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Inconsistencies in topographic assessments may enhance value of other variables in ectasia risk formula
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CHICAGO — In a discussion on the role of the Ectasia Risk Score System, a presenter here suggested that variability in topographic assessments may make consideration of the remaining variables even more significant.
“There is discrepancy in topographic analysis between surgeons. … Subtle abnormalities are unfortunately still missed,” J. Bradley Randleman, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Risk factors included in the scoring system are topography, residual stromal bed, corneal thickness, myopia and age. Dr. Randleman highlighted that corneal thickness, residual stromal bed estimates and ablation depth are all linked to variability in final thickness.
“Corneal thickness is a potential marker for subclinical [ectatic] disease, and it also increases the risk for low residual stromal bed. There is a need for thin, reproducible flaps,” he said.
While particularly thin flaps may lead to ectasia, this occurrence is rare, Dr. Randleman noted. Moreover, a 2008 dataset from Optical Express suggested a 0.03% incidence of ectasia among patients treated with femtosecond laser. The study included 64,695 eyes of 33,561 patients with 2 to 3 years of follow-up.
“[Additionally,] age remains a defined risk factor, until surgeons determine other ways to do screening,” Dr. Randleman said.
- Disclosure: Dr. Randleman has no relevant financial disclosures.