Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)

Detalhes bibliográficos
Autor(a) principal: Ambrósio Jr,Renato
Data de Publicação: 2014
Outros Autores: Ramos,Isaac, Lopes,Bernardo, Canedo,Ana Laura Caiado, Correa,Rosane, Guerra,Frederico, Luz,Allan, Price Jr,Francis W., Price,Marianne O., Schallhor,Steven, Belin,Michael W.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000200075
Resumo: Purpose: To compare the ability to detect preoperative ectasia risk among LASIK candidates using classic ERSS (Ectasia Risk Score System) and Pentacam Belin-Ambrósio deviation index (BAD-D), and to test the benefit of a combined approach including BAD-D and clinical data. Methods: A retrospective nonrandomized study involved preoperative LASIK data from 23 post-LASIK ectasia cases and 266 stable-LASIK (follow up > 12 months). Preoperative clinical and Pentacam (Oculus; Wetzlar, Germany) data were obtained from all cases. Mann-Whitney's test was performed to assess differences between groups. Stepwise logistic regression was used for combining parameters.The areas under the Receiver Operating Characteristic (ROC) curves (AUC) were calculated for all parameters and combinations, with pairwise comparisons of AUC (DeLong's method). Results: Statistically significant differences were found for age, residual stromal bed (RSB), central corneal thickness and BAD-D (p<0.001), but not for sphere, cylinder or spherical equivalent (p>0.05). ERSS was 3 or more on 12/23 eyes from the ectasia group (sensitivity = 52.17%) and 48/266 eyes from the stable LASIK group (18% false positive). BAD-D had AUC of 0.931 (95% CI: 0.895 to 0.957), with cut-off of 1.29 (sensitivity = 87%; specificity = 92.1%). Formula combining BAD-D, age and RSB provided 100% sensitivity and 94% specificity, with better AUC (0.989; 95% CI: 0.969 to 0.998) than all individual parameters (p>0.001). Conclusion: BAD-D is more accurate than ERSS. Combining clinical data and BAD-D improved ectasia susceptibility screening. Further validation is necessary. Novel combined functions using other topometric and tomographic parameters should be tested to further enhance accuracy.
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spelling Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)Keratomileusis, laser in situ/adverse effectsDilatation, pathologic/etiologyCorneal diseases/etiologyCorneal topography Purpose: To compare the ability to detect preoperative ectasia risk among LASIK candidates using classic ERSS (Ectasia Risk Score System) and Pentacam Belin-Ambrósio deviation index (BAD-D), and to test the benefit of a combined approach including BAD-D and clinical data. Methods: A retrospective nonrandomized study involved preoperative LASIK data from 23 post-LASIK ectasia cases and 266 stable-LASIK (follow up > 12 months). Preoperative clinical and Pentacam (Oculus; Wetzlar, Germany) data were obtained from all cases. Mann-Whitney's test was performed to assess differences between groups. Stepwise logistic regression was used for combining parameters.The areas under the Receiver Operating Characteristic (ROC) curves (AUC) were calculated for all parameters and combinations, with pairwise comparisons of AUC (DeLong's method). Results: Statistically significant differences were found for age, residual stromal bed (RSB), central corneal thickness and BAD-D (p<0.001), but not for sphere, cylinder or spherical equivalent (p>0.05). ERSS was 3 or more on 12/23 eyes from the ectasia group (sensitivity = 52.17%) and 48/266 eyes from the stable LASIK group (18% false positive). BAD-D had AUC of 0.931 (95% CI: 0.895 to 0.957), with cut-off of 1.29 (sensitivity = 87%; specificity = 92.1%). Formula combining BAD-D, age and RSB provided 100% sensitivity and 94% specificity, with better AUC (0.989; 95% CI: 0.969 to 0.998) than all individual parameters (p>0.001). Conclusion: BAD-D is more accurate than ERSS. Combining clinical data and BAD-D improved ectasia susceptibility screening. Further validation is necessary. Novel combined functions using other topometric and tomographic parameters should be tested to further enhance accuracy. Sociedade Brasileira de Oftalmologia2014-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000200075Revista Brasileira de Oftalmologia v.73 n.2 2014reponame:Revista Brasileira de Oftalmologia (Online)instname:Sociedade Brasileira de Oftalmologia (SBO)instacron:SBO10.5935/0034-7280.20140018info:eu-repo/semantics/openAccessAmbrósio Jr,RenatoRamos,IsaacLopes,BernardoCanedo,Ana Laura CaiadoCorrea,RosaneGuerra,FredericoLuz,AllanPrice Jr,Francis W.Price,Marianne O.Schallhor,StevenBelin,Michael W.eng2014-12-16T00:00:00Zoai:scielo:S0034-72802014000200075Revistahttps://rbo.emnuvens.com.br/rbo/indexhttps://old.scielo.br/oai/scielo-oai.phpsob@sboportal.org.br||rbo@sboportal.org.br1982-85510034-7280opendoar:2014-12-16T00:00Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO)false
dc.title.none.fl_str_mv Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
title Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
spellingShingle Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
Ambrósio Jr,Renato
Keratomileusis, laser in situ/adverse effects
Dilatation, pathologic/etiology
Corneal diseases/etiology
Corneal topography
title_short Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
title_full Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
title_fullStr Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
title_full_unstemmed Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
title_sort Assessing ectasia susceptibility prior to LASIK: the role of age and residual stromal bed (RSB) in conjunction to Belin-Ambrósio deviation index (BAD-D)
author Ambrósio Jr,Renato
author_facet Ambrósio Jr,Renato
Ramos,Isaac
Lopes,Bernardo
Canedo,Ana Laura Caiado
Correa,Rosane
Guerra,Frederico
Luz,Allan
Price Jr,Francis W.
Price,Marianne O.
Schallhor,Steven
Belin,Michael W.
author_role author
author2 Ramos,Isaac
Lopes,Bernardo
Canedo,Ana Laura Caiado
Correa,Rosane
Guerra,Frederico
Luz,Allan
Price Jr,Francis W.
Price,Marianne O.
Schallhor,Steven
Belin,Michael W.
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Ambrósio Jr,Renato
Ramos,Isaac
Lopes,Bernardo
Canedo,Ana Laura Caiado
Correa,Rosane
Guerra,Frederico
Luz,Allan
Price Jr,Francis W.
Price,Marianne O.
Schallhor,Steven
Belin,Michael W.
dc.subject.por.fl_str_mv Keratomileusis, laser in situ/adverse effects
Dilatation, pathologic/etiology
Corneal diseases/etiology
Corneal topography
topic Keratomileusis, laser in situ/adverse effects
Dilatation, pathologic/etiology
Corneal diseases/etiology
Corneal topography
description Purpose: To compare the ability to detect preoperative ectasia risk among LASIK candidates using classic ERSS (Ectasia Risk Score System) and Pentacam Belin-Ambrósio deviation index (BAD-D), and to test the benefit of a combined approach including BAD-D and clinical data. Methods: A retrospective nonrandomized study involved preoperative LASIK data from 23 post-LASIK ectasia cases and 266 stable-LASIK (follow up > 12 months). Preoperative clinical and Pentacam (Oculus; Wetzlar, Germany) data were obtained from all cases. Mann-Whitney's test was performed to assess differences between groups. Stepwise logistic regression was used for combining parameters.The areas under the Receiver Operating Characteristic (ROC) curves (AUC) were calculated for all parameters and combinations, with pairwise comparisons of AUC (DeLong's method). Results: Statistically significant differences were found for age, residual stromal bed (RSB), central corneal thickness and BAD-D (p<0.001), but not for sphere, cylinder or spherical equivalent (p>0.05). ERSS was 3 or more on 12/23 eyes from the ectasia group (sensitivity = 52.17%) and 48/266 eyes from the stable LASIK group (18% false positive). BAD-D had AUC of 0.931 (95% CI: 0.895 to 0.957), with cut-off of 1.29 (sensitivity = 87%; specificity = 92.1%). Formula combining BAD-D, age and RSB provided 100% sensitivity and 94% specificity, with better AUC (0.989; 95% CI: 0.969 to 0.998) than all individual parameters (p>0.001). Conclusion: BAD-D is more accurate than ERSS. Combining clinical data and BAD-D improved ectasia susceptibility screening. Further validation is necessary. Novel combined functions using other topometric and tomographic parameters should be tested to further enhance accuracy.
publishDate 2014
dc.date.none.fl_str_mv 2014-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000200075
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802014000200075
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/0034-7280.20140018
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Oftalmologia
publisher.none.fl_str_mv Sociedade Brasileira de Oftalmologia
dc.source.none.fl_str_mv Revista Brasileira de Oftalmologia v.73 n.2 2014
reponame:Revista Brasileira de Oftalmologia (Online)
instname:Sociedade Brasileira de Oftalmologia (SBO)
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instname_str Sociedade Brasileira de Oftalmologia (SBO)
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institution SBO
reponame_str Revista Brasileira de Oftalmologia (Online)
collection Revista Brasileira de Oftalmologia (Online)
repository.name.fl_str_mv Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO)
repository.mail.fl_str_mv sob@sboportal.org.br||rbo@sboportal.org.br
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