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1 2형 오브스캔 각막지형도를 이용한 원추각막과 원추각막의증의 각막형태비교 1599

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3 Figure 1. The map of Orbscan II topography in keratoconus. The parameters including central corneal power, anterior and posterior elevation from BFS and central corneal thickness are significantly different from normal eyes. Figure 2. The map of Orbscan II topography in keratoconus suspect. Anterior elevation from BFS is the only significantly different parameter comparing with normal eyes, and central corneal power, posterior elevation from BFS, central corneal thickness and most protruded corneal thickness are the parameters significantly different from keratoconic eyes. 1601

4 Table 1. Comparison of parameters of Orbscan II system in keratoconic and normal eyes. The parameters including central corneal power, anterior and posterior elevation from BFS and central corneal thickness are significantly different from normal eyes Parameter Keratoconic eye Normal eye p-value Central corneal power (Diopter) 48.81±6.33 (37.60~72.06) 42.48±1.71 (38.98~44.81) Anterior elevation from BFS * (µm) 43.05± ±4.91 Posterior elevation from BFS * (µm) (4.00~125.00) 93.93±54.64 (1.00~14.00) 25.70±7.13 Central corneal thickness (µm) (9.00~225.00) ±61.01 (15.00~41.00) ±44.24 (282.00~560.00) (441.00~611.00) Anterior chamber depth (mm) Corneal diameter (mm) Pupil size (mm) 3.34±0.36 (2.64~4.04) 11.74±0.36 (11.10~12.50) 4.91±1.48 (3.20~10.80) 3.07±0.23 (2.73~3.47) 11.56±0.45 (11.10~13.00) 5.15±1.44 (3.70~8.00) * : Best-fit sphere. (By Scheffe s method) Table 2. Comparison of parameters of Orbscan II system in keratoconus-suspected and normal eyes. Anterior elevation from BFS is the only significantly different parameter compared with normal eyes Parameter Keratoconus-suspected eye Normal eye p-value Central corneal power (Diopter) 42.74±1.59 (40.32~46.12) 42.48±1.71 (38.98~44.81) Anterior elevation from BFS * (µm) 24.28± ± Posterior elevation from BFS * (µm) (6.00~37.00) 30.72±19.03 (1.00~14.00) 25.70± Central corneal thickness (µm) (1.00~64.00) ±55.34 (15.00~41.00) ± (362.00~580.00) (441.00~611.00) Anterior chamber depth (mm) Corneal diameter (mm) Pupil size (mm) 3.27±0.35 (2.45~3.83) 11.81±0.43 (10.80~12.50) 4.95± ±0.23 (2.73~3.47) 11.56±0.45 (11.10~13.00) 5.15± (3.40~7.80) (3.70~8.00) * : Best-fit sphere. (By Scheffe s method) 1602

5 Table 3. Comparison of parameters of Orbscan II system in keratoconic and keratoconus-suspected eyes. Central corneal power, posterior elevation from BFS, central corneal thickness and most protruded corneal thickness are the parameters significantly differed from keratoconus-suspected eyes Parameter Keratoconic eye Keratoconus suspected eye p-value Central corneal power (Diopter) 48.81±6.33 (37.60~72.06) 42.74±1.59 (40.32~46.12) Anterior elevation from BFS * (µm) 43.05± ± Posterior elevation from BFS * (µm) (4.00~125.00) 93.93±54.64 (6.00~37.00) 30.72±19.03 Central corneal thickness (µm) (9.00~225.00) ±61.01 (1.00~64.00) ± (282.00~560.00) (362.00~580.00) Most protruded corneal thickness (µm) Anterior chamber depth (mm) Corneal diameter (mm) Pupil size (mm) ±66.38 (280.00~560.00) 3.34±0.36 (2.64~4.04) 11.74±0.36 (11.10~12.50) 4.91±1.48 (3.20~10.80) ±59.13 (362.00~579.00) 3.27±0.35 (2.45~3.83) 11.81±0.43 (10.80~12.50) 4.95±1.24 (3.40~7.80) * : Best-fit sphere. (By Scheffe s method) 1603

6 1) Rabinowitz YS. Keratoconus. Surv Ophthalmol 1998;42: ) Krachmer JH, Feder RS, Belin MW. Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol 1604

7 1984;28: ) Caroline PJ, Doughman DJ, McGuire JR. Preliminary report on a new contact lens design for keratoconus. Contact Intraocul Lens 1978;4: ) Soper JW, Jarrett A. Results of a systematic approach to fitting keratoconus and corneal transplants. Cont Lens Med Bull 1972;5: ) Edrington TB, Barr JT, Zadnik K, et al. Standardized rigid contact lens fitting protocol for keratoconus. Optom Vis Sci 1996;73: ) Rosenthal P. The Boston Lens and the management of keratoconus. Int Ophthalmol Clin 1986;26: ) Maguire LJ, Bourne WM. Corneal topography of early keratoconus. Am J Ophthalmol 1989;108: ) Maguire LJ, Lowry JC. Identifying progression of subclinical keratoconus by serial topography analysis. Am J Ophthalmol 1991;112: ) Rao SN, Raviv T, Majmudar PA, Epstein RJ. Role of Orbscan II in screening keratoconus suspects before refractive corneal surgery. Ophthalmology 2002;109: ) Rabsilber TM, Becker KA, Frisch IB, Auffarth GU. Anterior chamber depth in relation to refractive status measured with the Orbscan II Topography System. J Cataract Refract Surg 2003;29: ) Pflugfelder SC, Liu Z, Feuer W, Verm A. Corneal thickness indices discriminate between keratoconus and contact lens induced corneal thinning. Ophthalmology 2002;109: ) Amsler M. The forme fruste of keratoconus. Wien klin Wocherschr 1961;73: ) Wilson SE, Klyce SD. Advances in the analysis of corneal topography. Surv Ophthalmol 1991;35: ) Guarnieri FA, Guarnieri JC. Comparison of Placido-based, rasterstereography, and slit-scan corneal topography system. J Refract Surg 2002;18: ) Maeda N, Klyce SD, Smolek MK. Comparison of methods for detecting keratoconus using videokeratography. Arch Ophthalmol 1995;113: ) Rabinowitz YS, McDonnel PJ. Computer-assisted corneal topography in keratoconus. Refract Corneal Surg 1989;5: ) Rabinowitz YS. Videokeratographic indices to aid in screening for keratoconus. J Refract Surg 1995;11: ) Rabinowitz YS, Rasheed K. KISA index: a quantitative videokeratography algorithm embodying minimal topographic criteria for diagnosing keratoconus. J Cataract Refract Surg 2000;26: ) Smolek MK, Klyce SD. Current keratoconus detection methods compared with a neural network approach. Invest Ophthalmol Vis Sci 1997;38: ) Lee HH, Shin MC, Lee HB. The Analysis of Corneal Topography after Laser in Situ Keratomileusis (LASIK) for Myopic Correction. J Korean Ophthalmol Soc 2001;42: ) Liu Z, Huang AJ, Pflugfelder SC. Evaluation of corneal thickness and topography in normal eyes using the Orbscan corneal topography system. Br J Ophthalmol 1999;83: ) Kim JD, Park KS, Kim SD. Corneal thickness variation and consistency according to daytime. J Korean Ophthalmol Soc 2000;41: ) Choi HJ, Kim MK, Lee JL. Diagnostic criteria for keratoconus using Orbscan II slit scanning topography/pachymetry system. J Korean Ophthalmol Soc 2004;45: ) Auffarth GU, Wang L, Volcker HE. Keratoconus evaluation using the Orbscan Topography System. J Cataract Refract Surg 2000;26: ) Kawana K, Miuta K, Tokunaga T, et al. Central corneal thickness measurements using Orbscan II scanning slit topography, noncontact specular microscopy, and ultrasonic pachymetry in eyes with keratoconus. Cornea 2005;24: ) Arntz A, Duran JA, Pijoan JI. Subclinical keratoconus diagnosis by elevation topography. Arch Soc Esp Oftalmol 2003;78: ) Mohammad HD, Hassan H. A quantitative corneal topography index for detection of keratoconus. J Refract Surg 1998;14:

8 Corneal Topographic Study Using Orbscan II between Keratoconus and Keratoconus Suspect Seung Uk Lee, M.D. 1, Chang Hwan Lee, M.D. 2, Ji-Eun Lee, M.D., Ph.D. 1, Jong Soo Lee, M.D., Ph.D. 1 Department of Ophthalmology, College of Medicine, Pusan National University 1, Pusan, Korea Department of Ophthalmology, Wallace Memorial Baptist Hospita 2, Pusan, Korea Purpose: To compare corneal topographic changes using Orbscn II between keratoconus and keratoconussuspected eyes. Methods: Thirty-seven keratoconus eyes, 17 keratoconus-suspected eyes and 37 normal eyes were evaluated by using Orbscan II corneal topography. We compared central phachymetry, anterior elevation from best-fit sphere (BFS), posterior elevation from BFS, most protruded corneal thickness, central corneal thickness, anterior chamber depth, corneal diameter, and pupil size. Results: Central pachymetry, anterior and posterior elevation from BFS, central corneal thickness, and anterior chamber depth were statistically significantly different between keratoconus and control eyes. Anterior elevation from BFS showed a significant difference between keratoconus-suspected and control eyes. There were statistically significant differences in central pachymetry, posterior elevation from BFS, central corneal thickness and most protruded corneal thickness between keratoconus and keratoconus-suspected eyes. Corneal diameter and pupil size showed no differences among the 3 groups. Conclusions: Suspected keratoconus eyes have a higher value of anterior elevation from BFS on Orbscan II topography as compared with control eyes. Central pachymetry, posterior elevation from BFS, central corneal thickness and most protruded corneal thickness may be helpful in distinguishing between keratoconus and keratoconus-suspected eyes. J Korean Ophthalmol Soc 48(12): , 2007 Key Words: Anterior chamber depth, Best fit sphere (BFS), Keratoconus, Keratoconus suspect, Orbscan II corneal topography 1606

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