Atlas of Corneal Imaging

A comprehensive reference for physicians, surgeons, and trainees, Atlas of Corneal Imaging covers all aspects of corneal imaging from basic map interpretation to advanced diagnostic uses and features over 1200 illustrative images and figures representing a wide variety of devices and techniques.

Drs. J. Bradley Randleman, Marcony Santhiago, and William J. Dupps Jr guide readers through the process of analyzing corneal images using a multitude of different techniques, technologies, and individual devices. This creates a complete picture of the cornea’s basic methods and pathological processes and allows readers to directly visualize how their technology would display the pathology in question. 

Atlas of Corneal Imaging is designed to help practitioners recognize subtle findings and evaluate signs of weakening or pathology, no matter how they present or what device is being used. Multiple iterations of the same clinical condition are shown with numerous complementary images for the same eye to provide a comprehensive presentation of each case.

Chapters feature information on:
•    Topographic patterns and mapping
•    Corneal ectasia evaluations
•    Cornea and refractive surgery evaluations
•    Clinical correlations with corneal disorders
•    Cornea and refractive surgery complications
•    Evaluation for cataract surgery

Atlas of Corneal Imaging fills a significant void in corneal imaging resources available today by presenting an image-first approach to understanding all the many different technologies for imaging the cornea.

Contents

Dedication
Acknowledgments
About the Author
About the Associate Editors
Contributing Authors
Foreword by Stephen D. Klyce, PhD
Introduction

Chapter 1    Fundamental Concepts in Corneal Imaging
Mehdi Roozbahani, MD; Marcony R. Santhiago, MD, PhD; William J. Dupps, MD, PhD; and J. Bradley Randleman, MD
    Basic Definitions and Terminology
    Confusing Clinical Concepts
    Imaging Devices
    Placido-Based Reflection Devices
    LED-Based Reflective Devices
    Tomography-Based Imaging Devices
    Slit Scanning-Based Tomography
    Scheimpflug-Based Tomographers
    Optical Coherence Tomography
    Very High–Frequency Digital Ultrasound
    Aberrometers for Wavefront Analysis
    Summary

Chapter 2    Corneal Imaging Devices: Applications and Set Up    
Mehdi Roozbahani, MD; Marcony R. Santhiago, MD, PhD; William J. Dupps, MD, PhD; and J. Bradley Randleman, MD
    Basic Device Set Up    
    Specific Imaging Devices    
    Placido Topography     
    Scanning Slit Imaging (Orbscan II)    
    Scheimpflug Imaging (Pentacam)    
    Dual Scheimpflug/Placido Imaging (Galilei)    
    Scheimpflug/Placido Imaging (Sirius)    
    Anterior Segment Optical Coherence Tomography    
    Very High–Frequency Digital Ultrasound    
    Imaging Artifacts    
    Summary    

Chapter 3    Basic Topographic Patterns and Tomographic Correlates    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Notes on Maps in This Section    
    Section 1: Symmetric Nonastigmatic Patterns (Normal Patterns and Variants)    
    Section 2: Symmetric Astigmatic Patterns (Normal Variants)    
    Section 3: Asymmetric Astigmatic Patterns (Suspicious Patterns)    
    Section 4: Abnormal Asymmetric Patterns    
    Against-the-Rule Astigmatism     
    Inferior Steepening     
    Focally Steep Patterns    
    Skewed Radial Axes     
    Asymmetric Bowtie With Skewed Radial Axis Pattern     
    Truncated Bowtie Pattern     
    Vertical D Pattern     
    Drooping D Pattern     
    Pellucid Marginal Degeneration–Like (Crab Claw) Pattern     
    Section 5: Keratometry/Topography Relationship in Ectatic Corneas  
 
Chapter 4    Epithelial Mapping    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Epithelial Thickness and Remodeling Patterns    
    Section 1: General Epithelial Mapping Images in Normal Eyes    
    Section 2: Epithelial Mapping in Keratoconus    
    Section 3: Epithelial Mapping in Refractive Surgery Screening    
    Section 4: Epithelial Mapping After Refractive Surgery    
    Section 5: Irregular Epithelial Mapping With Corneal Irregularities 
   
Chapter 5    Corneal Ectasia Evaluations    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Progressively Advanced Presentations of Corneal Ectasias    
    Section 1: Corneal Ectasia Suspects    
    Section 2: Keratoconus    
    Highly Asymmetric (Clinically Unilateral) Keratoconus     
    Asymmetric Keratoconus      
    Mild Keratoconus     
    Moderate Keratoconus     
    Severe Keratoconus     
    Atypical Keratoconus Images     
    Stable Keratoconus     
    Progressive Keratoconus     
    Corneal Hydrops    
    Section 3: Pellucid Marginal Corneal Degeneration    
    Section 4: Postoperative Corneal Ectasia    

Chapter 6    Corneal Imaging in Refractive Surgery Evaluations    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Note on Screening Recommendations    
    Section 1: Suitable Refractive Surgery Candidates: Normal Imaging and Variants    
    Section 2: Suspicious Imaging in Refractive Surgery Evaluations     
    Section 3: Abnormal Imaging in Refractive Surgery Evaluations    
    Section 4: Ectasia After LASIK Cases: Preoperative Corneal Imaging 
   
Chapter 7    Postoperative Patterns After Corneal and Refractive Surgery    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Section 1: Keratoplasty    
    Section 2: Incisional Refractive Surgery    
    Section 3: LASIK    
    Section 4: Photorefractive Keratectomy    
    Section 5: Small Incision Lenticule Extraction    
    Section 6: Phakic Intraocular Lens    
    Section 7: Intracorneal Ring Segments    
    Section 8: Orthokeratology    
    Section 9: Corneal Cross-Linking Imaging    
    Section 10: Therapeutic Topography-Guided Ablations    

Chapter 8    Corneal and Refractive Surgery Complications    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Section 1: Ablation Issues    
    Section 2: LASIK Flap Complications    
    Section 3: Interface Complications    
    Section 4: Ocular Surface Complications    
    Section 5: Complications After Incisional Refractive Surgery    
    Section 6: Complications After Intracorneal Ring Segments Implantation    
    Section 7: Phakic Intraocular Lens Complications    
    Section 8: Complications After Keratoplasty    

Chapter 9    Clinical/Topographic Correlations    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Section 1: Dry Eye    
    Section 2: Corneal Scarring Resulting From Infectious Keratitis    
    Section 3: Epithelial Basement Membrane Dystrophy    
    Section 4: Salzmann’s Nodular Degeneration    
    Section 5: Pterygium     
    Section 6: Fuchs’ Corneal Dystrophy    
    Section 7: Corneal Stromal Dystrophies    
    Section 8: Limbal Stem Cell Deficiency    
    Section 9: Floppy Eyelid Syndrome    

Chapter 10    Corneal Imaging for Evaluations of Patients With Cataracts    
J. Bradley Randleman, MD; Marcony R. Santhiago, MD, PhD; and William J. Dupps, MD, PhD
    Section 1: Routine Cataract Evaluations    
    Section 2: Toric Intraocular Lens Evaluations    
    Section 3: Cataract Evaluations in Patients With Prior Laser Vision Correction    
    Section 4: Cataract Evaluations in Patients With Prior Radial Keratotomy    
    Section 5: Cataract Evaluations in Patients With Keratoconus  
 
Financial Disclosures
Index

About the Editors

J. Bradley Randleman, MD is a Professor in the Department of Ophthalmology at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Staff Ophthalmologist and Co-Director of the Refractive Surgery Section at the Cole Eye Institute of the Cleveland Clinic Foundation in Cleveland, Ohio. Prior to his arrival in Cleveland, Dr. Randleman was Professor of Ophthalmology at the Keck School of Medicine of University of Southern California and Director of the Cornea & Refractive Surgery Service at the University of Southern California Roski Eye Institute in Los Angeles, California, and the Hughes Professor of Ophthalmology at Emory University and Director of the Cornea Section at the Emory Eye Center. A widely respected cornea specialist, his areas of expertise include corneal and intraocular (IOL) refractive surgical procedures, including LASIK and premium cataract and IOL surgery, complicated cataract surgery, and the management of corneal ectatic disorders. His primary research focuses on identification and management of corneal ectatic diseases, including keratoconus and postoperative ectasia after LASIK, and the avoidance, diagnosis, and management of refractive surgical complications. He has been awarded multiple research grants throughout his career, including R01 funding from the National Institutes of Health to evaluate corneal biomechanical analysis using Brillouin microscopy.

Dr. Randleman received his BA degree from Columbia College at Columbia University in New York City; his MD degree from Texas Tech University School of Medicine in Lubbock, Texas, where he was elected to the Alpha Omega Alpha medical honor society in his junior year; and followed by his Ophthalmology residency and fellowship in Cornea/External Disease, and Refractive Surgery at Emory University in Atlanta, Georgia. 

Dr. Randleman has been awarded the Claus Dohlman Fellow Award, the inaugural Binkhorst Young Ophthalmologist Award from the American Society of Cataract and Refractive Surgery, the Kritzinger Memorial Award, Founder’s Award, President’s Award, and the Inaugural Recognition Award from the International Society of Refractive Surgery, and the Secretariat Award, Achievement Award, and Senior Achievement Award from the American Academy of Ophthalmology. He was named to The Power List by The Ophthalmologist in both 2018 and 2020. 

Dr. Randleman has served as Editor-in-Chief for the Journal of Refractive Surgery since 2011. He has authored more than 165 peer-reviewed publications in leading ophthalmology journals in addition to 40 book chapters on refractive surgery evaluation, corneal cross-linking, and management of complications with IOLs, and has authored 4 previous textbooks, Corneal Collagen Cross-Linking; Corneal Cross-Linking, Second Edition; Refractive Surgery: An Interactive Case-Based Approach; and Intraocular Lens Surgery: Selection, Complications, and Complex Cases.