![]() Figure 4 demonstrates a change of 2.35D after three months of treatment. If significant change is noted at one month, further treatment and repeated topography may be indicated. The steep meridian increased from 41.58D to 42.12D. Figure 3 demonstrates the change in Effective Refractive Power (ERP) from 40.86D to 41.38D after one month of treatment. Treatment of significant ocular surface disease may change the corneal power. The iTrace measures quality of vision and visual function using a fundamental thin beam principle of optical ray tracing, a first in eye care diagnostics. Demonstrate the effect for the patient in order to reassure them the treatment is working, and this will improve their final outcome. Upon return, reassess topography for a change in curvature. ( Figure 2) If treatment is indicated, initiate your course of therapy. ( Figure 1) Patients with a history of refractive surgery should be treated for at least one month prior to surgery for best results. When examining a patient for cataract surgery, consider the tear film, examine the lids and assess the ocular surface using topography. When assessing topography, one should examine the pattern as well as indices and keratometry values. ![]() ![]() Note the change in Effective Refractive Power (ERP) from 40.86D to 41.38D after one month of treatment. This may be accomplished by referring to a corneal specialist for both corneal and cataract evaluation, or may require separate referrals.įigure 3. Consider addressing corneal issues such as EBMD, Salzmann’s degeneration or keratoconus prior to cataract surgery. Treating ocular inflammation, lid disease including meibomian gland dysfunction and blepharitis, and corneal issues prior to referral ensures correct measurements and demonstrates clinical prowess to the surgeon. It is important to consider whether the patient you are referring for surgery is ready for these measurements. Autokeratometry or topography used in intraocular lens (IOL) calculations is critical for strong outcomes and also may be influenced by ocular surface disease. Biometry, or axial length measurement, is now performed optically rather than with ultrasound. Ocular surface disease can affect these measurements and, subsequently, the outcomes.Ĭataract surgery also requires corneal measurements. These require higher order aberrations and topography information to be acquired for surgical planning. Not only do we have wavefront-guided and wavefront-optimized LASIK, we now have topography-integrated as well as topography-guided applications. Patients’ options for vision correction have advanced considerably. Images: Tracy Schroeder Swartz, OD, MS, FAAO, Dipl ABO This patient’s blurry vision is due to the cataract, and this patient is read for surgery. This iTrace display (Tracey Technologies, Houston, TX) demonstrates the effect of the healthy external cornea (clear, left “E”), cataractous lens (blurry, middle “E”) and overall vision (blurry right “E”).
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