Corneal Topography Systems
Corneal Topography Systems
Corneal Topography Systems
analysis is performed, data is displayed in the form of models list produced, repeatable measurements
a color-coded map, or videokeratograph, which is cre- within 0.25 diopter (when properly used).
ated from a sample of thousands of light points (as
Alignment errors may also be misinterpreted for
opposed to only four points on the keratometer) and
real data. Since videokeratographs are often handled
can be interpreted qualitatively or quantitatively.
and maintained by a technician, documentation of
One of the color-coded maps produced by the video- errors should be recorded at this stage. If these errors
keratoscope measures corneal curvature according to are not recorded, the eye specialist may mistake them
a scale. This map, called the corneal power map, is an for real data. Such problems can be eliminated if
approximation of the corneal power at any given point. specialists use devices that have mechanisms to pre-
Because it calculates corneal power by measuring cur- vent misaligned maps (in the case that an override
vature from an axis, the map is more correctly called function has not been specified).
an axial map. The originally established scale — the
Such precision does not ensure accuracy. In the
absolute scale — uses cool colors (blue, black) to repre-
display of dioptric measurements, accuracy proves a
sent flatter areas with below-normal refractive pow-
more complex and variable factor than does precision.
ers, warm colors (orange, red) to indicate steeper areas
While spherical surfaces may be easy to measure ac-
with above-normal powers, and midlevel colors (green,
curately to within 0.1 diopter, aspheric surfaces like
yellow) to show normal powers. A standard 1.5-diopter
the cornea are more difficult to analyze. Overall, quali-
interval between color map contours has been estab-
tative descriptions of the corneal shape have shown
lished on this scale to consistently show significant
greater accuracy than have quantitative measure-
details (a diopter is the unit of measurement referring
ments of power. Such assessments of dioptric power
to a lens’s ability to bend light). While the absolute
have varied significantly among models. Technological
scale remains in clinical use, personalized scales and
advancements are likely to improve VK accuracy, par-
higher resolutions have gained preference among eye
ticularly in the cases of refractive surgery patients.
specialists.
Other maps that can be obtained with video- Purchase considerations
keratoscopes are refractive power maps, elevation
Eye specialists should take into account both the
maps, and tangential maps. The refractive power map
size and character of their practices before buying a
is similar to the axial map in that it measures corneal
videokeratoscope. They should also carefully consider
power, but the refractive power map determines cor-
the advantages of VK over conventional keratometry
neal power using Snell’s law and may be more accurate
before investing in a VK unit. The keratometer can
than axial maps. The elevation map is a map of actual
adequately measure normal corneas or those with
surface height and is a model of the overall shape of
regular astigmatism; however, it cannot provide infor-
the cornea. The tangential map (local curvature map)
mation on the shape of irregular corneas. If a specialist
measures local changes in corneal curvature relative
regularly deals with corneal abnormalities, such as
to an overall curvature. Data obtained from these
keratoconus or irregular astigmatism, he or she may
maps, as well as from the axial map, can be used to
decide that a corneal topography system is more valu-
diagnose vision problems and plan for the treatment
able than a keratometer. VK is a helpful process for all
of those problems.
patients with an atypical corneal shape, particularly
for refractive surgery and contact lens candidates.
2 ©2001 ECRI. Duplication of this page by any means for any purpose is prohibited.
Corneal Topography Systems
development of systems that use methods other than Young JA, Talamo JH, Siegel IM. Contour resolution
Placido disks continues. For example, holographic sys- of the EyeSys corneal analysis system. J Cataract
tems use the interference fringes of light reflected from Refract Surg 1995 Jul;21(4):404-6.
the cornea to obtain data. Corneal topography systems
continue to demonstrate increased clinical utility, and Standards and guidelines
faster processors and increasingly sophisticated graph-
Note: Although every effort is made to ensure that the
ics make data acquisition and display more efficient.
following list is comprehensive, please note that other
applicable standards may exist.
Bibliography American Academy of Ophthalmology. Corneal topog-
raphy [procedure assessment]. Committee on Oph-
Alvi NP, McMahon TT, Devulapally J, et al. Charac- thalmic Procedures Assessment. Ophthalmology
teristics of normal corneal topography using the 1999 Aug;106(8):1628-38.
EyeSys corneal analysis system. J Cataract Refract
American National Standards Institute/Association
Surg 1997 Jul-Aug;23(6):849-55.
for the Advancement of Medical Instrumentation.
Binder PS. Videokeratography. CLAO J 1995 Apr; Safe current limits for electromedical apparatus
21(2):133-44. [standard]. 3rd ed. ANSI/AAMI ES1-1993. 1985 (re-
vised 1993).
Cuaycong MJ, Gay CA, Emery J, et al. Comparison of International Electrotechnical Commission. Medical
the accuracy of computerized videokeratography electrical equipment — part 1: general require-
and keratometry for use in intraocular lens calcula- ments for safety [standard]. IEC 60601-1 (1988-12).
tions. J Cataract Refract Surg 1993;19(Suppl):178- 1988.
81.
Medical electrical equipment — part 1: general re-
Dishler JG. Corneal topography has range of options. quirements for safety. Amendment 1 [standard].
Ophthalmol Times 1997 May 1;22(9):36-40. IEC 60601-1-am1 (1991-11). 1991.
Medical electrical equipment — part 1: general re-
Donshik PC, Reisner DS, Luistro AE. The use of com- quirements for safety. Amendment 2 [standard].
puterized videokeratography as an aid in fitting IEC 60601-1-am2 (1995-03). 1995.
rigid gas permeable contact lenses. Trans Am
Medical electrical equipment — part 1: general re-
Ophthalmol Soc 1996 Dec;94:135-45.
quirements for safety. Section 2. Collateral stan-
McQueen BR, Martinez CE, Klyce SD. Corneal topog- dard: electromagnetic compatibility — requirements
raphy in cataract surgery. Curr Opin Ophthalmol and tests. IEC 60601-1-2 (1993-04). 1993.
1997 Feb;8(1):22-8.
Citations from other ECRI publications
Moura RC, Bowyer BL, Stevens SX, et al. Comparison Health Devices Alerts
of three computerized videokeratoscopy systems
with keratometry. Co rnea 1998 Sep;17(5):522-8. This Product Comparison lists Health Devices Alerts
(HDA) citations published since the last update of this
Rabinowitz YS, Wilson SE, Klyce SD. Color atlas of report. Each HDA abstract is identified by an Acces-
corneal topography: interpreting videokeratogra- sion Number. Recalls and hazard reports include de-
phy. New York: Igaku-Shoin; 1993. scriptions of the problem involved; abstracts of other
published articles are referenced by bibliographic in-
Reynolds AE. History of corneal measurement [intro- formation. HPCS subscribers can call the Hotline for
duction]. In: Schanzlin D, Robin JB, eds. Corneal additional information on any of these citations or to
topography: measuring and modifying the cornea. request more extensive searches of the HDA database.
New York: Springer-Verlag; 1992:7-10. 36233 Liu Z, Pflugfelder SC. The effects of long-term
contact lens wear on corneal thickness, curvature, and
Thornton SP. Clinical evaluation of corneal topogra-
surface regularity. Ophthalmology 2000 Jan;107(1):
phy. J Cataract Refract Surg 1993;19(Suppl):198-
105-11.
202.
36234 Boxer Wachler BS, Krueger RR. Agreement
Wilson SE, Klyce SD, Husseini ZM. Standardized color- and repeatability of pupillometry using videokera-
coded maps for corneal topography. Ophthalmology tography and infrared devices. J Cataract Refract
1993 Nov;100(11):1723-7. Surg 2000 Jan;26(1):35-40.
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Healthcare Product Comparison System
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Corneal Topography Systems
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Healthcare Product Comparison System
CLINICAL
APPLICATIONS
Refractive surgery
planning Yes Yes Yes Yes
Cataract surgery
planning Yes Yes Yes Not specified
Keratoconus
detection Yes Yes Yes Yes
Contact lens
fitting Yes Yes Yes Yes
Others Donor eye screening Keratoconus Mapping back surface Move axis, Maloney
detection of RGP contact lens indexes, PRK simula-
tion, Calco and Wave
contact lens
AUTOFOCUS OR AUTO-
CORRECTION No, passive eye Yes Yes Both
tracking
COMPUTER SYSTEM
CPU 933 MHz Pentium, 32-bit User supplied Any Pentium desktop
Storage capacity
Hard drive 20 GB, 40,000 2 MB User supplied User supplied
Floppy drive 650 MB CDR-W, 1,300 2 floppies User supplied User supplied
Modem speed, bps 14,400 (network Not specified User supplied User supplied
card)
Monitor size 17" 15" User supplied User supplied
Type SVGA SVGA/opt flat screen User supplied SVGA
Pixel matrix 1024x768, Win NT 4.0 1024 x 768 Not specified >800 x 600 required
Software features See Additional Multiple custom Fourier analysis Filing, contact lens
Features displays and reports simulation, zoom,
caliper, difference,
comparison, follow-
up, trial set editor
RESOLUTION
Number of projected
rings 20; 40 slits 32 22; 22,000 points 28
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Corneal Topography Systems
CART Custom workstation CT, computer, print- Optional Electric base with
standard er, modem, monitor, headrest
network card, re-
fractive module,
flat-screen monitor,
opt voice module
DIMENSIONS, cm (in)
Unit 132 x 101.6 x 76.2 45.7 x 45.7 x 33 42 x 26 x 17 61 x 19 x 44
(52 x 40 x 30) (18 x 18 x 13) (16.5 x 10.2 x 6.7) (24 x 7.5 x 17.3)
measuring unit
WEIGHT, kg (lb)
Unit 92 (202.9) Not specified 12 (25) 11 (24)
POWER REQUIREMENTS 110/220 VAC, 110/120 VAC, 50/60 100-240 VAC, Desktop PC
50/60 Hz Hz; 220 VAC, 30 Hz 50/60 Hz
ADDITIONAL FEATURES 49 different types Data archives, auto- Data archiving True curvature,
of maps, Aconic out- focus and alignment, axial, refractive,
put, incision plan- offset fixation for and elevation maps
ner, statistics central corneal (spherical offset);
package, Iomega 1- measurements, limbus process editing;
step backup, archiv- to limbus coverage, profiles; “Move
ing, import/export * stand-alone analysis Axis"; small/large
options printouts
PURCHASE INFORMATION
List price, std
configuration $40,000 $8,500-16,000 $10,000-13,500 Not specified
Delivery time, ARO 2-3 weeks 2-4 weeks 2-4 weeks Not specified
Fiscal year January to December January to December January to December Not specified
OTHER SPECIFICATIONS Posterior corneal None specified. Integrated automatic 85-95% corneal
surface; full (up to keratometer. coverage; Arc-Step
10 mm) pachymetry algorithm; 10- to
A.C. depth; white 130-diopter corneal
to white; angle curvature measuring
Kappa; thinnest range.
point; pupil size.
©2001 ECRI. Duplication of this page by any means for any purpose is prohibited. 7
Healthcare Product Comparison System
CLINICAL
APPLICATIONS
Refractive surgery
planning Intraoperative No No Yes
Cataract surgery
planning Not specified No No No
Keratoconus
detection Yes Yes Yes Yes
Contact lens
fitting Yes Yes Yes Yes
Others Move axis, Maloney Corneal statistics, Corneal statistics, Pathfinder corneal
indexes, PRK simula- enhanced height and enhanced height and analysis, MasterFit
tion, Calco and Wave height change maps height change maps contact lens module *
contact lens
AUTOFOCUS OR AUTO-
CORRECTION Both Joystick alignment/ Both Software driven
software correction
RESOLUTION
Number of projected
rings 28 28; 34 31 20
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Corneal Topography Systems
DIMENSIONS, cm (in)
Unit 28 x 10 x 24 52.5 x 39.7 x 44.1 38.1 x 22.9 x 35.6 31.3 x 45.7
(11 x 3.9 x 9.4) (20.5 x 15.5 x 17.5) (15 x 9 x 14) (12.3 x 18)
WEIGHT, kg (lb)
Unit 1 (2.2) 22 (48) 5.5 (12.1) 17 (38)
POWER REQUIREMENTS 100-240 VAC 110/220 VAC, 110-120/220-240 VAC, 100/120/220/240
and/or battery 50/60 Hz, 50/60 Hz VAC ±10%
operated using ~100 VA (max)
battery module
ADDITIONAL FEATURES True curvature, Pupil detection, Automatic focus, QuickVue and Full
axial, and elevation Klyce corneal alignment, and Exam MultiVue dis-
maps (spherical statistics, 3-D acquisition; pupil plays, Arc-Step
offset); process maps, height maps detection; 3-D maps; algorithm, shape
editing; profiles height maps; Klyce factor, simulated
and 3-D plots; “Move corneal statistics keratometry, CIM,
Axis"; repeatability FileVue archiving *
check **
PURCHASE INFORMATION
List price, std
configuration Not specified $13,495 $8,595 $16,950
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Healthcare Product Comparison System
Humphrey Systems
ATLAS Eclipse 995
WHERE MARKETED Worldwide
CLINICAL
APPLICATIONS
Refractive surgery
planning Yes
Cataract surgery
planning No
Keratoconus
detection Yes
Contact lens
fitting Yes
AUTOFOCUS OR AUTO-
CORRECTION Software driven
WORKING DISTANCE, mm 70
COMPUTER SYSTEM
CPU 566 MHz
Storage capacity
Hard drive 20 GB
Floppy drive 1.44 MB; 12 exams
Modem speed, bps Not specified
RESOLUTION
Number of projected
rings 22 (18 superiorly)
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Corneal Topography Systems
Humphrey Systems
ATLAS Eclipse 995
CART Optional
DIMENSIONS, cm (in)
Unit 31.3 x 45.7
(12.3 x 18)
WEIGHT, kg (lb)
Unit 20 (43)
POWER REQUIREMENTS 100/120/220/240
VAC ±10%
PURCHASE INFORMATION
List price, std
configuration $18,950
Warranty 1 year
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