Keratoconus. Yellow Rings

76
YELLOW RINGS PAULO FERRARA EYE CLINIC BELO HORIZONTE MG PAULO FERRARA, MD, PhD

description

 

Transcript of Keratoconus. Yellow Rings

Page 1: Keratoconus. Yellow Rings

YELLOW RINGS

PAULO FERRARA EYE CLINICBELO HORIZONTE – MG

PAULO FERRARA, MD, PhD

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Material PMMA

YELLOW FILTER

Apical Diameter 5mm

Triangular cross section= prismatic

effect

Hole in each extremity

FLAT BASIS WIDTH 0,6 MM

Variable arch lengh segments

Ferrara Ring Characteristics

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Flat basis responds for astigmatism induction

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PRISMATIC EFFECT

LESS HALOS

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VISIBLE LIGHT ESPECTRUM

Wavelength Range

(nanometers)Perceived Color

340-400 Near Ultraviolet (UV; Invisible)

400-430 Violet

430-500 Blue

500-570 Green

570-620 Yellow to Orange

620-670 Bright Red

670-750 Dark Red

Over 750 Near Infrared (IR; Invisible)

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COMPLEMENTARY COLORS

Cyan = White - Red

Magenta = White - Green

Yellow = White - Blue

The complementary colors (cyan, yellow, and magenta) are also commonly

referred to as the primary subtractive colors because each can be formed by

subtracting one of the primary additives (red, green, and blue) from white light.

PRIMARY COLORS

Red + Green + Blue = White

COLOR PERCEPTION

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ABSORPTION FILTERS

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DAY AND NIGHT VISION – COLOR SENSIBILITY

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The cornea is 100% transparent and is YELLOW.

It is responsible for the absorption of radiations bellow 300

nm

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Cristaline lens = YELLOW , responsible for the

absorption of 50% of the incident light, increases

with age and can simulate tritanopy in advanced

cataracts

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METHODS TO EVALUATE

LIGHT SCATTERING AFTER FERRARARING Y/W

IMPLANTATION

C QUANT

PSF COMPARATIVE STUDY

CLINICAL EVIDENCE

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MEASUREMENT OF THE RETINAL STRAYLIGHT

The amount of straylight in an eye is expressed in one

number called the STRAYLIGHT PARAMETERS. This

parameter determines the ratio between the unawanted

scattered light which causes retinal contrast reduction and

the wanted NON scattered light which forms the retinal

image

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COMPARATIVE MEASUREMENTS OF

THE STRAYLIGHT

C-QUANT

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J.L.S.N. male 26 y.o

KC II LE

Type 2

PRE-OP DATA 08/07/2008

MANIFEST REFRACTION

LE: +3.00 – 5.00 x 135

BSCVA

LE: 20/80

SURGICAL STRATEGY

01 AFR 160/25

Incision axis 75

Incision depth 470 micra

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J.L.S.N. male 26 y.o

KC II LE

Type 2

POST-OP DATA 08/08/2008

MANIFEST REFRACTION

LE: +0.50 – 2.00 X 113

BSCVA

LE: 20/40

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R.L.M. female 17 y.O

KC II RE

Type 2

PRE-OP DATA 04/22/2008

MANIFEST REFRACTION

RE: +1.00 -5.00 X 80

BSCVA

LE: 20/50

SURGICAL STRATEGY

01 AFR 160/25

Incision axis 90

Incision depth 450 micra

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R.L.M. female 17 y.O

KC II RE

Type 2

POST OP DATA 06/17/2008

MANIFEST REFRACTION

RE: +2.00 -3.50 X 90

BSCVA

LE: 20/40

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R.P.S.J. male 28 Y.O

KC II LE

Type 2

PRE-OP DATA 08/04/2008

MANIFEST REFRACTION

LE: -4.50 X 115

BSCVA

LE: 20/60

SURGICAL STRATEGY

01 AFR 160/25

Incision axis 135

Incision depth 520 micra

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R.P.S.J. male 28 Y.O

KC II LE

Type 2

POST OP DATA 11/08/2008

MANIFEST REFRACTION

LE: -4.50 X 110

BSCVA

LE: 20/40

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M.M.C. female 36 y.O

KC III LE

Type 2

PRE-OP DATA 24/03/2008

MANIFEST REFRACTION

LE: -1.00 -3.50 X 125

BSCVA

LE: 20/80

SURGICAL STRATEGY

02 AFR 160/20-20

Incision axis 90

Incision depth 480 micra

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M.M.C. female 36 y.O

KC III LE

Type 2

POST OP DATA 08/08/2008

MANIFEST REFRACTION

LE: -2.00

BSCVA

LE: 20/40

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C.C.J. male 24 y.O

KC III LE

Type BOW-TIE

PRE-OP DATA 27/09/2007

MANIFEST REFRACTION

LE: -3.00 -3.50 X 150

BSCVA

LE: 20/80

SURGICAL STRATEGY

02 AFR 160/15-20

Incision axis 75

Incision depth 520 micra

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C.C.J. male 24 y.O

KC III LE

Type BOW-TIE

POST OP DATA 27/06/2008

MANIFEST REFRACTION

LE: -1.50 X 60

BSCVA

LE: 20/40

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C.C.J. male 24 y.O

KC III RE

Type BOW-TIE

PRE-OP DATA 07/07/2008

MANIFEST REFRACTION

LE: -1.50 X 45

BSCVA

LE: 20/80

SURGICAL STRATEGY

02 AFR 160/15-15

Incision axis 90

Incision depth 480 micra

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C.C.J. male 24 y.O

KC III LE

Type BOW-TIE

POST OP DATA 07/08/2008

MANIFEST REFRACTION

LE: PLANO

BSCVA

LE: 20/25

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B.S.N.A. female 17 y.O

KC II RE

Type 2

PRE-OP DATA 02/26/2008

MANIFEST REFRACTION

LE: +1.00 -5.00 X 80

BSCVA

LE: 20/50

SURGICAL STRATEGY

01 AFR 160/25

Incision axis 90

Incision depth 450 micra

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B.S.N.A. female 17 y.O

KC II RE

Type 2

POST OP DATA 08/08/2008

MANIFEST REFRACTION

LE: +2.00 -3.50 X 90

BSCVA

LE: 20/40

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R.R.S. male 19 y.O

KC II LE

Type 2

PRE-OP DATA 11/22/2006

MANIFEST REFRACTION

LE: +2.00 -4.00 X 100

BSCVA

LE: 20/40

SURGICAL STRATEGY

01 AFR 160/20

Incision axis 90

Incision depth 450 micra

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R.R.S. male 19 y.O

KC II LE

Type 2

POST OP DATA 08/08/2008

MANIFEST REFRACTION

LE: -2.25 -1.50 X 130

BSCVA

LE: 20/40

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COMPARATIVE STUDY OF

THE PSF

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MCU 26a Fem Wavefront total Pré e Pós

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AC 26a Fem Coma Pré e Pós

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AC 26a Fem Mapa de Zernike Pré e Pós

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MCH 26 Fem

Refração +0.50DE<>-

4.25DCx30

Acuidade visual sem

correção 20/400

Acuidade visual com

correção 20/200

Diâmetro pupilar 6.30mm

Planejamento 1 arco de

anel 160°/250µ

Refração –0.50DE<>-

2.50x60

Acuidade visual sem

correção 20/100

Acuidade visual com

correção 20/70

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MCU 26a Fem Topo Pré e Pós

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MCU 26a Fem OPD (mapa

refracional) Pré e Pós

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MCU PSF Pré e Pós

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MCU 26a Fem Wavefront HO Pré e

Pós

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MCU 26a Fem Coma Pré e Pós

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MCU 26a Fem Aberração Esférica Pré

e Pós

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MCU 26a Fem Mapa de Zernike Pré e

Pós

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NSSJ 25A Masc

Refração pré operatoria

+ 1.00DE<>-6.00x150

Av s/c 20/400

Av c/c 20/60

Planejamento 1 arco de

anel de 160°/250µ

Refração pós operatória

–0.50DE<>-1.00x150

Av s/c 20/40

Av c/c 20/25

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NSSJ 25 Masc Topo Pré e Pós

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NSSJ 25a Masc OPD (mapa

refracional) Pré e Pós

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NSSJ 25a Mas Wavefront Total Pré e

Pós

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NSSJ 25a Masc Coma Pré e Pós

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NSSJ 25a Masc Aberração Esférica

Pré e Pós

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NSSJ 25a Masc PSF Pré e Pós

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NSSJ 25a Masc Wavefront HO Pré e

Pós

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NSSJ 25a Masc Mapa de Zernike Pré

e Pós

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CLINICAL EVIDENCE

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D.N.B, MALE, 03/07/1952

ICLRGPKP

BSCVA RE 20/50

MANIFEST REFRACTION: -8,00 SPH

KONUS EVOLUTIVE STAGE III

Surgery date: 15/06/2005

Surgical strategy:

01 FR 210/25 incision 90 depth 470 micra

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HALOS COMPLAINT

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HALOS COMPLAINT

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HALOS COMPLAINT

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HALOS COMPLAINT

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HALOS COMPLAINT

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DECEMBER 2007

EXCHANGING THE W

FERRARARING FOR A YELLOW

ONE

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DISAPPEARENCE OF

HALOS COMPLAINT

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WHY PIGMENTED RING IS BETTER?

LIGHT SOURCES SPECTRA