September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A Multicenter Study of Ocular Response Analyzer Custom Variables in Disqualified and Candidate Refractive Surgery Screening Patients
Author Affiliations & Notes
  • Vinicius Silbiger De Stefano
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Ibrahim Seven
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • James Bradley Randleman
    Emory Eye Center, Emory University, Atlanta, Georgia, United States
  • William J Dupps
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Vinicius De Stefano, None; Ibrahim Seven, None; James Randleman, None; William Dupps, Cleveland Clinic / OptoQuest (P)
  • Footnotes
    Support  CAPES Grant PDSE - 99999.007333/2015-03; R01 EY023381; Ohio Third Frontier Innovation Platform Award TECH 13-059; Unrestricted Grant from RPB to the Dept. of Ophthalmology of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Unrestricted Grant from RPB to the Dept. of Ophthalmology of the Emory University
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2389. doi:
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      Vinicius Silbiger De Stefano, Ibrahim Seven, James Bradley Randleman, William J Dupps; A Multicenter Study of Ocular Response Analyzer Custom Variables in Disqualified and Candidate Refractive Surgery Screening Patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2389.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the ability of air-puff derived measures of biomechanical behavior to predict clinical decisions on refractive surgery candidacy.

Methods : Data were retrospectively collected from consecutive refractive surgery screening exams by two surgeons from different academic centers (Cleveland Clinic Cole Eye Institute (CC) and Emory Eye Center (EEC)). Only right eyes were analyzed. The disqualified subject groups consisted of 19 (CC) and 28 (EEC) eyes and included subjects who were disqualified as candidates based on clinical impression after reviewing available clinical, topo/tomographic (Placido and Scheimpflug), and biomechanical data (Ocular Response Analyzer (ORA)). Control groups consisted of eyes deemed clinically to be safe candidates for LASIK (n=26 (CC) and 23 (EEC)). Keratometric and pachymetric data from the Pentacam were compared for each group. While standard ORA variables were available to surgeons at the time of the decision, the 3 investigator-derived variables (Table 1, previously described by Hallahan et al, Ophthalmol 2014) were calculated retrospectively and surgeons were effectively masked to them. Comparisons were performed using t-tests for independent samples.

Results : Anterior curvature and corneal thickness data were significantly different between groups (Table 1). Hysteresis loop area (HLA) was the only biomechanical variable that was significantly different between disqualified and control subjects across both centers (Table 2).

Conclusions : Across two clinical sites, a custom biomechanical variable, HLA, was predictive of which refractive surgery screening patients were selected for LASIK and which were disqualified. Certain measures of the corneal dynamic response to an air puff may serve as objective correlates to clinically perceived risk of ectasia.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Table 1. Disqualified patients group and control group baseline and pre-operative corneal features.

Table 1. Disqualified patients group and control group baseline and pre-operative corneal features.

 

Table 2. Pre-operative variables derived from the ORA for disqualified and control (candidate) patient groups.

Table 2. Pre-operative variables derived from the ORA for disqualified and control (candidate) patient groups.

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