Ring simulator : Principles and
interests
H. Kamoun
Introduction
Predicting the post-op results of ICRS is everycorneal surgeon’s dream.
Our objective: improving the predictibility of the results using topographic simulations of ICRS treatment.
Ring simulator :Problematic
The miss 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 »
How to get started ?
In the very begining we have tried to calculatethe average effect of each ring to makesimulations
Wrong channel
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 .
The solution ?Conceive an 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 eyeto find out about another with similar
characteristics
The adventure of Ring 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.
Project : Ring Simulator
HOW TO ENTER A CLINICAL CASE
PRE-OP TOPOGRAPHY POST-OP TOPOGRAPHY
DIFFERANTIAL TOPOGRAPHYCALCULATED BY THE SOFTWARE
List of clinical cases
Simulation
Simulation
LIST OF CLINICAL CASES CLOSER TO THE ONE YOU’RE WORKING ON. THAN YOU CHOOSE THE CLOSEST ONE FOR SIMULATION.
.
Simulation
Ring simulators: the principles
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.
Smart software Using a database of treated cases .
The more the database is important, the more performing it will be.
It integrates the Keraring nomogramalong with more suggestions and advice.
Ring simulators: the principles
Exemple 1 :KK stade 3/ K max 53D
Ref: Myopie: 3D / Cyl: 5D
Keraring SI6 :6mm 300μm/ 150°
Exemple 1 :KK stade 3/ K max 53D
Ref: Myopie: 3D / Cyl: 5D
Keraring SI5 :5mm 300μm/ 160°
REAL POST-OP TOPO TOPO POST OP SIMULATED
Exemple 2 :KK stade 2/ K max 49D
Ref: Myopie: 1 / Cyl: 3.5D
Keraring SI6 :6mm 200μm/ 150°
TOPO POST OP REELLE TOPO POST OP SIMULATED
Exemple 3 :KK stade 3/ K max 57D
Ref: Myopie: 7D / Cyl: 9D
Keraring SI5 5mm 160° 300μm / 120° 250μm
TOPO POST OP REELLE TOPO POST OP SIMULATED
Exemple 4 :KK stade 3/ K max 55D
Ref: Myopie: 1D / Cyl: 8D
Keraring 2X SI6 6mm 150° 300μm
TOPO POST OP REELLE TOPO POST OP SIMULATED
Conclusion
Ring simulator
It’s a valuable 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.
Conclusion
Ring simulator
The need to enlarge the databasewith a greater number of cases to increase reliability.
Multicentric evaluation is needed to validate this software.
Thank you
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