J. Bradley Randleman, MD Professor Department of Ophthalmology Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Co-Director Refractive Surgery Section Cole Eye Institute Cleveland Clinic Foundation Cleveland, Ohio Editor-in-Chief Journal of Refractive Surgery Associate Editors Marcony R. Santhiago, MD, PhD Professor Department of Ophthalmology University of São Paulo São Paulo, Brazil Associate Editor Journal of Refractive Surgery Section Editor Journal of Cataract & Refractive Surgery William J. Dupps, MD, PhD Professor Department of Ophthalmology Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Professor Department of Biomedical Engineering Case School of Engineering Case Western Reserve University Co-Director Refractive Surgery Section Cole Eye Institute Cleveland Clinic Foundation Cleveland, Ohio Editor Journal of Cataract & Refractive Surgery Senior Vice President: Stephanie Arasim Portnoy Vice President, Editorial: Jennifer Kilpatrick SLACK Incorporated Vice President, Marketing: Mary Sasso 6900 Grove Road Acquisitions Editor: Tony Schiavo orofare, NJ 08086 USA Director of Editorial Operations: Jennifer 856-848-1000 Fax: 856- Cahill 848-6091 Vice President/Creative Director: omas www.slackbooks.com Cavallaro © 2022 by SLACK Cover Artist: Lori Shields Incorporated Project Editor: Emily Densten All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written permission from the publisher, except for brief quotations embodied in critical articles and reviews. e procedures and practices described in this publication should be implemented in a manner consistent with the professional standards set for the circumstances that apply in each specific situation. Every effort has been made to confirm the accuracy of the information presented and to correctly relate generally accepted practices. e authors, editors, and publisher cannot accept responsibility for errors or exclusions or for the outcome of the material presented herein. ere is no expressed or implied warranty of this book or information imparted by it. Care has been taken to ensure that drug selection and dosages are in accordance with currently accepted/recommended practice. Off-label uses of drugs may be discussed. Due to continuing research, changes in government policy and regulations, and various effects of drug reactions and interactions, it is recommended that the reader carefully review all materials and literature provided for each drug, especially those that are new or not frequently used. Some drugs or devices in this publication have clearance for use in a restricted research setting by the Food and Drug and Administration or FDA. Each professional should determine the FDA status of any drug or device prior to use in their practice. Any review or mention of specific companies or products is not intended as an endorsement by the author or publisher. SLACK Incorporated uses a review process to evaluate submitted material. Prior to publication, educators or clinicians provide important feedback on the content that we publish. We welcome feedback on this work. Library of Congress Cataloging-in-Publication Data Names: Randleman, J. Bradley (James Bradley), 1970- author. | Santhiago, Marcony R., editor. | Dupps, William J., Jr. editor. Title: Atlas of corneal imaging / J. Bradley Randleman ; associate editors, Marcony R. Santhiago, William J. Dupps. Description: orofare, NJ : SLACK Incorporated, [2022] | Includes bibliographical references and index. Identifiers: LCCN 2021061864 (print) | LCCN 2021061865 (ebook) | ISBN 9781630916473 (hardcover) | ISBN 9781630916480 (epub) | ISBN 9781630916497 (pdf) Subjects: MESH: Cornea--diagnostic imaging | Corneal Diseases--diagnostic imaging | Atlas | BISAC: MEDICAL / Ophthalmology | MEDICAL / Optometry Classification: LCC RE336 (print) | LCC RE336 (ebook) | NLM WW 17 | DDC 617.7/190754--dc23/eng/20220119 LC record available at https://lccn.loc.gov/2021061864 LC ebook record available at https://lccn.loc.gov/2021061865 For permission to reprint material in another publication, contact SLACK Incorporated. Authorization to photocopy items for internal, personal, or academic use is granted by SLACK Incorporated provided that the appropriate fee is paid directly to Copyright Clearance Center. Prior to photocopying items, please contact the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923 USA; phone: 978-750-8400; website: www.copyright.com; email: [email protected] D EDICATION is book is dedicated to my lovely wife, best friend, and colleague, Claudia, without whose love, patience, and support this work would never come to fruition; my dear daughters Taylor, Casey, and Mia, who have grown into such amazing, passionate young women blazing their own trails through their educations and early careers; and to our newest addition, my son, Eric, whose boundless energy and endless curiosity inspire me daily to work harder, learn more, and be a better man. And finally, this book is dedicated to my mother, who remains with me always—I think she would have enjoyed it! —J. Bradley Randleman, MD To all those who love me and understand my unwanted absence sometimes. Who respect my dedication to my work and the pursuit of professional dreams. is book represents one of those dreams. To my sincere friends, especially these 2 who are co-editors of this book. To all the ones who gave me extra strength when I needed it. Purposely or not. ank you very much. —Marcony R. Santhiago, MD, PhD To my parents, Bill and Jackie, whose love story, now more than ever, embodies unconditional love that transcends circumstances. You are my heroes. —William J. Dupps, MD, PhD C ONTENTS Copyright Dedication Acknowledgments About the Author About the Associate Editors Contributing Authors Foreword by Stephen D. Klyce, PhD Introduction Chapter 1 Fundamental Concepts in Corneal Imaging Mehdi Roozbahani, MD; Marcony R. Santhiago, MD, PhD; William J. Dupps, MD, PhD; and J. Bradley Randleman, MD Basic Definitions and Terminology Confusing Clinical Concepts Imaging Devices Placido-Based Reflection Devices LED-Based Reflective Devices Tomography-Based Imaging Devices Slit Scanning-Based Tomography Scheimpflug-Based Tomographers Optical Coherence Tomography Very High–Frequency Digital Ultrasound Aberrometers for Wavefront Analysis Summary