
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METHODS 2Chapter Chapter 2 - Method
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METHODS 2.1. MEASUREMENT OF OPTICAL
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METHODS In both profilometers, cust
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METHODS The measurement method that
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METHODS Fig. 2. 9. Set of points in
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METHODS Slit lamp Scheimpflug Camer
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METHODS representing the deviation
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METHODS 2.2.2.2. Ablation pattern f
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METHODS direction. These calculatio
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METHODS eye through the whole pupil
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METHODS (1993) power thresholds for
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METHODS alignment (frontal-illumina
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METHODS Fig. 2. 24. Example frame f
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METHODS 4) New image processing too
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METHODS Fig. 2. 28. Corrected entra
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METHODS Badal lens, corresponds to
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METHODS Each VA measurement consist
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REFRACTIVE SURGERY PMMA MODEL 3.1.
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CHAPTER 3 optimization of refractiv
Page 104 and 105: CHAPTER 3 These data demonstrate th
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Page 108 and 109: CHAPTER 3 Figure 3.3 shows one of t
Page 110 and 111: CHAPTER 3 Ablation efficiency facto
Page 112 and 113: CHAPTER 3 considering the same set
Page 114 and 115: CHAPTER 3 3.5.3 Impact of correctio
Page 117: ABLATION PROPERTIES OF FILOFOCON A
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Page 133: ABLATION PROPERTIES OF FILOFOCON A
Page 137: OPTIMIZED LASER PLATFORMS 5.1 ABSTR
Page 140 and 141: CHAPTER 5 pulses. Fluence, repetiti
Page 142 and 143: CHAPTER 5 ablations. The slit-confo
Page 144 and 145: CHAPTER 5 (Anera et al., 2003): d S
Page 146 and 147: CHAPTER 5 asymmetries also appeared
Page 148 and 149: CHAPTER 5 5.3.4. Ablation patterns
Page 150 and 151: CHAPTER 5 a) b) : 6.5 mm c) Fig. 5.
Page 152 and 153: CHAPTER 5 achieve proper reflection
Page 157: HYBRID PORCINE/PLASTIC MODEL 6.1. A
Page 160 and 161: CHAPTER 6 6.3.1. Hybrid porcine-pla
Page 162 and 163: CHAPTER 6 is detected. Therefore, i
Page 164 and 165: CHAPTER 6 no preferential orientati
Page 167: ANTERIOR AND POSTERIOR CORNEAL ELEV
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Page 187: SOFT CONTACT LENS FITTING USING MOD
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Page 194: ON-EYE OPTICAL PERFORMANCE OF RIGID
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ON-EYE OPTICAL PERFORMANCE OF RIGID
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SOFT MONOFOCAL AND MULTIFOCAL CONTA
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SOFT MONOFOCAL AND MULTIFOCAL CONTA
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CORRELATION BETWEEN RADIUS AND ASPH
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CONCLUSIONS Conclusions This thesis
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CONCLUSIONS 5We have developed a pr
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CONCLUSIONS LIST OF METHODOLOGICAL
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CONCLUSIONS FUTURE RESEARCH LINES T
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CONCLUSIONS LIST OF PUBLICATIONS AN
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REFERENCES References AIZAWA, D., S
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REFERENCES PHOTODECOMPOSITION (APD)
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REFERENCES DORRONSORO, C., CANO, D.
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REFERENCES GISPETS, J., ARJONA, M.
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REFERENCES KOPF, M., YI, F., ISKAND
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REFERENCES MARCOS, S., DORRONSORO,
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REFERENCES NOVO, A., PAVLOPOULOS, G
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REFERENCES SAKIMOTO, T., ROSENBLATT
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REFERENCES WANG, L., DAI, E., KOCH,
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RESÚMENES pacientes reales fue com
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RESÚMENES experimentales de cirug
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RESÚMENES cada punto de las cornea
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RESÚMENES plástico medidas anteri
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RESÚMENES 8 Evaluación óptica de
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RESÚMENES 9 Prestaciones ópticas
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RESÚMENES 10 Calidad óptica y cal
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RESÚMENES A Correlación entre rad
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CONCLUSIONES clínicos. La descripc
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CONCLUSIONES 12 Las superficies ocu
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CONCLUSIONES IMPLICACIONES DE ESTA
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CONCLUSIONES contribuyen a la compr
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(y muchísimo más difícil). Me da
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