5/8/2019 1 Ihab M. Osman Ass. Prof. of Ophthalmology Alexandria University FRCS Glasgow ESOIRS 2018 Regular Pentacam HR Pentacam Light source blue LEDs (475 nm UV-free) Speed 50 images in 2 seconds, 500 measuring points per image 50 images in 2 seconds, 2760 measuring points per Scheimpflug image Number of measured points max. 25.000 max. 138.000
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5/8/2019
1
Ihab M. Osman
Ass. Prof. of Ophthalmology
Alexandria University
FRCS Glasgow
ESOIRS 2018
Regular Pentacam HR Pentacam
Light source blue LEDs (475 nm UV-free)
Speed50 images in 2 seconds, 500 measuring points
per image
50 images in 2 seconds, 2760 measuring points per
Scheimpflug image
Number of measured
points
max. 25.000 max. 138.000
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Keratoconus Assay
4 Maps Refractive
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Amsler-Krumeich (AK) system
In the AK system, the severity of keratoconus is graded from stage 1–4 using spectacle refraction, central keratometry, presence or absence of scarring, and central corneal thickness.Limited by:• Absent posterior corneal data• Failure to put thinnest location into consideration
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Thickness Indices
Belin/Ambrosio AssayDeviation Indices
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How to Monitor KC Progression
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Fast screening report
Pentacam HR and Cataract
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Fast screening report
Calculation of K readings for IOL formulas
1. Holladay report
2. Detailed holladay report
Pentacam HR and Cataract
(EKR) that can be used in older version IOL formulas that correct for n=1.3375.
Total corneal refractive power map cannot be used in conventional IOL formulas but can be used for newer versions of IOL calculation formulas
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Holladay Report
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The EKR65 values is optimal to use in IOL power
calculations formulas using the Holladay IOL consultant software.
It needs no additional adjustments are necessary for the back surface in toric IOL calculations.
Fast screening report
Calculation of K readings for IOL formulas
1. Holladay report
2. Detailed holladay report
Cataract preoperative report for premium IOL
Pentacam HR and Cataract
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Less than 0.3 micron
Evaluation of irregular astigmatismDetection of abnormal corneal shape
Evaluation of corneal spherical aberrations
•0.1 micron( 6 mm) or higher for aspheric IOLs
•Less than 0.1 for spherical IOL
Evaluation of corneal cylinder
Fast screening report
Calculation of K readings for IOL formulas
1. Holladay report
2. Detailed holladay report
Cataract preoperative report for premium IOL
Grading of nuclear cataract density(PNS)
Pentacam HR and Cataract
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It evaluates the optical density of the lens by analyzing the backward scatter.
Examination with the eye is dilated.
The software automatically calculates the density of a central, 3-dimensional reference block, grading it from 0 to 5.
Pentacam®Nucleus Staging (PNS)
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Fast screening report
Calculation of K readings for IOL formulas
1. Holladay report
2. Detailed holladay report
Cataract preoperative report for premium IOL
Grading of nuclear cataract density(PNS)
Phakic IOLs
Pentacam HR and Cataract
Phakic IOLs
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Calculates the required pIOL power using the implanted
calculator.
Allows a simulation of the pIOL position in up to 30 years.
The crystalline lens grows approximately 19 μm per year a with possible consequence of endothelial cell loss.
3D pIOL Simulation Software and Aging Prediction for iris fixated
pIOL
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Normal depth AC
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Shallow AC
Deep AC
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Fast screening report
Calculation of K readings for IOL formulas
1. Holladay report
2. Detailed holladay report
Cataract preoperative report for premium IOL
Grading of nuclear cataract density(PNS)
Phakic IOLs
Iris details for Toric IOLs
Pentacam HR and Cataract
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Iris details for Toric IOL Implantation
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Wavefront
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For following up corneal haze post PRK, or with infectious
keratitis, corneal mucopolusaccharidosis and keratoconus.
Limitations
1. Opaque corneas causes high backscatter and unreliable measurements.
2. Corneal densitometry increases with age in the periphery but remains stable centrally
3. Scleral backscatter can artificially elevate the values near the limbus.
Densitometry Assessment
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Fast Screening Report
ACD
ACA
Pachymetry
IOP-correction
ACV
Cutoff value of 113 mm3 for ACV discriminates narrow angles
Glaucoma Screening
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Pentacam HR and RGP Fitting
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As a UBM
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PENTACAM AXL
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