FIND THE CORNEA THAT SHOULD NOT BE ABLATED.

Post-refractive ectasia is the complication every surgeon plans against. RLES AI screens every cornea with a full battery of tomographic, topographic and biomechanical indices — interpreted together, never in isolation — and runs even when the device’s own software reports "Normal".

MANY INDICES, ONE DISCIPLINED READING

BAD-D, ART max, Kmax, ISK, IVA, posterior elevation, pachymetric progression^[4], CBI/TBI, anterior I-S asymmetry^[1] and the Sirius index family are evaluated against graded bands — normal, borderline, pathologic — and combined in a decision matrix that determines eligibility, follow-up interval and the place of cross-linking.

Crucially, the counting is correlation-aware: mathematically related indices (ART max is literally thinnest pachymetry divided by pachymetric progression)^[2] are never counted as independent evidence. One geometric feature moving four derived indices is one finding — not four. This single discipline prevents a whole class of false-positive ectasia verdicts.

The case for reading indices together rather than one at a time is itself measured. When a weighted composite scale was tested against 50 eyes that developed ectasia and 50 controls, it classified 92% of the ectasia eyes as high risk, while the traditional screening parameters of the day — abnormal topography or a residual stromal bed below 250 µm — classified 50%.^[5] Neither figure is a guarantee, and the scale predates today’s tomographic and biomechanical indices; what the comparison establishes is that the gain came from weighing several variables together rather than from any single new measurement.

BORDERLINE EYES GET A CLINICAL PROTOCOL, NOT A GUESS

• Retinoscopy — including the early, non-scissoring irregular reflex that naive yes/no questions miss
• Slit-lamp verification set: Vogt striae, Fleischer ring, apical thinning
• Epithelial thickness mapping, corneal biomechanics (Corvis ST / ORA), serial tomography at defined intervals
• A positive clinical finding escalates the eye regardless of what tomography claimed — and a normal exam never downgrades borderline tomography

SCREENING THAT DOESN'T TRUST THE DEVICE'S VERDICT

In a documented RLES AI case, the topographer’s built-in keratoconus module reported "Normal" in both eyes of a patient whose corneas were deformed by contact-lens wear — the irregularity only appeared when indices and maps were read together. RLES AI performs its own analysis on every eye, every time. The system never rules that surgery "cannot be done"; it grades the risk,^[3] explains the reasons, and leaves the decision with the surgeon.

FREQUENTLY ASKED QUESTIONS