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Dr. Haykel Kamoun presentation at the Mediphacos User Meeting 2013
This document discusses a ring simulator software for predicting outcomes of intracorneal ring segment (ICRS) treatments. The software aims to improve predictability by simulating topographic results. It was developed over 2 years using a refractive and topographic database of past ICRS patients. The simulator allows users to enter a pre-op case and choose similar past cases for simulation. It integrates a nomogram but can suggest alternatives. Examples show simulated post-op maps closely match real results 95% of time when a similar prior case is selected. The developer concludes it is a valuable tool but the database needs expanding through multicenter evaluation to increase reliability.
Dr. Haykel Kamoun presentation at the Mediphacos User Meeting 2013
- 1. Ring simulator :Principles and interests H. Kamoun
- 2. Introduction Predicting the post-opresults of ICRS is every corneal surgeon’s dream. Our objective: improving the predictibility of the results using topographic simulations of ICRS treatment.
- 3. Ring simulator :Problematic Themiss understanding of mecanism of action of different ring models. The unpredictibility of the results: the corneal reaction is different from case to case. «the Surprise effect »
- 4. How to getstarted ? In the very begining we have tried to calculate the average Wrong channel effect of each ring to make simulations the corneal response to the ring differs from one cornea to an other and basicly dépends on 2 reasons: - Cornel factors: K, Pachy,age .. Ect - Extra-corneal factors : related to the surgery channel: centering ,depth ,diameter and width …..ect .
- 5. The solution ? Conceivean expert software. Topographic module based on experience. « An expert sofware» Using a refractive and topographic database of treated patients . nothing is worth the experience of an eye to find out about another with similar characteristics
- 6. The adventure ofRing smulator started in 2011 The big companies did not see any financial interest « few users » We decided to develop this software alone with local engineers. It took us 2 years of research.
- 7. Project : RingSimulator
- 9. HOW TO ENTERA CLINICAL CASE PRE-OP TOPOGRAPHY POST-OP TOPOGRAPHY DIFFERANTIAL TOPOGRAPHY CALCULATED BY THE SOFTWARE
- 10. List of clinicalcases
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- 12. Simulation . LIST OF CLINICALCASES CLOSER TO THE ONE YOU’RE WORKING ON. THAN YOU CHOOSE THE CLOSEST ONE FOR SIMULATION.
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- 14. Ring simulators: theprinciples Universal software :Adaptable to almost all topographers . Digitizing and interpreting the database using the colour scale. the software automatically detects the majority of the topographers scale.
- 15. Ring simulators: theprinciples Smart software Using a database of treated cases . The more the database is important, the more performing it will be. It integrates the Keraring nomogram along with more suggestions and advice.
- 16. Exemple 1 :KKstade 3/ K max 53D Ref: Myopie: 3D / Cyl: 5D Keraring SI6 :6mm 300μm/ 150°
- 17. Exemple 1 :KKstade 3/ K max 53D Ref: Myopie: 3D / Cyl: 5D Keraring SI5 :5mm 300μm/ 160° REAL POST-OP TOPO TOPO POST OP SIMULATED
- 18. Exemple 2 :KKstade 2/ K max 49D Ref: Myopie: 1 / Cyl: 3.5D Keraring SI6 :6mm 200μm/ 150° TOPO POST OP REELLE TOPO POST OP SIMULATED
- 19. Exemple 3 :KKstade 3/ K max 57D Ref: Myopie: 7D / Cyl: 9D Keraring SI5 5mm 160° 300μm / 120° 250μm TOPO POST OP REELLE TOPO POST OP SIMULATED
- 20. Exemple 4 :KKstade 3/ K max 55D Ref: Myopie: 1D / Cyl: 8D Keraring 2X SI6 6mm 150° 300μm TOPO POST OP REELLE TOPO POST OP SIMULATED
- 21. Conclusion Ring simulator It’s avaluable tool in the choice of the indication . In my practice it allows : - to choose the adapted ring models - the best axes The simulated topographies are very close to the real post op topographies in 95% of cases on the condition to choose a similar case.
- 22. Conclusion Ring simulator The needto enlarge the database with a greater number of cases to increase reliability. Multicentric evaluation is needed to validate this software.
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