masterThesis
Índice acumulativo de riesgo (nice) como prueba diagnóstica con base en tomografía corneal por elevación en la prevención de ectasia corneal post-lasik
Fecha
2016Autor
Navarro Naranjo, Pedro Iván
Institución
Resumen
BackgroundPost-lasik corneal ectasia (PLCE) is an infrequent but devastating complication in lasik surgery to treat patients with myopia with or without astigmatism. Based on elevation corneal tomography through Scheimpflug imaging (Pentacam HR System, Oculus Weztlar, Germany), we proposed a novel cummulative risk index to be used as a screening diagnostic tool to prevent this surgical complication. MethodologyWe performed an analytic observational cross-sectional study with diagnostic test design aimed to evaluate receiver operating characteristics of NICE index using Belin-Ambrosio display as a standard of reference (Pentacam HR, Wetzlar Germany). We performed a binary logistic regression model, 2x2 contingence tables and measured area under curve ROC. ResultsA final study sample of 361 eyes, 59, 3% from female patients with median age of 30 years old (IQR 11, 0) were evaluated. Binary logistic regression model included four independent quantitative variables (K2, PAQUI, EP, I-S) and one qualitative (SEX) were evaluated to know their relationship to dependent variable, NICE (Final Score). Four independent quantitative variables and one qualitative were statistically significant; NICE index classified adequately 92% of patients included in the study regarding presence or absence of PLCE risk. Nagelkerke coefficient was estimated on 74, 4%. ConclusionsCummulative risk index NICE is a novel diagnostic test to evaluate lasik refractive surgery candidates to prevent secondary corneal ectasia.