3-D OCT Biometry & the future of IOL selection
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1 57th Portuguese Congress of Ophthalmology, Dec D OCT Biometry & the future of IOL selection Susana Marcos, PhD Visual Optics and Biophotonics Lab Disclosures Partly funded by ended research project with Alcon; Patent
2 Superluminescent Diode (840 nm) Delay line Spectrometer Scanning & Collimation CMOS Line Camera Axial resolution: 6.9 µm in tissue Transverse resolution: 27 µm, Axial range: 5.2 mm in tissue. Sensitivy: 19.5 db Acquisition rate: up to Ascans/s Grulkowski et al.opt. Exp. 2009
3 Custom Spectral OCT Custom algorithms for fan distortion and optical distortion corrections
4 Quantitative OCT imaging Input data Denoising Statistical thresholding Segmentation 3-D merging Clustering Zernike fit Distortion correction Output data
5 Quantitative Anterior segment OCT Ortiz et al. Biomedical Optics Express 2012
6 & Pachymetry Pupilometry Anterior Chamber Depth Lens thickness Lens tilt and decentration Ortiz et al. BOE 2012
7 Lens shape Gradient Index (GRIN) In the same eyes As a function of aging and accommodation Ex vivo (shape/grin) In vivo (shape/ towards GRIN)
8 In vivo crystalline lens surfaces topographic maps Ortiz et al. BOE 2012
9 OCT-based biometry vs accommodation Pupil diameter Anterior Chamber Depth Lens thickness Lens phakometry Gambra et al. BOE 2013
10 OCT dynamic accommodative response Gambra et al. BOE 2013
11 Full 3-D OCT biometry in cataract surgery Ortiz et al. Biomedical Optics Express 2013 Optics & Photonics News, Best of 2013
12 A-IOL Study Crystalens AO B&L 20 patients bilaterally implanted with Crystalens AO A-IOLs Pre-op and Post-op (>6 months) measurements Accommodative demands: 0, 1.25 and 2.5 D Natural viewing, Phenilephrine and Pilocarpine conditions
13 Experimental measurements Custom soct Custom Laser Ray Tracing Commercial PowerRefractor 0 D 1.25 D 2.5 D
14 Pre- and Post-A-IOL Implantation A-IOL -480 µm relative to the anterior natural crystalline lens Marcos et al. Ophthalmology 2014
15 A-IOL change with Acc. demand Patient 1 Relative A-IOL shift: 110 µm (forward); Relative IOL tilt: 1.6º Marcos et al. Ophthalmology D 1.25 D 2.5 D
16 A-IOL change with Acc. demand Patient 2 Relative A-IOL shift: 700 µm (backward); Relative IOL tilt: 0.4º Marcos et al. Ophthalmology D 1.25 D 2.5 D
17 A-IOL shift with accommodative demand Forward shift Backward shift Measurements under phenylephrine Marcos et al. Ophthalmology 2014
18 A-IOL tilt Natural lens tilt (Pre-op) OD OS IOL A-IOL lens tilt (Post-op) OD OS Measurements under phenylephrine Marcos et al. Ophthalmology 2014
19 A-IOL tilt with accommodative demand Measurements under phenylephrine Marcos et al. Ophthalmology 2014
20 Customized eye modelling Predicted Measured IOL with tilt & dec. Anterior cornea ACD & AL Total aberrations Rosales & Marcos, Optics Express 2007 IOL geometry, tilt & dec.
21 Measured Only cornea Predicted from experimental data Cornea + IOL design Cornea + IOL tilt & dec #1 #2 #3 Rosales & Marcos, Optics Express 2007
22 Linking geometry and optical performance Towards Full OCT-based eye models
23 Patient and IOLs Three Patients (5 eyes) 72 years old (average) Three types of IOL: 1 CT Asphina 409M (ZEISS, Jena, Germany) 2 Akreos AO M160 (Bausch and Lomb, Rochester, New York,US) 2 Acrysof IQ SN60WF (Alcon, Texas, US)
24 OCT-based ray tracing vs LRT aberrations LRT vs simulation Zernike weight /um) Zernike term Cornea LRT LRT Ray Tracing Ray Tracing with Tilt/Dec Sun et al. 2014
25 OCT and the future of IOL surgery 1-D biometry 3-D biometry
26 OCT and the future of IOL surgery IOL-power regression formulae Ray-tracing based IOL Power selection
27 OCT and the future of IOL surgery More comprehensive account of the Estimated Lens Position (ELP) No need of keratometric index More accurate ACD data OCT-based Customized computer eye models Ray tracing based IOL power calculation Allows IOL customized selection Complete post-surgical evaluation of IOL implantation and eye optical quality Essential in the implant and assessment of premium IOLs
28 Visual Optics and Biophotonics Lab VIOBIO, Daniel Cortés, Alberto de Castro, Enrique Bustos, Carlos Dorronsoro, Sabine Kling, Susana Marcos, Maria Viñas, Nandor Bekesi, Sergio Barbero, Judith Birkenfeld, Jorge Lamela, Daniel Pascual, Miriam Velasco, Lucie Sawides, Mengchan Sun, Pablo de Gracia, Sergio Ortiz, Aiswaryah Radhakrishnan, Eduardo Martínez
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