This document appears to be a presentation on intracorneal ring segments (ICRS) given by Renato Ambrósio Jr. It discusses the history of ICRS dating back to the 1950s, their use for keratoconus beginning in the 1990s, implantation techniques including manual dissection and use of femtosecond lasers, and the biomechanical effects of different ring designs and thicknesses. Slides include comparisons of Keraring to INTACS rings and advantages of using femtosecond lasers for ICRS implantation like ensuring centration and depth of dissection. The presentation touches on various topics within the field of ICRS but does not appear to have an overarching conclusion or purpose beyond providing an overview of

1. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Clinical Experience
with Keraring
Renato Ambrósio Jr, MD, PhD

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Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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Rio de Janeiro
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Tomography and
Biomechanics
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R. Ambrósio Jr.
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São Paulo, 2012
Rio de Janeiro
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Tomography and
Biomechanics
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R. Ambrósio Jr.
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Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Refrativa
São Paulo
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Rio de Janeiro
Corneal
Tomography and
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R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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Finantial Disclosure
Alcon-Wavelight
Allergan
Mediphacos
Oculus
Technicall
Zeiss

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R. Ambrósio Jr.
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Tomography and
Biomechanics
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R. Ambrósio Jr.
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São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
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Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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R. Ambrósio Jr.
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Rio de Janeiro
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Tomography and
Biomechanics
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1950 - Barraquer: Intracorneal Implants
1966 – Blavatskaya: Corneal Tissue Rings
1970 – Galvão: Silicone Rings
1986 – Simon: Silicone Rings
1987 – Fleming: Adjustable PMMA Rings
1991 – Guimarães: One-Piece PMMA rings
For high myopia
1991 – Nosé: One-Piece PMMA rings for low
myopia (Intacs)
1995 – Ferrara: Intrastromal rings for keratoconus
1997 – Colin: Intrastromal rings for keratoconus
Intra Corneal Ring Segments
(ICRS): History

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Corneal
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Rio de Janeiro
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Tomography and
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São Paulo, 2012
Rio de Janeiro
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Biomechanics
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Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
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Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
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Tomography and
Biomechanics
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Rio de Janeiro
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Biomechanics
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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Tomography and
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ICRS for Keratoconus
1997 – Joseph Colin, MD
1995 – Paulo Ferrara, MD PhD

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Corneal
Tomography and
Biomechanics
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Biomechanics
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Refrativa
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Biomechanics
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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Corneal Flettening
Remove tissuel from the center
Add tissue to the periphery
Corneal Steepening
Remove tissuel from the periphery
Add tissue to the center
Barraquer’s Thickness Law

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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Refrativa
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Tomography and
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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Blavatskaya: Smaller “OZ” => More effect

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São Paulo, 2012
Rio de Janeiro
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Tomography and
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Refrativa
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Tomography and
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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Blavatskaya: Thicker => More effect

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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Tomography and
Biomechanics
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Refrativa
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Tomography and
Biomechanics
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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1,3
2
2,7
3,4
4,1
0
2
4
6
8
10
12
14
200 250 300 350 400 450
Implant Thickness (µm)
Diopters
Keraring
INTACS
Comparison of the Flattening Effect

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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Refrativa
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Refrativa
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Rio de Janeiro
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Rio de Janeiro
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Tomography and
Biomechanics
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Tomography and
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Rio de Janeiro
Corneal
Tomography and
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R. Ambrósio Jr.
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Implantation Technique for ICRS
Manual Dissection

10. Rio de Janeiro
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Tomography and
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Rio de Janeiro
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Tomography and
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São Paulo, 2012
Rio de Janeiro
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Refrativa
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Tomography and
Biomechanics
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Refrativa
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Setembro 2013
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Tomography and
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Rio de Janeiro
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Tomography and
Biomechanics
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São Paulo, 2012
Rio de Janeiro
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Biomechanics
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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Rio de Janeiro
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Femtosecond laser

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São Paulo, 2012
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Refrativa
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Biomechanics
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Refrativa
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Rio de Janeiro
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Tomography and
Biomechanics
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
Corneal
Tomography and
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Rio de Janeiro
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Advantages of FS laser for ICRS
Centration and Depth

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Tomography and
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São Paulo, 2012
Rio de Janeiro
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Tomography and
Biomechanics
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R. Ambrósio Jr.
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Refrativa
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Tomography and
Biomechanics
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Refrativa
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Tomography and
Biomechanics
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
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Rio de Janeiro
Corneal
Tomography and
Biomechanics
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Rio de Janeiro
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Tomography and
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Cornea is Stronger in the periphery

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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Refrativa
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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Cornea Anisotropy

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São Paulo, 2012
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Refrativa
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Rio de Janeiro
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Rio de Janeiro
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First Nomograms (1999 - 2004)
Ferrara Albertazzi
Only one type of ICRS

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Rio de Janeiro
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São Paulo, 2012
Rio de Janeiro
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Refrativa
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
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Rio de Janeiro
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2006 - Keraring Variable arc lengths
Allows for Customization
Short Arc = more cylinder and less spherical
correction
Long arc = less cylinder and more spherical
correction
Thckness from 150 - 350µm

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Rio de Janeiro
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São Paulo, 2012
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Tomography and
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Refrativa
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Tomography and
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
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Rio de Janeiro
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2012/2013 – 355 e 340°

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São Paulo, 2012
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Tomography and
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Refrativa
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
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Rio de Janeiro
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Clinical Example of 340°/200µm

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São Paulo, 2012
Rio de Janeiro
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Tomography and
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Refrativa
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Tomography and
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Refrativa
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Rio de Janeiro
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São Paulo, 2012
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Rio de Janeiro
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Evolution of Nomograms
Safety Parameters
Pachymetric Limits

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São Paulo, 2012
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Tomography and
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Refrativa
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Tomography and
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Refrativa
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Rio de Janeiro
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R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
2007 - Mediphacos Nomogram 4.0

20. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
2007 - Mediphacos Nomogram 4.0

21. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Enhanced Diagnosis for Ectasia:
Applications for Corneal Ring Segments
Surgery Planning
Post-op Evaluation

22. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Enhanced Diagnosis for Ectasia:
Applications for Corneal Ring Segments

23. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Enhanced Diagnosis for Ectasia:
Applications for Corneal Ring Segments

24. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
2009 – SI6

25. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Elevation X Curvature (Axial)

26. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Elevation X Curvature (Axial)

27. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Clinical Example

28. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Clinical Example of 2x SI6 120°/250µm

29. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Clinical Study: 1 year results of FS-ICRS
Retrospective study including 24 eyes of 18
patients (19.2 years [range, 18.3 to 42.0 years])
UDVA
Manifest refraction and DCVA
Corneal tomography (Pentacam, Oculus Gmb,
Wetzlar, Germany)
Exams prior and one year after femtosecond
laser-assisted implantation of the intrastromal
corneal ring segment (Intralase iFS 150 kHz and
Keraring)

30. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Clinical Study: 1 year results of FS-ICRS
Improvement in (LogMAR) UDVA (0.75 [20/100]
±0.44 versus 1.25 [20/400] ±0.48, p=0.0004)
Improvement in CDVA (0.20 [20/30]±0.14 post-
operatively versus 0.39 [20/50]±0.25, p<0.0001)
Reduction in mean spherical equivalent (-4.76 ± 4.23
post-operatively versus -6.34 ± -6.36, p=0.0093).
Corneas were statistically less prolate in asphericity
(Q front 30° less negative values)
Reduction in K2, front and back elevation values at the
thinnest point (Best-fit sphere for 8mm), keratometric
astigmatism, and maximal keratometry (KMax) readings
at the 1 year postoperative (p=<0.05)

31. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
ICRS have a definitive role in the treatment
of ECD (Ectatic corneal diseases)
Combination of Treatments (CXL, ASA,
phakic IOL)
Femtosecond laser offers more safety and
efficiency
Keraring Technology for custom planning
When and How to plan it?
Surgery for ECD is NOT Refractive but
Therapeutic
Conclusions

32. Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Refrativa
São Paulo
Setembro 2013
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
São Paulo, 2012
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Rio de Janeiro
Corneal
Tomography and
Biomechanics
Study Group
R. Ambrósio Jr.
&
Obrigado, Thank you!
dr.renatoambrosio@gmail.com