PENTACAM

Complied & Submitted by

Aaisha

180MOPTOM007
Master in Optometry, III Semester
School of Health Sciences
Ansal University
Gurugram, Haryana 122003, India
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Pentacam
Introduction
Imaging is paying an increasingly important role in the decision of making process of the eye care
providers. There are several instruments for anterior segment imaging, but there should be a
comprehensive diagnostic tool that can image entire anterior segment and present data in an easy to
interpret form. To some extent, Pentacam manufactured by Oculus Inc. is one of the tools that
qualifies for this category.

Instrumentation
The OCULUS Pentacam® is a rotating Scheimpflug camera. The rotational measuring procedure
generates Scheimpflug images in three dimensions, with the dot matrix fine-meshed in the centre
due to the rotation. It takes a maximum of 2 seconds to generate a complete image of the anterior
eye segment. Any eye movement is detected by a second camera and corrected for in the process.
The Pentacam® calculates a 3D model of the anterior eye segment from as many as 25.000 (HR:
138.000) distinct elevation points.
The topography and pachymetry of the entire anterior and posterior surface of the cornea from
limbus to limbus are calculated and depicted. The analysis of the anterior eye segment includes a
calculation of the chamber angle, chamber volume and chamber height and a manual measuring
function that can be applied to any location in the anterior chamber of the eye. Images of the
anterior and posterior surface of the cornea, the iris and the anterior and posterior surface of the
lens are generated in a moveable virtual eye. The densitometry of the lens and cornea is
automatically quantified.
The Scheimpflug images taken during the examination are digitalized in the main unit, and all image
data are transferred to the PC.
When the examination is finished, the PC calculates a 3D virtual model of the anterior eye segment,
from which all additional information is derived.
During the scan, fixation control is achieved via a second camera focused on the pupil that monitors
size and orientation; eye movements are corrected for automatically using a central registration after
the scan is completed.

Principle
Scheimpflug Principle – It states that if a lens is tilted such that the lens plane intersects the film
plane, the plane of sharp focus must also pass through that same line. The major advantage of
Scheimpflug geometry is that a wide depth of focus is achieved allowing to obtain optical sections of
the entire anterior segment of the eye, from the anterior surface of the cornea to the posterior
surface of the lens.

The Pentacam uses a rotating Scheimpflug camera to obtain 50 slit images within 2 seconds. It
provides a comprehensive, 3-dimentionsal scan of anterior chamber form the anterior surface of the
cornea up to the posterior surface of the crystalline lens. The image plane of this camera slanted at a
45-degree angle toward the optical axis of the camera optics. It performs a 360° rotating scan but
captures the images only in the temporal 180° in order to avid nose shadow.

Assignment Title: Pentacam

Submitted by: Aaisha
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Procedure
The procedure is done in dark room conditions. This is because a poorly dilated pupil interferes with
the device’s sampling technology, Adjust the head rest and chin rest. After feeding the patient’s
demographic data, patient is asked to fixate at the fixation light and asked not to blink. Examiner can
then proceed with scan acquisition.

Indication
Pentacam is widely used for corneal ectasic conditions. It is a comprehensive diagnostic tool that can
image entire anterior segment and present data in an easy to interpret form. Below we have listed
some of its indication.

1. Corneal topography
2. Screening for corneal refractive surgery
3. Glaucoma screening.
4. Screening for refractive surgery
5. Corneal ectasia
6. Detection of forme fruste keratoconus
7. Cataract surgery and IOL calculation for virgin and post refractive corneas

Contraindication
There is no contraindication to use Pentacam. However, eyes with any active infection should not
undergo Pentacam scan to avoid infection of other patients.

Assignment Title: Pentacam

Submitted by: Aaisha
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Scans Interpretation

Assignment Title: Pentacam

Submitted by: Aaisha
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Assignment Title: Pentacam

Submitted by: Aaisha
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Role of Optometrists

Innovation/recent advancements
1. Densitometry software for cataracts
The densitometry software provides an objective record of a cataract’s grade prior to
surgery.
Comparison studies with the LOCS III system have shown that the Pentacam better predicts
the amount of phaco energy needed to remove various grades of cataract.
1. Topography for premium-channel cataract surgery
2. Wavefront aberrometry – Zernike polynomial analysis

References

Assignment Title: Pentacam

Submitted by: Aaisha
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Assignment Title: Pentacam

Submitted by: Aaisha