Placido disk-based topography versus high-resolution rotating Scheimpflug camera for corneal power measurements in keratoconic and post-LASIK eyes：reliability and agreement

AIM：To compare the repeatability/reproducibility of measurement by high-resolution Placido disk-based topography with that of a high-resolution rotating Scheimpflug camera and assess the agreement between the two instruments in measuring corneal power in eyes with keratoconus and post-laser in situ keratomileusis（LASIK）. METHODS：One eye each of 36 keratoconic patients and 20 subjects who had undergone LASIK was included in this prospective observational study. Two independent examiners worked in a random order to take three measurements of each eye with both instruments. Four parameters were measured on the anterior cornea：steep keratometry（Ks）,flat keratometry（Kf）,mean keratometry（Km）,and astigmatism（Ks-Kf）. Intra-examiner repeatability and inter-examiner reproducibility were evaluated by calculating the within-subject standard deviation（Sw）the coefficient of repeatability（R）,the coefficient of variation（Co V）,and the intraclass correlation coefficient（ICC）. Agreement between instruments was tested with the BlandAltman method by calculating the 95% limits of agreement（95% Lo A）.RESULTS：In keratoconic eyes,the intra-examiner and inter-examiner ICC were 〉0.95. As compared with measurement by high-resolution Placido disk-based topography,the intra-examiner R of the high-resolution rotating Scheimpflug camera was lower for Kf（0.32 vs 0.88）,Ks（0.61 vs 0.88）,and Km（0.32 vs 0.84）but higher for Ks-Kf（0.70 vs 0.57）. Inter-examiner R values were lower for all parameters measured using the high-resolution rotating Scheimpflug camera. The 95% Lo A were-1.28 to ＋0.55 for Kf,-1.36 to ＋0.99 for Ks,-1.08 to ＋0.50 for Km,and-1.11 to ＋1.48 for Ks-Kf. In the post-LASIK eyes,the intra-examiner andinter-examiner ICC were 〉0.87 for all parameters. The intra-examiner and inter-examiner R were lower for all parameters measured using the high-resolution rotating Scheimpflug camera. The intra-examiner R was 0.17 vs 0.88 for Kf,0.21 vs 0.88 for Ks,0.17 vs 0.86 for Km,and 0.28 vs 0.33 for Ks-Kf. The inter-examiner R was 0.09 vs 0.64 for Kf,0.15 vs 0.56 for Ks,0.09 vs 0.59 for Km,and 0.18 vs 0.23 for Ks-Kf. The 95% Lo A were-0.54 to ＋0.58 for Kf,-0.51 to ＋0.53 for Ks and Km,and-0.28 to ＋0.27 for Ks-Kf. CONCLUSION：As compared with Placido disk-based topography,the high-resolution rotating Scheimpflug camera provides more repeatable and reproducible measurements of Ks,Kf and Ks in keratoconic and post-LASIK eyes. Agreement between instruments is fair in keratoconus and very good in post-LASIK eyes.

角膜地形图仪中Placido盘及投射照明系统的设计与实现

为了实现检测角膜的表面形貌,设计了基于Placido盘的角膜地形图仪投射照明系统。首先,根据人眼的明视觉光谱光视效率、CCD元件光谱响应曲线以及仪器对面光源照度与发光均匀性的要求,进行了LED背光源设计。其次,根据角膜地形图仪检测原理,比较了球形和椭球形Placido盘的利弊,在背光源照明下分析了这两种面型Placido盘的光照情况。分析显示,椭球形Placido盘的最大辐照度优于球形盘。采用反向逆推法建立数学模型,利用Matlab软件求解确定了盘上黑白条纹环的分布。最后,根据上述设计参数进行了Placido盘加工,搭建了投影照明实验装置,并利用标准模型眼对所获得的投射照明系统进行检测。实验结果表明:在主波长为625nm的AlGalnP红色LED面光源照明的情况下,采用所设计的24环椭球型Placido盘成像到CCD上的黑白条纹环满足等间隔均匀分布的要求,检测精度可达到0.05m^(-1),较好地满足了角膜地形图仪对投射照明系统的高对比度、高精度的要求。

Placido氏盘下调整缝线控制人工晶体术后角膜散光

目的观察在Placido氏盘下调整缝线控制人工晶体术后角膜散光的疗效。方法在装有Placido氏盘的显微镜下行20例人工晶体植入术，术中在盘下调整缝线。结果有效降低了术后角膜散光，与对照组相比差异显著（P＜0.01）。结论Placido氏盘下调整缝线能有效降低人工晶体术后角膜散光。

基于Placido盘法的角膜地形图仪成像系统优化设计

现有的基于Placido盘的角膜地形图仪成像系统采用对称式消色差结构,其视场角小、角膜覆盖面积小,分辨率和检测精度不高。为实现角膜形貌的高覆盖率采集,根据人眼角膜的特点以及所选用的CCD相机,在传统的成像系统基础上利用ZEMAX软件对其进行优化设计。优化后系统由5片镜片组成,有效焦距为25mm,后工作距离为17mm,相对孔径为1/3,全视场为15°,光学总长为55mm。在镜头分辨率145lp/mm处,所有视场的调制传递函数值均接近0.4,场曲在全视场下小于0.1。优化系统角膜覆盖率大、成像质量更好,对实现高分辨率角膜地形图仪工程化生产具有实际意义。

Adaptive preprocessing algorithms of corneal topography in polar coordinate system

New adaptive preprocessing algorithms based on the polar coordinate system were put forward to get high-precision corneal topography calculation results. Adaptive locating algorithms of concentric circle center were created to accurately capture the circle center of original Placido-based image, expand the image into matrix centered around the circle center, and convert the matrix into the polar coordinate system with the circle center as pole. Adaptive image smoothing treatment was followed and the characteristics of useful circles were extracted via horizontal edge detection, based on useful circles presenting approximate horizontal lines while noise signals presenting vertical lines or different angles. Effective combination of different operators of morphology were designed to remedy data loss caused by noise disturbances, get complete image about circle edge detection to satisfy the requests of precise calculation on follow-up parameters. The experimental data show that the algorithms meet the requirements of practical detection with characteristics of less data loss, higher data accuracy and easier availability.

基于精确中心定位的角膜复原算法

Placido盘在角膜地形图系统中应用最为广泛。针对Placido角膜地形图系统中角膜中心定位不准的问题,提出了一种基于Placido盘的角膜复原算法。关键技术是利用图像最内环的数据精确求解角膜中心顶点曲率半径。该方法根据图像分析的结果,利用圆弧连接角膜顶点和第一个反射点,通过迭代精确求解角膜顶点的曲率半径,进而求解角膜各反射点的位置以及屈光度,建立真实人眼的伪彩图。利用标准钢球模拟人眼角膜,结果误差小于0.25 D,表明所采用的算法具有较好的精度和稳定性。

基于偏折术的角膜地形图测量方法研究

为了提高获取角膜地形图的测量精度,将相位测量偏折术和传统Placido盘法相结合,研究了一种新型的人眼角膜地形图获取方法。将人眼顶点处的法线与相机光轴共线,且与显示器的法线平行。显示器上显示的二维正交条纹图经人眼反射后,被相机接收。利用相位提取算法和迭代算法得到显示器和人眼角膜的坐标,再根据两者的几何关系,进而得到人眼角膜地形图。数值模拟表明模型眼的曲率半径和屈光度的测量精度理论上可达±14.7μm和±0.07D。最后实验上对曲率半径与人眼接近的球面元件进行了测量验证,结果表明,本方法具有测量精度高、装置简单、成本低等优点。