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    Corneal tomography or topography: When to make the clinical decision

    Tomography brings novel abilities, but classic imaging technologies aren't going anywhere


    Corneal tomography represents a major advance for diagnosis, prognosis, and treatment planning, but there remains a need for classic imaging technologies, such as Placido topography, along with a comprehensive clinical evaluation, said Renato Ambrósio Jr., MD, PhD.

    Scheimpflug corneal tomography is a three-dimensional imaging technique that characterizes the anterior/posterior corneal surfaces, along with corneal thickness distribution.


    Discussing applications

    Dr. Ambrósio said that a classic question about tomography relates to whether it is a more sensitive modality than Placido disk-based topography to detect mild forms of keratoconus and screen for ectasia risk prior to refractive laser vision correction (LVC).

    Findings from research conducted by Dr. Ambrósio and others involving cases with very asymmetric ectasia (VAE) along with lessons learned from many case reports of post-LVC ectasia indicate that the answer is unquestionably “yes”.1-13

    Nevertheless, there is still room for improving its performance in this application.

    “In the quest for enhanced ectasia diagnosis, we have to go beyond topography, which only provides two-dimensional information about the front surface of the cornea," said Dr. Ambrósio, professor of ophthalmology, Federal University of the State of Rio de Janeiro (UniRIO), Brazil.

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