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    Hidden in Plain Sight: Corneal Wavefront Analysis for Ectasia Management: Time to Go Beyond Conventional Tomography?

    AAO 2023 Video Program
    Cornea/External Disease, Diagnostic & Imaging

    Keratoconus and ectasia evaluation rely predominantly on tomographic parameters derived from Scheimpflug imaging devices. However, these parameters have problems, such as overlaps between disease and normal, proprietary software dependence, frequent discordance from patient symptoms and slow changes. Corneal wavefront (CW), a highly sensitive, customizable, and comprehensive yet symptom-mappable feature, has been shown to detect progressive ectasia exponentially quicker than conventional tomographic parameters. This blend of comprehensiveness and granularity gives CW analysis a unique vantage point, bridging the symptom-sign gap with enhanced comprehensiveness. In this video we discuss basics of CW analysis and its role in keratoconus/ectasia detection in clinical scenarios with real-life examples. This video will help cornea specialists with an existing tomography device to look beyond conventional tomography without increasing the burden of equipment cost, as CW maps can be derived from existing commercially available tomography devices.