REFRACTIVE EWAP MARCH 2023 31 Contact information Hura: ah@maloneyshamie.com Reinstein: dzr@londonvisionclinic.com Shamie: ns@maloneyshamie.com Trattler: wtrattler@gmail.com Still a relatively new technology that is being incorporated into more and more devices, epithelial mapping use continues to become more widespread among refractive surgeons. From an availability standpoint, Dan Reinstein, MD, who pioneered mapping the epithelium, said “every OCT company is developing or has developed this functionality into their machines: Avanti OCT [Optovue], MS39 OCT [CSO Italia], Cirrus OCT [Carl Zeiss Meditec], and Anterion OCT [Heidelberg]. This is in addition to the Insight 100 [ArcScan], which uses the Artemis very high-frequency [VHF] digital ultrasound technology, and the Precisio [iVis] ultra-thin blue scanning laser slit tomography.” “As more doctors get routine access to epithelial thickness Word on the street about epithelial mapping by Liz Hillman Editorial Co-Director maps, there are an increasing number of publications,” Prof. Reinstein said. William Trattler, MD, said that while epithelial thickness mapping has been on everyone’s radar for a while, like Prof. Reinstein, he thinks that more physicians are incorporating it into their diagnostic practice. “We’re still trying to understand a bit better how it will help us clinically,” Dr. Trattler said. In March 2021, EyeWorld spoke with Prof. Reinstein and others about the utility of epithelial mapping in their practice. At the time, Prof. Reinstein shared the history of developing epithelial mapping and where it has come since then: Prof. Reinstein developed epithelial mapping and applications as a bioengineering research fellow working in D. Jackson Coleman’s lab with Ronald Silverman, PhD. Prof. Reinstein was the first to measure the epithelium of the cornea in vivo in 1991 using VHF digital ultrasound and the first to produce a 3-mm map of the epithelium in 1993. 1 He went on to develop the first method of mapping the full 10-mm epithelial profile of the cornea by 1997 2 when he began scanning and elucidating the epithelial changes in LASIK and analyzing the complications of corneal refractive surgery. With this work and the commercialization of the first epithelial mapping device (ArcScan Insight 100 VHF and other anterior segment OCT devices with this capability), Prof. Reinstein is considered This article originally appeared in the December 2022 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. Mean epithelial thickness profile for a population of 110 normal eyes (A) and a population of 54 keratoconic eyes (B). The epithelial thickness profiles for all eyes in each population were averaged using mirrored left eye symmetry. The color scale represents epithelial thickness in microns. A Cartesian 1-mm grid is superimposed with the origin of the corneal vertex. Source: Reprinted with permission from SLACK Incorporated. Reinstein DZ, et al. Epithelial, stromal, and total corneal thickness in keratoconus: three-dimensional display with Artemis very-high frequency digital ultrasound. J Refract Surg. 2010;26:259–271.
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