{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T17:51:14Z","timestamp":1759773074262},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T00:00:00Z","timestamp":1460678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Biophotonics"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>Ectasia after refractive surgery represents a major concern among refractive surgeons. Corneal abnormalities and preexisting corneal ectasia are the most important risk factors. Corneal topography and central corneal thickness are the factors traditionally screening for in refractive surgery candidates. Study of the anterior surface by Placido topography allows for identification of keratoconus before biomicroscopy. However, this is insufficient for the evaluation of pre\u2010operative refractive surgery. There are cases of ectasia after laser <jats:italic>in situ<\/jats:italic> keratomilusis (LASIK) without identifiable risk factors such that there is a need to go beyond the corneal surface. A key requirement is quantifying susceptibility to corneal biomechanical instability and progression to ectasia. Tomographic indices derived from elevation maps and pachymetry spatial variation produce a Belin Ambrosio display final D index (BAD\u2010D index), which has shown better results compared to surface curvature indices for detecting very mild forms of ectasia. A logistic regression formula, integrating age, residual stromal bed, and BAD\u2010D (Ectasia Susceptibility Score, ESS) resulted in a significant improvement in accuracy, leading to 100% sensitivity and 94% specificity for detecting susceptible cases. A comprehensive corneal structural analysis based on corneal segmental tomography can detect susceptible corneas, which increases safety for refractive surgery patients.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jbio201500236-gra-0001-m.png\"><jats:alt-text>magnified image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p>","DOI":"10.1002\/jbio.201500236","type":"journal-article","created":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T10:42:08Z","timestamp":1460716928000},"page":"445-453","source":"Crossref","is-referenced-by-count":7,"title":["Application of corneal tomography before keratorefractive procedure for laser vision correction"],"prefix":"10.1002","volume":"9","author":[{"given":"Allan","family":"Luz","sequence":"first","affiliation":[{"name":"Department of Ophthalmology of the Federal University of Sao Paulo  Sao Paulo Brazil"},{"name":"Cornea and Refractive Surgery Department Hospital de Olhos de Sergipe  Aracaju Brazil"},{"name":"Rio de Janeiro Corneal Tomography and Biomechanics Study Group  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardo","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology of the Federal University of Sao Paulo  Sao Paulo Brazil"},{"name":"Rio de Janeiro Corneal Tomography and Biomechanics Study Group  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela","family":"Salom\u00e3o","sequence":"additional","affiliation":[{"name":"Rio de Janeiro Corneal Tomography and Biomechanics Study Group  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Ambr\u00f3sio","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology of the Federal University of Sao Paulo  Sao Paulo Brazil"},{"name":"Rio de Janeiro Corneal Tomography and Biomechanics Study Group  Rio de Janeiro Brazil"},{"name":"Instituto de Olhos Renato Ambr\u00f3sio and Visare Personal Laser Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/IIO.0b013e31820f1d2d"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0b013e3283622a94"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20130318-01"},{"issue":"1","key":"e_1_2_6_5_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3928\/1081-597X-20030101-05","article-title":"Corneal topographic and pachymetric screening of keratorefractive patients","volume":"19","author":"Ambrosio R.","year":"2003","journal-title":"J Refract Surg"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-200107000-00001"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(90)32516-2"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.80.7.610"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20100428-02"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.12.033"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2005.12.002"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31821e42b2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20140218-03"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5935\/0034-7280.20140018"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000266"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20130719-04"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20101006-01"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(02)01121-1"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40135-012-0003-z"},{"key":"e_1_2_6_20_1","first-page":"92","article-title":"Topometric and tomographic indices for the diagnosis of keratoconus","volume":"2012","author":"Correi F. 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