Dr Agarwals’ Textbook on Corneal Topography (Including Pentacam and Anterior Segment OCT) Amar Agarwal
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1Dr Agarwals' Textbook on CORNEAL TOPOGRAPHY Including Pentacam and Anterior Segment OCT2
3Dr Agarwals' Textbook on CORNEAL TOPOGRAPHY Including Pentacam and Anterior Segment OCT
THIRD EDITION
Editor Amar Agarwal MS FRCS FRCOphth Chairman and Managing Director Dr Agarwal's Group of Eye Hospitals and Eye Research Center Chennai, Tamil Nadu, India Foreword Bonnie An Henderson
4
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Dr Agarwals' Textbook on Corneal Topography Including Pentacam and Anterior Segment OCT
First Edition: 2006
Second Edition: 2010
Third Edition: 2015
9789351527855
Printed at
5Dedicated to
Sonia Yoo a wonderful Surgeon and human being6
7CONTRIBUTORS
  • Ahmad MM Shalaby MD
  • Instituto Oftalmologico De Alicante
  • Alicante, Spain
  • Amar Agarwal MS FRCS FRCOphth
  • Chairman and Managing Director
  • Dr Agarwal's Group of Eye Hospitals and Eye Research Center,
  • Chennai, Tamil Nadu, India
  • Amin Ashrafzadeh MD
  • Northern California Eye Physicians
  • Modesto and Turlock, CA
  • Assistant Clinical Professor of Ophthalmology
  • University of California
  • Davis, USA
  • Arun C Gulani MD MS
  • Director
  • Gulani Vision Institute
  • Jacksonville, Florida, USA
  • Athiya Agarwal MD FRSH DO
  • Dr Agarwal's Group of Eye Hospitals and Eye Research Center
  • Chennai, Tamil Nadu
  • India
  • Cristina Simón-Castellvi MD
  • Simon Eye Clinic
  • Barcelona, Spain
  • David P Piñero PhD
  • Instituto Oftalmologico De Alicante
  • Alicante, Spain
  • Dhivya Ashok Kumar MD
  • Dr Agarwal's Group of Eye Hospitals and Eye Research Center
  • Chennai, Tamil Nadu, India
  • Erik L Mertens MD FEBO
  • Medical Director
  • Antwerp Eye Center
  • Belgium
  • Francisco Sánchez León MD
  • Instituto NovaVision
  • Medical Director
  • Cornea, Refractive and Anterior
  • Segment Clinic
  • Cd de México, Acapulco
  • Mexico
  • Gemma Walsh B Optom
  • New Vision Clinics
  • Melbourne, Australia
  • Gregg Feinerman MD FACS
  • Feinerman Vision Center
  • Newport Beach
  • California
  • Associate Professor
  • University of California, Irvine
  • California, USA
  • Guillermo L Simón-Castellvi MD
  • Chief Anterior Segment Surgeon
  • Refractive Surgery Unit
  • Simon Eye Clinic
  • Barcelona, Spain
  • Helen Boerman OD
  • Wang Vision Institute
  • Nashville, TN, USA
  • Hoo Yeun Kim
  • Feinerman Vision Center
  • Newport Beach
  • California, USA
  • Jairo E Hoyos MD PhD
  • Chairman of Ophthalmology of the Instituto Oftalmológico Hoyos
  • KM Study Group
  • President Sabadell
  • Barcelona, Spain
  • Jairo Hoyos-Chacón MD
  • Ophthalmologist of the
  • Instituto Oftalmológico Hoyos
  • Sabadell, Barcelona, Spain
  • Jorge L Alió MD PhD
  • Instituto Oftalmologico De Alicante
  • Alicante, Spain
  • José I Belda Sanchis MD PhD
  • Instituto Oftalmologico De Alicante
  • Alicante, Spain
  • José Maria Simón-Castellvi MD
  • Chairman
  • Simon Eye Clinic
  • Barcelona, Spain
  • Karolinne Maia Rocha MD PhD
  • Cleveland Clinic Foundation
  • Cole Eye Institute, USA
  • Laurent Laroche
  • Center Hospitalier National d’Ophtalmologie des XV-XX, Pierre and Marie Curie University
  • Paris 06, Research Team 968, Institut de la Vision, Paris, France
  • Marcus Solorzano
  • USA
  • Masanao Fujieda MA
  • Nidek Ltd, Co, Japan
  • Melania Cigales MD
  • Ophthalmologist of the Instituto
  • Oftalmológico Hoyos
  • Sabadell
  • Barcelona, Spain
  • Ming Wang MD PhD
  • Wang Vision Institute
  • Nashville, TN, USA
  • Mohamad Rosman MD FRCS(Ed) FAMS
  • Instituto Oftalmologico De Alicante
  • Alicante, Spain
  • Mohamed Alaa El-Danasoury MD
  • Magrabi Eye Hospital Jeddah
  • Saudi Arabia
  • Mukesh Jain PhD
  • Nidek Ltd, Co, Australia
  • N Timothy Peters MD
  • Clear Advantage Vision Correction Center
  • Portsmouth, New Hampshire, USA
  • Noel A Alpins MD FRACO FRCOphth FACS
  • University of Melbourne
  • Australia
  • Otman Sandali
  • Center Hospitalier National d’Ophtalmologie des XV-XX, Pierre and Marie Curie University
  • Paris 06, Research Team 968
  • Institut de la Vision
  • Paris, France
  • Paul Karpecki OD FARO
  • Director (Research)
  • Moyes Eye Center
  • Kansas City
  • USA
  • Roger F Steinert MD
  • Professor of Ophthalmology
  • Professor of Biomedical Engineering
  • Vice Chair of Clinical Ophthalmology
  • Director of Cornea, Refractive, and Cataract Surgery
  • University of California
  • Irvine, California
  • USA
  • 8Ronald R Krueger MD MSE
  • Cleveland Clinic Foundation
  • Cole Eye Institute, USA
  • Sarabel Simón-Castellvi MD
  • Simon Eye Clinic
  • Barcelona, Spain
  • Shiela Scott MD
  • USA
  • Soosan Jacob MS FRCS DNB MNAMS
  • Dr Agarwal's Group of Eye Hospitals
  • and Eye Research Center
  • Chennai, Tamil Nadu
  • India
  • Tracy Schroeder Swartz OD MS FAAO
  • Wang Vision Institute
  • Nashville, TN, USA
  • Vincent Borderie
  • Center Hospitalier National d’Ophtalmologie des XV-XX, Pierre and Marie Curie University
  • Paris 06, Research Team 968
  • Institut de la Vision
  • Paris, France
9FOREWORD
Being a surgeon is a humbling experience. While most surgeons are competent in their field, every surgeon will experience a horrible case or two. After suffering through a particularly difficult case, where my surgical performance was less than ideal (to put it kindly), I was in full self-flagellation mode. As I was sullenly licking my wounds, I happened to attend my first Dr Amar Agarwal lecture. If you have not heard Dr Agarwal lecture, you are in for a treat. It is a cross between a heart stopping thriller, a Cirque du Soleil performance of exceptional surgical skill, and a slap-stick comedy. Amar delivered a memorable lecture of surgical acrobatics complete with self-effacing and good-humored criticism.
Amar Agarwal approaches life in this same manner. Always gracious and humble, he is the hardest working and most productive person that I know. He replies to emails almost instantaneously, at any hour of the day or night. I tried to test the hypothesis that he does not sleep by sending random emails at all hours. Without fail, he replies within minutes—even at 2 am in his native time zone. While traveling, I will often work-off my jet lag in the hotel fitness center in the off hours. The treadmill somehow seems more inviting when you cannot sleep in the middle of the night. Much to my delight, I often find Dr Agarwal as my sole workout partner.
When Amar asked me to write a foreword for the 3rd edition of Textbook on Corneal Topography, my first thought was “you are writing another book!”. This will be his 60th textbook on ophthalmology. The book is a comprehensive reference tool for anterior segment surgeons. It helps readers to understand the currently available machine capabilities, differences, and highlights special uses. With the merging of the fields of cataract and refractive surgeries, anterior segment surgeons must be well-versed in understanding diagnostic technologies. The cornea, which by all accounts should be a simple tissue, is a difficult organ to understand and evaluate. Corneal topographies have been the gold standard to evaluate the anterior surface but new machines have been developed not only to evaluate this surface in more detail but also to evaluate the posterior and inner portions of the cornea. Using these technologies help determine the health of the cornea and thereby assess any surgical risk. These technologies assist in both the preoperative evaluation and the postoperative diagnosis of corneal abnormalities.
In the same fashion as his previous textbooks, Amar Agarwal delivers another complete but yet entertaining educational resource for ophthalmologists worldwide. Most people have a goal to have published the same number of articles as their age. Amar has raised that goal to another level and will have published not just articles but more full textbooks than his age. By the time you read this book, Dr Amar Agarwal will probably have written another 5 books.
Bonnie An Henderson MD
Ophthalmic Consultant
Boston, USA10
11PREFACE TO THE THIRD EDITION
To recapitulate the considerations that have led to the publication of the 3rd edition of Textbook on Corneal Topography Including Pentacam and Anterior Segment OCT are that the manual is prepared with the idea that revisions must be made periodically in order to have an available text that represents the status and details of corneal topography. The book provides a detailed text to assist with the interpretation and diagnosis of corneal surface disorders and also provides an up-to-date reference book for all the ophthalmologists. The editor hopes that this judicious compilation of work from various authors across the globe that highlights the fundamentals and the advanced stage disorders of cornea by topography analysis are well appreciated.
Amar Agarwal12
13PREFACE TO THE FIRST EDITION
Medical frontiers are never ending, there can be no end to division, the more you go deeper and deeper into any subject, the more we understand how little we know of it. “Multiplication ruins everything”, says Lao-Tsu the author of Tao Te Ching.
However, we still need to understand the lakes, mountains and valleys of the corneal surface, for us to be able to understand how to modify the surface to suit the patients' refractive needs. Just as we understand the geography of the land by seeing from far its topography, so to the corneal surface.
Today, we not only use the topographical analysis for our LASIK cases, with our knowledge on relaxing incisions, we have stretched the doors to include cataract cases where incisions can be made to decrease the preoperative astigmatism. Wavefront technology heralds yet another dimension when the topography is fed into the LASIK machine to give us a customized ablation.
Aberrations have long played havoc with vision, and doctors world over have only now really understood where the problem really lies. The understanding has brought in better modalities of its treatment, we not only have LASIK treating aberrations, we have customized intraocular lenses taking the aberrations into consideration.
The same concept is also being used for the making of lens power to be fitted to spectacles where not only the spherical and cylindrical diopters are fed into lens power-cutting machines, they are surface modified to fit the aberration as well; thus, we come into an era of customized fittings of eyeglass power.
Authors from all over the world give you a taste of their facts and figures with their cohesive findings for topographical documentation and assessment. To grasp a meaning into this world of multicolored charts, we bring the textbook on corneal topography to keep on your desk, to enable you to read a picture effortlessly.
Sunita Agarwal
Athiya Agarwal
Amar Agarwal1415161718