Ring simulator : Principles and interests

1. Ring simulator : Principles and
interests
H. Kamoun

2. Introduction
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Predicting the post-op results of ICRS is every
corneal surgeon’s dream.
Our objective: improving the predictibility of
the results using topographic simulations of
ICRS treatment.

3. Ring simulator :Problematic
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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 »

4. How to get started ?
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In the very begining we have tried to calculate
the average Wrong channel
effect of each ring to make
simulations
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 .

5. The solution ?
Conceive an expert software.
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Topographic module based on experience.
« An expert sofware»
Using a refractive and topographic database of
treated patients .
nothing is worth the experience of an eye
to find out about another with similar
characteristics

6. The adventure of Ring smulator
started in 2011
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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.

7. Project : Ring Simulator

9. HOW TO ENTER A CLINICAL CASE
PRE-OP TOPOGRAPHY
POST-OP TOPOGRAPHY
DIFFERANTIAL TOPOGRAPHY
CALCULATED BY THE SOFTWARE

10. List of clinical cases

11. Simulation

12. Simulation
.
LIST OF CLINICAL CASES CLOSER TO THE ONE YOU’RE WORKING ON. THAN
YOU CHOOSE THE CLOSEST ONE FOR SIMULATION.

13. Simulation

14. Ring simulators: the principles
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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.

15. Ring simulators: the principles
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Smart software Using a database of
treated cases .
The more the database is important, the
more performing it will be.
It integrates the Keraring nomogram
along with more suggestions and advice.

16. Exemple 1 :KK stade 3/ K max 53D
Ref: Myopie: 3D / Cyl: 5D
Keraring SI6 :6mm 300μm/ 150°

17. 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

18. 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

19. 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

20. 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

21. Conclusion
Ring simulator
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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.

22. Conclusion
Ring simulator
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The need to enlarge the database
with a greater number of cases to
increase reliability.
Multicentric evaluation is needed to
validate this software.

23. Thank you