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Ryu J, Asaoka R, Nakakura S, Murata H, Nakaniida Y, Ishii K, Obana A, Kiuchi Y. Usefulness of Intraocular Pressure With the Ocular Response Analyzer to Predict Postoperative Hypotony Complications in Glaucoma. Transl Vis Sci Technol 2024; 13:7. [PMID: 39361316 PMCID: PMC11451824 DOI: 10.1167/tvst.13.10.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/19/2024] [Indexed: 10/06/2024] Open
Abstract
Purpose To investigate the usefulness of intraocular pressure (IOP) using the ocular response analyzer to predict the occurrence of hypotony complications following trabeculectomy or bleb needling revision with mitomycin C. Methods This study included 66 eyes of 66 patients who underwent trabeculectomy (58 eyes of 58 patients) or bleb needling (8 eyes of 8 patients) with mitomycin C. A significant predictor of hypotony complications was identified from (1) operation (trabeculectomy or bleb needling), (2) age, (3) sex, (4) disease type (primary open-angle glaucoma, primary angle closure glaucoma, or exfoliation glaucoma), (5) lens status (phakia or pseudophakia), (6) preoperative Goldmann applanation tonometry IOP, (7) preoperative central corneal thickness, (8) preoperative axial length, (9) preoperative anterior chamber depth, (10) preoperative corneal hysteresis, (11) preoperative corneal resistance factor, (12) preoperative corneal compensated IOP (IOPcc), and (13) minimum IOP (IOP value when hypotony complications occurred, otherwise the minimum IOP during 3 months from trabeculectomy or bleb needling) using multivariate logistic regression. Results The probability of the occurrence of hypotony complications tended to increase by applying higher cutoff values to preoperative Goldmann applanation tonometry IOP and IOPcc, but not lower cutoff values to the minimum IOP. Multivariate logistic regression suggested that higher preoperative IOPcc and pseudophakia were significant predictors of the occurrence of hypotony complications (P = 0.0062 and 0.0069, respectively). Conclusions Higher preoperative IOPcc and pseudophakia were significant predictors of the occurrence of hypotony complications. Translational Relevance It is useful to measure IOP using the ocular response analyzer before trabeculectomy.
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Affiliation(s)
- Juri Ryu
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
- Seirei Christopher University, Shizuoka, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | - Yuta Nakaniida
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | - Kaori Ishii
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
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Jin G, Zou M, Li L, Liu Z, Young C, Qi H, Zheng D. Corneal biomechanics and their association with severity of lens dislocation in Marfan syndrome. Int Ophthalmol 2024; 44:148. [PMID: 38502381 DOI: 10.1007/s10792-024-03079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate corneal biomechanical properties and its associations with the severity of lens dislocation in patients with Marfan syndrome. METHODS A total of 30 patients with Marfan syndrome and 30 age-, sex- and axial length (AL)-matched controls were recruited. Corneal biomechanical parameters of both groups were measured by CorVis ST and were compared between groups. Potential associations between corneal biomechanical parameters and severity of lens dislocation were also investigated. RESULTS Lower applanation 1 velocity (A1V) (0.13 ± 0.004 vs. 0.15 ± 0.003, P = 0.016), shorter applanation 2 time (A2T)(22.64 ± 0.11 vs. 22.94 ± 0.11, P = 0.013), longer peak distance (PD) (5.03 ± 0.07 vs. 4.81 ± 0.05, P = 0.008), longer radius (R) of highest concavity (7.44 ± 0.16 vs. 6.93 ± 0.14, P = 0.012), greater Ambrosio relational thickness horizontal (ARTh) (603 ± 20 vs. 498 ± 12, P < 0.001), and integrated radius (IR) (8.32 ± 0.25 vs. 8.95 ± 0.21, P = 0.033) were detected among Marfan eyes compared with controls (all P < 0.05). Marfan individuals with more severe lens dislocation tended to have increased stiffness parameter as longer A1T, slower A1V, shorter A2T, slower application 2 velocity (A2V), smaller PD and smaller Distance Amplitude (DA) (P < 0.05). CONCLUSION Marfan patients were detected to have increased corneal stiffness compared with normal subjects. Corneal biomechanical parameters were significantly associated with the severity of lens dislocation in Marfan patients.
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Affiliation(s)
- Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Longhui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Charlotte Young
- Albany Medical College, 49 New Scotland Ave, Albany, NY, USA
| | - Haotian Qi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
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Pérez-López M, Ting DSJ, Lanzagorta-Aresti A, Montolio-Marzo S, Davó-Cabrera J, Cid-García I. Influence of corneal biomechanical properties on intraocular pressure measurement in different types of Graves’ orbitopathy. Eur J Ophthalmol 2023; 33:567-573. [PMID: 36062595 DOI: 10.1177/11206721221124655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND/AIMS To compare the ocular biomechanical properties of inactive Grave's orbitopathy (GO) patients and healthy subjects and to evaluate the influence of severity and phenotype of GO on these parameters. METHODS This was a cross-sectional study. All included inactive GO patients and healthy controls underwent complete ocular examination, including Goldman applanation tonometry (GAT), corneal biomechanical analysis using Ocular Response Analyser (ORA), and corneal epithelial thickness analysis using Optovue. Patients with inactive GO were classified based on the severity and orbital phenotype (predominantly myogenic or lipogenic). Comparison among groups was performed. RESULTS 60 eyes from 30 inactive GO patients and 30 healthy eyes were examined. Corneal hysteresis (CH) was significantly lower in inactive GO patients (9.6 [p25 8.1; p75 11.2]) compared to controls (10.4 [9.8; 11.5]) (p = 0.012). In GO patients, cornea compensated intraocular pressure (IOPcc) was significantly higher than Goldman applanation tonometry IOP (IOP-GAT) (p = 0.001). A total of 13.3% GO patients were initially classified as having ocular hypertension (OHT; defined as IOP > 21 mmHg with no signs of glaucomatous optic neuropathy) based on IOP-GAT measurement. According to IOPcc, 27.8% of GO patients were classified as OHT. In GO patients, no differences were found in corneal bimechanical properties according to the disease severity or orbital phenotype. CONCLUSIONS CH is significantly lower in inactive GO patients compared to healthy subjects. ORA corrected IOP was significantly higher in GO patients compared to IOP-GAT. No differences in corneal biomechanical properties between mild and moderate-to-severe GO disease and between myogenic and lipogenic orbitopathy were found.
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Affiliation(s)
- Marta Pérez-López
- Ophthalmology Department, 16273Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Darren S J Ting
- Academic Ophthalmology, School of Medicine, 6123University of Nottingham, Nottingham, UK.,Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
| | | | | | - Juan Davó-Cabrera
- Ophthalmology Department, 16273Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Isabel Cid-García
- Ophthalmology Department, 150239Fisabio Oftalmología Médica, Valencia, Spain
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Ohta M, Wakuta M, Sakuma A, Hasegawa M, Hamada W, Higashijima F, Yoshimoto T, Ogata T, Kobayashi Y, Kimura K. Evaluation of corneal hysteresis after pars plana vitrectomy combined phacoemulsification and intraocular lens implantation. Sci Rep 2022; 12:14630. [PMID: 36028519 PMCID: PMC9418308 DOI: 10.1038/s41598-022-18299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2022] Open
Abstract
We evaluated the early effects of pars plana vitrectomy (PPV) on corneal biomechanics by comparing corneal hysteresis (CH) after cataract surgery (phacoemulsification and aspiration with intraocular lens implantation; PEA + IOL) alone and PPV combined with cataract surgery. This study included 20 eyes (18 patients), who underwent cataract surgery alone (PEA + IOL group), and 28 eyes (27 patients) who underwent PPV combined with cataract surgery (PPV triple group). The CH was 11.1 ± 1.1, 10.4 ± 1.1, and 11.0 ± 1.0 mmHg in the PEA + IOL group and 11.0 ± 1.4, 9.8 ± 1.4, and 10.6 ± 1.6 mmHg in the PPV triple group, preoperatively, at 2 weeks, and 3 months after surgery, respectively. The CH was not significantly different after surgery in the PEA + IOL group, but decreased significantly in the PPV triple group 2 weeks following surgery (p < 0.01). Intraocular pressure (IOP) and central corneal thickness (CCT) did not change significantly after surgery in either group. Preoperatively, there was a positive correlation between CH and CCT in the PPV triple group, but the correlation disappeared postoperatively. In PPV combined with cataract surgery, CH temporarily decreased postoperatively, independent of IOP and CCT. Removal of the vitreous may reduce the elasticity and rigidity of the entire eye.
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Affiliation(s)
- Manami Ohta
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Makiko Wakuta
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan.,Clinical Research Center, Yamaguchi University Hospital, Ube, Yamaguchi, 755-8505, Japan
| | - Ayano Sakuma
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Mina Hasegawa
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Waka Hamada
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Fumiaki Higashijima
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Takuya Yoshimoto
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Tadahiko Ogata
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Yuka Kobayashi
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan
| | - Kazuhiro Kimura
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
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Repeatability of Corneal Hysteresis Measurements in Glaucoma Patients During Routine Follow Up and After Cataract Surgery. J Glaucoma 2022; 31:590-594. [PMID: 35763681 PMCID: PMC9240401 DOI: 10.1097/ijg.0000000000002008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 02/11/2022] [Indexed: 01/31/2023]
Abstract
PRCIS Corneal hysteresis (CH) measurements are relatively stable during routine follow up of glaucoma patients over an intermediate time frame. Cataract surgery does not change the CH significantly after an average follow up of 6 months. PURPOSE The aim was to assess the repeatability of CH measurements in glaucoma patients over time, during routine follow up and after cataract surgery. MATERIALS AND METHODS Retrospective analysis of patients records in a glaucoma clinic where routine measurements by the Ocular Response Analyzer were done. Patients with at least 2 CH measurements were included. Repeatability was assessed using the intraclass correlation coefficient (ICC). RESULTS A total of 164 eyes (87 patients) were included. Twenty-eight of them had measurements before and after cataract surgery with mean follow up time of 29.64±9.63 weeks. There was no evidence for a difference in CH between the before and after cataract surgery measurements (ICC=0.79, 95% confidence interval: 0.60-0.89). In the remaining 136 eyes, without any surgical treatment between measurements, there was moderate agreement among the repeated CH measurements (ICC=0.64, 95% confidence interval: 0.61-0.82) with mean time of 32.06±25.32 weeks between first and last measurement. CONCLUSION CH measurements in glaucoma patients were repeatable over a 6-month period during routine follow up or following cataract surgery. These findings suggest that the intraocular pressure reduction following cataract surgery is unlikely to be because of a change in this biomechanical property.
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Rahimi M, Panahi Bazaz M, Sharifipour F, Hajizadeh M, Cheraghian B. Corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty, penetrating keratoplasty, and phacoemulsification. Int Ophthalmol 2022; 42:3183-3190. [PMID: 35552955 DOI: 10.1007/s10792-022-02318-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty (DSAEK), penetrating keratoplasty (PK), and phacoemulsification (PE). METHODS This prospective study included 138 eyes which underwent PK (26 eyes), DSAEK (26 eyes), PE (57 eyes), and 29 normal eyes. Intraocular pressure (IOP) was measured by Goldmann applanation tonometer (GAT), and central corneal thickness (CCT) and axial length by ultrasound. The ocular response analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-related IOP (IOPg), and cornea-compensated IOP (IOPcc) preoperatively and 1, 3, and 6 months postoperatively. RESULTS At baseline, PK group had the lowest CH and CRF. There was a significant increase in CH and CRF to normal values in PK (P = 0.015 and 0.006) and PE (P = 0.005 and 0.0001) groups over the study period. At 6 months, CH and CRF increased and reached normal values in the PK group; increased to a lower level than normal in the DSAEK group; and, after an initial reduction, increased to normal values in the PE group. At 6 months, DSAEK group had the lowest CH and CRF. There was a significant positive correlation between CRF and GAT (r = 0.281, P = 0.009), IOPg and GAT (r = 0.335, P = 0.001), and IOPcc and GAT (r = 0.282, P = 0.001). CH was negatively correlated with age (r = - 0.189, P = 0.04). CONCLUSION Corneal biomechanical factors increase after DSAEK and PK. At post-operative month six, they reach normal values in PK group, but are lower than normal in DSAEK group.
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Affiliation(s)
- Mahnaz Rahimi
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Farideh Sharifipour
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Labbafinejad Medical Center, Boostan 9th st., Pasdaran Ave, Tehran, 1666663111, Iran.
| | - Maryam Hajizadeh
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
PURPOSE OF THE REVIEW This review summarizes recent findings on corneal hysteresis, a biomechanical property of the cornea. Corneal hysteresis measurements can be easily acquired clinically and may serve as surrogate markers for biomechanical properties of tissues in the back of the eye, like the lamina cribrosa and peripapillary sclera, which may be related to the susceptibility to glaucomatous damage. RECENT FINDINGS Several studies have provided evidence of the associations between corneal hysteresis and clinically relevant outcomes in glaucoma. Corneal hysteresis has been shown to be predictive of glaucoma development in eyes suspected of having the disease. For eyes already diagnosed with glaucoma, lower corneal hysteresis has been associated with higher risk of progression and faster rates of visual field loss over time. Such associations appear to be stronger than those for corneal thickness, suggesting that corneal hysteresis may be a more important predictive factor. Recent evidence has also shown that cornealcorrected intraocular pressure measurements may present advantages compared to conventional Goldmann tonometry in predicting clinically relevant outcomes in glaucoma. SUMMARY Given the evidence supporting corneal hysteresis as an important risk factor for glaucoma development and its progression, practitioners should consider measuring corneal hysteresis in all patients at risk for glaucoma, as well as in those already diagnosed with the disease.
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Affiliation(s)
| | - Felipe A Medeiros
- Duke Eye Center and Department of Ophthalmology
- Department of Electrical and Computer Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
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Díaz-Barreda MD, Sánchez-Marín I, Boned-Murillo A, Pérez-Navarro I, Martínez J, Pardina-Claver E, Pérez D, Ascaso FJ, Ibáñez J. Modification of Corneal Biomechanics and Intraocular Pressure Following Non-Penetrating Deep Sclerectomy. J Clin Med 2022; 11:jcm11051216. [PMID: 35268307 PMCID: PMC8911357 DOI: 10.3390/jcm11051216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 12/18/2022] Open
Abstract
Changes in the cornea can influence outcomes in patients with primary open-angle glaucoma (POAG). We aimed to evaluate the relevance of changes in corneal biomechanics and intraocular pressure (IOP) in patients undergoing non-penetrating deep sclerectomy (NPDS) with the Esnoper V2000 implant® (AJL Ophthalmic S.A., Gasteiz, Spain). We included 42 eyes of 42 patients with POAG scheduled for NPDS with the Esnoper V2000 implant. Biomechanical properties were measured by Ocular Response Analyzer® G3 (ORA; Reichert Inc., Depew, NY, USA). Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) were measured the day before surgery and on day 1, 7, and 30 and 2 and 3 months after surgery. CH initially increased, fell below the presurgical value at 30 days after the surgery, and increased again at 2 and 3 months. CRF, IOPcc, and IOPg decreased on the first day after surgery, then followed a trend of increasing but stayed below pre-surgery levels. All values reached statistical significance. While observed changes in corneal biomechanics after NPDS and Esnoper V2000 implant were significant, more studies are needed if we are to understand their influence on corneal biomechanics and their clinical relevance in POAG.
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Affiliation(s)
- María Dolores Díaz-Barreda
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
- Correspondence: (M.D.D.-B.); (F.J.A.); Tel.: +34-629-863-827 (M.D.D.-B.); +34-686-574-389 (F.J.A.)
| | - Ignacio Sánchez-Marín
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Ana Boned-Murillo
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Itziar Pérez-Navarro
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Juana Martínez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Elena Pardina-Claver
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
| | - Diana Pérez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Francisco Javier Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
- Correspondence: (M.D.D.-B.); (F.J.A.); Tel.: +34-629-863-827 (M.D.D.-B.); +34-686-574-389 (F.J.A.)
| | - Juan Ibáñez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (I.S.-M.); (A.B.-M.); (I.P.-N.); (J.M.); (E.P.-C.); (D.P.); (J.I.)
- Department of Surgery, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
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Choi YJ, Lee EJ. The Effects of Anti-glaucoma Eyedrops on Corneal Hysteresis in Patients with Open-angle Glaucoma and Glaucoma-suspect. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We explored the effects of topical anti-glaucoma medications on the corneal biochemical properties of patients with open-angle glaucoma (OAG) and glaucoma suspect (GS patients).Methods: We retrospectively reviewed data on 115 OAG and 98 GS patients (225 and 128 eyes respectively). Corneal hysteresis (CH) was measured using an ocular response analyzer. Factors influencing CH were determined using a generalized estimation equation.Results: The mean CH was lower in OAG than GS patients (p < 0.001). A lower cornea-compensated intraocular pressure, concomitant use of a beta-adrenergic blocker and an alpha2-adrenergic agonist, a higher visual field mean deviation, and a larger central corneal thickness were associated with a higher CH in the OAG group.Conclusions: Concomitant use of a topical beta-adrenergic blocker and an alpha2-adrenergic agonist was associated with a higher CH.
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Lopes BT, Bao F, Wang J, Liu X, Wang L, Abass A, Eliasy A, Elsheikh A. Review of in-vivo characterisation of corneal biomechanics. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Variations of Intraocular Pressure Measured by Goldmann Applanation Tonometer, Tono-Pen, iCare Rebound Tonometer, and Pascal Dynamic Contour Tonometer in Patients With Corneal Edema After Phacoemulsification. J Glaucoma 2020; 30:317-324. [PMID: 33137014 DOI: 10.1097/ijg.0000000000001725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 10/11/2020] [Indexed: 11/25/2022]
Abstract
PRCIS Edematous corneas had lower Goldmann applanation tonometer (GAT) intraocular pressure (IOP) compared with other tonometers. A significant, mild negative correlation between central corneal thickness (CCT) and GAT IOP was found in a group of significant edematous corneas with CCT increases of >100 µm. PURPOSE To compare the IOP that was randomly obtained with the GAT, Tono-Pen, iCare, and Pascal dynamic contour tonometer in patients with corneal edema after phacoemulsification. MATERIALS AND METHODS Corneal edema was quantified by CCT measurement. The agreement between IOP measurements assessed by different instruments was evaluated using Bland-Altman plots. The relationship between CCT and IOP was investigated using the coefficient of correlation. The CCT and IOP were compared between the periods of postsurgical edema and after its resolution. RESULTS The mean age of 60 patients was 75.9±7.8 years. CCT increased significantly after surgery, by an average of 96.1±39.9 µm (P<0.001). Relative to the IOPs measured with the GAT in edematous eyes: the mean difference in Tono-Pen IOPs was 4.7 mm Hg; 95% limits of agreement (LOA), -0.3 to 9.6 mm Hg. For iCare, was 2.3 mm Hg; 95% LOA, -2.2 to 6.8 mm Hg. For Pascal dynamic contour tonometer, was 3.0 mm Hg; 95% LOA, -0.4 to 6.5 mm Hg. Edematous corneas had significantly lower GAT IOP than Tono-Pen IOP; 12.3±3.2 versus 16.9±3.1 (P=0.02). Pearson correlation coefficients (r) showed a high correlation between the 4 tonometers in eyes without edema. There was a significant, mild negative correlation between CCT and GAT IOP (r=-0.25, P=0.02) in a group of significant edematous corneas with CCT increases of >100 µm: GAT IOP decreased by 3.1 mm Hg for every 10-µm increase in CCT. CONCLUSIONS IOP readings with GAT tended to be lower than those obtained with the other tonometers, especially the Tono-Pen. GAT IOP readings in cases of severe corneal edema should be interpreted with caution.
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Kontadakis GA, Pennos A, Pentari I, Kymionis GD, Pallikaris IG, Ginis H. Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas. Ther Adv Ophthalmol 2020; 12:2515841420923190. [PMID: 32577607 PMCID: PMC7288812 DOI: 10.1177/2515841420923190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/26/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose: To investigate in vitro the accuracy of dynamic contour
tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous
corneas. Methods: Experimental study included 20 freshly enucleated porcine eyes. Epithelium
was debrided, and eyes were divided in four groups. Groups were immersed in
35%, 40%, 50%, and 60% glycerin solutions for 3 hours. Subsequently, globes
were mounted in a special holder, and their intraocular pressure was
hydrostatically adjusted. Intraocular pressure was measured by means of
dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL
while adjusting true intraocular pressure to 17, 33, and 50 mm Hg.
Ultrasound pachymetry was performed. Results: Mean corneal thickness was 914.5 ± 33.3 μm (730–1015 μm). In true intraocular
pressure of 33 mm Hg, Goldmann applanation tonometry and dynamic contour
tonometry significantly underestimated true intraocular pressure (mean
Goldmann applanation tonometry: 14.7 ± 4.8 mm Hg,
p < 0.001, mean dynamic contour tonometry: 21.6 ± 6.8,
p < 0.001). Tono-Pen XL also underestimated, but
difference was not statistically significant (Tono-Pen XL: 27.9 ± 9.7,
p = 0.064). In true intraocular pressure of 50 mm Hg,
all three methods significantly underestimated (Goldmann applanation
tonometry: 17.6 ± 5.3 mm Hg, p < 0.001, dynamic contour
tonometry: 26.8 ± 6.3 mm Hg, p < 0.001, Tono-Pen XL:
35.6 ± 8.4 mm Hg, p < 0.001). The error in measured
intraocular pressure for each method (true minus measured intraocular
pressure) was significantly correlated to true intraocular pressure
(p < 0.001). The intraocular pressure measurements
of each eye taken under true intraocular pressure of 17 and 33 mm Hg with
the three methods were correlated to each other. Measurements taken under
intraocular pressure of 50 mmHg were not correlated to each other. Corneal
thickness was not correlated to intraocular pressure measurement. Conclusion: Goldmann applanation tonometry, dynamic contour tonometry, and Tono-Pen XL
underestimate intraocular pressure when measured under edematous conditions.
Tono-Pen XL showed better accuracy, especially in lower true intraocular
pressure. The measurement error increases when true intraocular pressure
increases in all three methods.
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Affiliation(s)
- George A Kontadakis
- Institute of Vision and Optics (IVO), Medical School, University of Crete, 71003 Heraklion, Crete, Greece
| | - Alexandros Pennos
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - Iro Pentari
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - George D Kymionis
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - Ioannis G Pallikaris
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - Harilaos Ginis
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece Athens Eye Hospital, Athens, Greece
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Corneal Biomechanical Changes After Uneventful Phacoemulsification in Patients With Type 2 Diabetes Mellitus and Patients Without Diabetes. Cornea 2020; 39:1073-1079. [PMID: 32301813 DOI: 10.1097/ico.0000000000002332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare corneal biomechanical changes after uneventful phacoemulsification cataract surgery between type 2 diabetic (DM) and nondiabetic patients. METHODS Forty-four diabetic (44 eyes) and 44 (44 eyes) age and sex-matched non-DM controls with age-related cataract were enrolled in this prospective observational study. Corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc) were evaluated by using the ocular response analyzer; central corneal thickness was recorded by using the Pentacam HR. Patients were evaluated preoperatively and 1 and 6 months after surgery. RESULTS In the DM group, CH was observed to be significantly lower than preoperative value (9.8 ± 1.5 mm Hg) at 1 month (9.4 ± 1.2 mm Hg, P = 0.040), but not at the 6-month follow-up (9.6 ± 1.6 mm Hg, P = 0.437),whereas it did not change significantly in the non-DM group (preoperative 9.8 ± 1.3 mm Hg vs. 1 month 9.6 ± 1.1 mm Hg vs. 6 months 10.1 ± 1.1 mm Hg, P > 0.05). CRF was significantly lower than the preoperative values at 1 and 6 months in both groups (P ≤ 0.001). Postoperative CH change was significantly associated with preoperative CH (P < 0.001), preoperative IOPcc (P = 0.004), and IOPcc change (P < 0.001), whereas CRF change was only correlated with preoperative CRF (P < 0.001). There was a significant postoperative IOPcc reduction 6 months after surgery (P < 0.001) in both DM and non-DM groups; however, central corneal thickness was not found to significantly change in the postoperative period (P > 0.05). CONCLUSIONS This study showed that phacoemulsification causes a significant and persistent decrease in intraocular pressure and CRF in both groups, whereas CH recovered to preoperative values, although more slowly in patients with diabetes.
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Can ME, Kızıltoprak H, Buluş AD, Özkoyuncu D, Koç M, Özdemir Yıldız Z. Corneal Biomechanical Properties in Childhood Obesity. J Pediatr Ophthalmol Strabismus 2020; 57:103-107. [PMID: 32203594 DOI: 10.3928/01913913-20200131-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/30/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate corneal biomechanical properties in patients with childhood obesity. METHODS The study included 47 patients with childhood obesity (study group) and 39 healthy patients (control group). Corneal hysteresis, corneal resistance factor, corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Ocular Response Analyzer (Reichert, Ophthalmic Instruments, Buffalo, NY) in each eye. Central corneal thickness (CCT), anterior chamber angle (ACA), anterior chamber volume (ACV), and anterior chamber depth (ACD) measurements were obtained by the Pentacam rotating Scheimpflug camera (Oculus Optikgeräte GmBh, Wetzlar, Germany). RESULTS The mean corneal hysteresis was 10.56 ± 1.52 mm Hg in the study group and 11.16 ± 1.92 mm Hg in the control group (P = .022). The mean IOP was 14.9 ± 2.0 mm Hg in the study group and 14.1 ± 1.3 mm Hg in the control group (P = .003). Corneal hysteresis showed a significant, positive correlation with corneal resistance factor (P < .001, r = 0.851), IOPg (P = .044, r = 0.213), CCT (P < .001, r = 0.477), and IOP (P = .005, r = 0.295). Corneal hysteresis showed a significant, negative correlation with IOPcc (P = .001, r = -0.355), ACA (P = .005, r = -0.294), ACV (P = .019, r = -0.246), and ACD (P = .046, r = -0.211). CONCLUSIONS Patients with childhood obesity have lower corneal hysteresis and higher IOPcc measurements when compared with healthy patients. Corneal tissue changes may occur in early life in childhood obesity, which could lead to ocular disease in the future. [J Pediatr Ophthalmol Strabismus. 2020;57(2):103-107.].
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Hirasawa K, Nakakura S, Nakao Y, Fujino Y, Matsuura M, Murata H, Kiuchi Y, Asaoka R. Changes in Corneal Biomechanics and Intraocular Pressure Following Cataract Surgery. Am J Ophthalmol 2018; 195:26-35. [PMID: 30071213 DOI: 10.1016/j.ajo.2018.07.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To investigate the effects of cataract surgery on corneal biomechanics and intraocular pressure (IOP) measured with the updated Corvis ST tonometer (CST). DESIGN Prospective, interventional case series study. METHODS This study included 39 eyes of 39 cataract patients. CST measurements were performed at presurgery (Pre) as well as 1 week (1W), 1 month (1M), and 3 months (3M) postsurgery. The following CST parameters were recorded: deformation amplitude max (DA max), DA ratio max 1 mm and 2 mm, integrated radius, stiffness parameter at applanation 1 (SP A1), Ambrosio relational thickness to the horizontal profile (ARTh), Corvis biomechanical index (CBI), central corneal thickness (CCT), noncorrected intraocular pressure (IOPnct), and biomechanically corrected IOP (bIOP). IOP was also measured with Goldmann applanation tonometry and the noncontact tonometer CT-90A. All measurements were compared at each period using the linear mixed model, with and without adjustment for bIOP and CCT. RESULTS All IOP measurements decreased over time (P < .01). CCT was increased at 1W and 3M (P < .01), whereas ARTh was decreased at 1W and 1M (P < .01), but returned to its Pre level at 3M. DA max and Integrated radius were increased at 3M (P < .01), whereas SP A1 was decreased at 3M (P < .01). CBI was increased at 1W (P < .01), but returned to its Pre level at 1M. CONCLUSIONS IOP and Corneal biomechanical properties are changed after cataract surgery. In particular, SP A1 decreases while DA max and integrated radius increase, even at 3M, suggesting a less stiff cornea.
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Aoki S, Murata H, Matsuura M, Fujino Y, Nakakura S, Nakao Y, Kiuchi Y, Asaoka R. The effect of air pulse-driven whole eye motion on the association between corneal hysteresis and glaucomatous visual field progression. Sci Rep 2018; 8:2969. [PMID: 29445204 PMCID: PMC5813173 DOI: 10.1038/s41598-018-21424-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/05/2018] [Indexed: 11/30/2022] Open
Abstract
Corneal hysteresis (CH) measured with Ocular Response Analyzer (Reichert: ORA) has been reported to be closely related to the glaucomatous visual field (VF) progression. The air pulse applied to an eye not only induces corneal deformation, but also whole eye motion (WEM), which may result in an inaccurate measurement of CH. Here we investigated the influence of air pulse-driven WEM measured with the Corivs ST (CST®, OCULUS) on the relationship between CH and VF progression in primary open angle-glaucoma patients. Using the CST parameters of the maximal WEM displacement (WEM-d) and the time to reach that displacement (WEM-t), the eyes were classified into subgroups (WEM-d low- and high-group, and WEM-t short- and long-group). For the whole population and all subgroups, the optimal linear mixed model to describe mean of total deviation (mTD) progression rate with eight reliable VFs was selected from all combinations of seven parameters including CH. As a result, optimal models for the mTD progression rate included CH in the whole population, the WEM-d low- group and the WEM-t short-group, but not in the WEM-d high-group and the WEM-t long-group. Our findings indicated association between CH and glaucomatous progression can be weakened because of large WEM.
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Affiliation(s)
- Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Masato Matsuura
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.,Department of Rehabilitation, Orthopic and Visual Science, School of Allied Health Sciences, Kitasato University, Tokyo, Kanagawa, Japan
| | - Yuri Fujino
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.
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The Effect of Dehydration and Fasting on Corneal Biomechanical Properties and Intraocular Pressure. Eye Contact Lens 2016; 42:392-394. [DOI: 10.1097/icl.0000000000000220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Perucho-González L, Martínez de la Casa JM, Morales-Fernández L, Bañeros-Rojas P, Saenz-Francés F, García-Feijoó J. Intraocular pressure and biomechanical corneal properties measure by ocular response analyser in patients with primary congenital glaucoma. Acta Ophthalmol 2016; 94:e293-7. [PMID: 26647905 DOI: 10.1111/aos.12912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/23/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE To measure the differences in corneal hysteresis (CH) and corneal resistance factor (CRF) in primary congenital glaucoma (PCG) and in control subjects using ocular response analyser (ORA) and also to compare intraocular pressure (IOP) measurements given by ORA against IOP given by Perkins tonometer, a handheld version of Goldman applanation tonometer (GAT), to determine correlation. METHODS One hundred and eighteen eyes of 78 patients with PCG (group I) and 103 eyes of 53 controls (group II) were evaluated using ORA. In all participants, IOP was measured using the Perkins tonometer. The ORA device uses applanation pressure peaks to generate the corneal-compensated IOP (IOPcc), which is reportedly independent of corneal thickness, and the measurement of Goldman-correlated IOP (IOPg), which is influenced by corneal thickness. RESULTS The measures in group I were as follows: IOPcc 20.92 ± 5.33; IOPg 18.87 ± 6.67; CH 8.51 ± 2.25; CRF 9.85 ± 3.03; and IOP measured by Goldman 18.32 ± 5.13. The measures in group II were as follows: IOPcc 14.33 ± 2.91; IOPg 14.77 ± 3.00; CH 11.37 ± 1.61; CRF 11.02 ± 1.74; and IOP measured by Goldman 13.74 ± 2.42. The differences of all parameters compared between both groups were statistically significant (p < 0.001 for CH and for all IOP measures and p = 0.001 for CRF). The values of IOPcc, IOPg and IOP measured with Goldman were higher in group I than the values in group II. However, CH and CRF values were lower in group I. CONCLUSION A decrease in CH and CRF has been observed in patients with PCG compared to controls. Future research should assess how these parameters are modified in PCG and whether they could provide more information about progression.
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Changes in Corneal Biomechanical Properties After Descemet Stripping Automated Endothelial Keratoplasty for Pseudophakic Bullous Keratopathy. Cornea 2016; 35:20-4. [PMID: 26555584 DOI: 10.1097/ico.0000000000000684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare corneal biomechanical properties and intraocular pressure (IOP) in eyes with pseudophakic bullous keratopathy (PBK) before and after Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS This prospective nonrandomized intrasubject comparative study was conducted on 44 eyes of 22 patients with the diagnosis of PBK who underwent DSAEK in one eye. IOP was measured by Goldmann applanation tonometer, and central corneal thickness was measured by ultrasound pachymetry. The ocular response analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-related IOP, and cornea-compensated IOP. The same measurements were performed in the normal fellow eyes which served as controls. All measurements were performed preoperatively and 6 months postoperatively. RESULTS The mean patient age was 67 ± 14 years. Mean preoperative CH and CRF values in the DSAEK group were 5.77 ± 2.94 and 6.39 ± 2.72 mm Hg, respectively, which were significantly lower than those measured in the control group (8.2 ± 2.47 and 8.43 ± 2.49 mm Hg, respectively, P = 0.001 for both comparisons). Postoperatively, CH and CRF demonstrated a significant increase (7.09 ± 3.68 mm Hg, P = 0.05 and 8.21 ± 3.84 mm Hg, P = 0.03, respectively) in operated eyes approaching the normal values measured in the control eyes. CONCLUSIONS Corneal biomechanical parameters were significantly lower in PBK eyes than in the normal fellow eyes. These metrics significantly increased after DSAEK and reached values measured in the normal fellow eyes.
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Zhang Z, Yu H, Dong H, Wang L, Jia YD, Zhang SH. Corneal biomechanical properties changes after coaxial 2.2-mm microincision and standard 3.0-mm phacoemulsification. Int J Ophthalmol 2016; 9:230-4. [PMID: 26949640 DOI: 10.18240/ijo.2016.02.08] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/20/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the changes in corneal biomechanics measured by ocular response analyzer (ORA) after 2.2-mm microincision cataract surgery and 3.0-mm standard coaxial phacoemulsification. METHODS The prospective nonrandomized study comprised eyes with cataract that had 2.2-mm coaxial microincision or 3.0-mm standard incision phacoemulsification. The corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg) were measured by ORA preoperatively and at 1d, 1-, 2-, 3- and 4-week postoperatively. Results were analyzed and compared between groups. RESULTS In both groups, CH decreased in the immediate postoperative period (P<0.05), returned to the preoperative level at one week (P=0.249) in the 2.2-mm group, and at two weeks in the 3.0-mm group (P=0.264); there was no significant change in CRF values. In 2.2-mm group, mean IOPcc and IOPg increased at 1d postoperatively (both P<0.05), and returned to preoperative level at one week (P=0.491 and P=0.923, respectively). In 3.0-mm group, mean IOPcc and IOPg increased at 1d and 1wk postoperatively (P=0.005 and P=0.029, respectively), and returned to preoperative level at 2wk (P=0.347 and P=0.887, respectively). CONCLUSION Significant differences between preoperative and postoperative corneal biomechanical values were found for CH, IOPcc and IOPg. But the recovery time courses were different between the two groups. The 2.2-mm coaxial microincision cataract surgery group seemed recovery faster compared to the 3.0-mm standard coaxial phacoemulsification group.
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Affiliation(s)
- Zhe Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 300070, China; Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China
| | - Hua Yu
- Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China
| | - Hui Dong
- Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China
| | - Li Wang
- Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China; Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Ya-Ding Jia
- Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China
| | - Su-Hua Zhang
- Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China
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Gür Güngör S, Akman A, Küçüködük A, Asena L, Şimşek C, Yazici AC. Non-Contact and Contact Tonometry in Corneal Edema. Optom Vis Sci 2016; 93:50-6. [DOI: 10.1097/opx.0000000000000744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Elsheikh A, Joda A, Abass A, Garway-Heath D. Assessment of the Ocular Response Analyzer as an Instrument for Measurement of Intraocular Pressure and Corneal Biomechanics. Curr Eye Res 2014; 40:1111-9. [PMID: 25495865 DOI: 10.3109/02713683.2014.978479] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study is to provide better understanding of the Ocular Response Analyzer (ORA) and how reliable it is to produce intraocular pressure (IOP) measurements that are free of the effects of corneal stiffness parameters, and stiffness estimates that are independent of IOP. MATERIALS AND METHODS A numerical parametric study that closely represents the in-vivo conditions of the human eye and the ORA procedure was conducted to determine the correlation coefficient r(2) between ORA output and the values of true IOP and a number of stiffness parameters, namely corneal thickness, curvature and age. For the purpose of this exercise, the ORA output was put in the form k1P1+k2P2 where k1 and k2 were variables and P1 and P2 were ORA's measured applanation pressures. Two separate clinical datasets involving Moorfields Eye Hospital, London and the University of New South Wales, Sydney participants, respectively, were used to validate the numerical results. RESULTS The numerical study results show a strong association between (k1P1 + k2P2) and the true IOP over a wide range of k1 and k2 values apart from a narrow region approximately extending from (k1 = +2, k2 = -2) to (k1 = -2, k2 = +2). On the other hand, (k1· P1 + k2· P2) was found to have a strong association with CCT, R and age (the stiffness parameters) over the same narrow region, beyond which the association was weak. Similar trends were found with the two clinical datasets. CONCLUSIONS The results of this study show the potential of the ORA to provide reliable IOP measurements with weak dependence on the cornea's stiffness parameters and the considerably reduced reliability in producing stiffness estimates that are unaffected by IOP values.
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Affiliation(s)
- Ahmed Elsheikh
- a School of Engineering, University of Liverpool , Brownlow Hill , Liverpool , UK .,b National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology , London , UK and
| | - Akram Joda
- a School of Engineering, University of Liverpool , Brownlow Hill , Liverpool , UK
| | - Ahmed Abass
- c Structural Biophysics Group, School of Optometry and Vision Sciences, Cardiff University , Cardiff , UK
| | - David Garway-Heath
- b National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology , London , UK and
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In vivo characterization of corneal biomechanics. J Cataract Refract Surg 2014; 40:870-87. [DOI: 10.1016/j.jcrs.2014.03.021] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 11/12/2013] [Accepted: 11/15/2013] [Indexed: 11/22/2022]
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Clemmensen K, Hjortdal J. Intraocular pressure and corneal biomechanics in Fuchs' endothelial dystrophy and after posterior lamellar keratoplasty. Acta Ophthalmol 2014; 92:350-4. [PMID: 23607620 DOI: 10.1111/aos.12137] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the precision of techniques for measuring intraocular pressure (IOP) in corneas with presumably altered biomechanical properties. METHODS Intraocular pressure was measured with a Goldmann applanation tonometer (GAT), ocular response analyzer (ORA) and dynamic contour tonometer (DCT) in 70 eyes. Thirty-five eyes were normal corneas, 18 eyes had Fuchs' endothelial dystrophy, and 17 eyes had undergone Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery. Corneal hysteresis (CH), corneal resistance factor (CRF) as well as central corneal thickness (CCT) were recorded with the ORA. RESULTS The measured cornea-corrected IOP using ORA was significantly higher than GAT in all three groups (p< 0.001). The DCT differed significantly from the Goldmann only in the Fuchs' group (p= 0.04). The Goldmann and DCT showed no significant between-group differences, whereas IOP measured with the ORA was different between groups (p< 0.001). CH in the DSEAK group differed significantly from the controls (p< 0.001), but there was no significant difference between the DSEAK and Fuchs' groups (p= 0.21). CCT did not differ significantly between the DSAEK and Fuchs' group (p= 0.47). However, both these groups differed significantly from the controls (p< 0.001). CONCLUSION Corneal hysteresis and CRF are reduced in Fuchs' endothelial dystrophy as well as after posterior lamellar keratoplasty. GAT and DCT seem to measure IOP correctly in patients with Fuchs' endothelial dystrophy as well as after posterior lamellar keratoplasty. Corneal-corrected IOP as measured with the ORA appears to overestimate IOP in patients with Fuchs' endothelial dystrophy as well as after posterior lamellar keratoplasty.
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Affiliation(s)
- Kåre Clemmensen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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Clinical Evaluation of Corneal Biomechanical Parameters After Posterior Chamber Phakic Intraocular Lens Implantation. Cornea 2014; 33:470-4. [DOI: 10.1097/ico.0000000000000088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Impaired corneal biomechanical properties and the prevalence of keratoconus in mitral valve prolapse. J Ophthalmol 2014; 2014:402193. [PMID: 24864193 PMCID: PMC4016888 DOI: 10.1155/2014/402193] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 03/26/2014] [Accepted: 03/31/2014] [Indexed: 11/18/2022] Open
Abstract
Objective. To investigate the biomechanical characteristics of the cornea in patients with mitral valve prolapse (MVP) and the prevalence of keratoconus (KC) in MVP. Materials and Methods. Fifty-two patients with MVP, 39 patients with KC, and 45 control individuals were recruited in this study. All the participants underwent ophthalmologic examination, corneal analysis with the Sirius system (CSO), and the corneal biomechanical evaluation with Reichert ocular response analyzer (ORA). Results. KC was found in six eyes of four patients (5.7%) and suspect KC in eight eyes of five patients (7.7%) in the MVP group. KC was found in one eye of one patient (1.1%) in the control group (P = 0.035). A significant difference occurred in the mean CH and CRF between the MVP and control groups (P = 0.006 and P = 0.009, resp.). All corneal biomechanical and topographical parameters except IOPcc were significantly different between the KC-MVP groups (P < 0.05). Conclusions. KC prevalence is higher than control individuals in MVP patients and the biomechanical properties of the cornea are altered in patients with MVP. These findings should be considered when the MVP patients are evaluated before refractive surgery.
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Tao C, Han Z, Sun Y, Zhou C, Roberts C, Zhou D, Ren Q. Corneal hysteresis with intraocular pressure of a wide range: a test on porcine eyes. J Refract Surg 2014; 29:850-4. [PMID: 24404607 DOI: 10.3928/1081597x-20131115-05] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the relationship between corneal hysteresis (CH) and intraocular pressure (IOP) using porcine eyes in the low to high IOP ranges. METHODS In vitro porcine eyes were used to investigate the relationship of CH and IOP. IOP was altered by changing the height of a drip stand within the dynamic range of 60 mm Hg. CH and IOP were measured with the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Depew, NY) at different heights. Second-order polynomial regression method was employed to assess the nonlinear correlation of CH and IOP. RESULTS CH demonstrated an initial plateau stage with low IOP, which then decreased as IOP increased to higher values up to 60 mm Hg. The maximum CH value of approximately 6 to 8 mm Hg was achieved when IOP ranged from 11 to 25 mm Hg. The nonlinear regression lines of Goldmann correlated IOP (IOPg) and CH can be described as CH = − 0.0029 × IOPg2 + 0.1005 × IOPg + 5.2824, R2 = 0.3676, P < .05. CONCLUSIONS CH was relatively constant for lower values of IOP and showed a decreasing relationship at higher values of IOP. This nonlinear relationship provides insight into understanding the viscoelastic nature of CH over a wider range of IOP values. The experimental data on porcine eyes may indicate that IOP should be taken into account when analyzing the deformation response of the cornea to an applied air puff.
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Taş M, Öner V, Özkaya E, Durmuş M. Evaluation of Corneal Biomechanical Properties in Patients with Rheumatoid Arthritis: A Study by Ocular Response Analyzer. Ocul Immunol Inflamm 2013; 22:224-7. [DOI: 10.3109/09273948.2013.841957] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
PURPOSE To evaluate the variation in biomechanical properties and central corneal thickness (CCT) for each trimester during pregnancy and to compare the values with those in nonpregnant women. METHODS We prospectively studied the eyes of 32 pregnant and 34 age-matched non-pregnant women. The parameters included corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOP), and corneal-compensated IOP measured by the Ocular Response Analyzer (ORA). The CCT was also measured with an ultrasonic pachymeter attached to the ORA. RESULTS The mean age was 27.0 ± 3.8 years in the study group and 28.0 ± 4.1 years in the control group. The mean CH measurement was 10.6 ± 1.4 mmHg in the study group and 10.1 ± 1.3 mmHg in the control group. The mean CRF value was 9.6 ± 1.7 mmHg in the study group and 10.0 ± 1.4 mmHg in the control group. The mean CCT value was 541.1 ± 22.4 µm in the study group and 536.5 ± 27.1 µm in the control group. No statistically significant differences were found regarding CH, CRF, or CCT values between the 2 groups (independent t test, p = 0.160, p = 0.355, p = 0.450, respectively). CONCLUSIONS Hormonal changes during pregnancy may not affect corneal biomechanics. This may be due to the balanced effect of the various hormones on the cornea during pregnancy.
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Corneal biomechanical properties: precision and influence on tonometry. Cont Lens Anterior Eye 2013; 37:124-31. [PMID: 24121009 DOI: 10.1016/j.clae.2013.09.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 08/19/2013] [Accepted: 09/16/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To assess the precision and reproducibility of the corneal biomechanical parameters, and their relationships with the intraocular pressure (IOP) measured with the Goldmann tonometer and a noncontact tonometer. METHODS Readings for biomechanical properties and for IOP measured with the Goldmann and noncontact tonometers, were taken on one randomly selected eye of 106 normal subjects, on each one of two measurement sessions. Measurements with the ocular response analyzer (ORA) and the noncontact tonometer were randomized, followed by the measurement of central corneal thickness and with the Goldmann tonometer. RESULTS Repeatability coefficients for CCT, corneal hysteresis (CH) and corneal resistance factor (CRF) in Session 1 were ± 0.01 μm, ± 3.05 mmHg and ± 2.62 mmHg, respectively. The mean CCT, CH, CRF, Goldmann and noncontact tonometry did not vary significantly between sessions. Reproducibility coefficients for CCT, CH and CRF were ± 0.02 μm, ± 2.19 mmHg and ± 1.97 mmHg, respectively. Univariate regression analysis showed that CCT, CH and CRF significantly (P<0.0001) correlated with the IOP measured with the Goldmann and noncontact tonometers (and with the differences between tonometers) in Session 1. There were no significant correlations with the differences between tonometers in Session 2. Multivariate analysis revealed a minimal effect of CCT on Goldmann measurements but a significant effect on those of the noncontact tonometer. CONCLUSIONS Measurement of the biomechanical properties of the cornea, using the ORA, are repeatable and reproducible, affect Goldmann tonometry less than noncontact tonometry, and have a minimal influence on the difference in measured intraocular pressure between tonometers.
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Denoyer A, Ricaud X, Van Went C, Labbé A, Baudouin C. Influence of corneal biomechanical properties on surgically induced astigmatism in cataract surgery. J Cataract Refract Surg 2013; 39:1204-10. [PMID: 23756347 DOI: 10.1016/j.jcrs.2013.02.052] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 02/21/2013] [Accepted: 02/22/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To perform an overall follow-up of the morphologic, optical, and biomechanical properties of the cornea to determine new parameters influencing the refractive outcomes of cataract surgery. DESIGN Clinical study. METHODS Patients scheduled for cataract surgery were assessed for surgically induced corneal astigmatism (SIA) and higher-order aberrations, (HOAs) using a Scheimpflug rotating camera (Pentacam) together with corneal imaging by optical coherence tomography (Spectralis) and biomechanical analysis by the Ocular Response Analyzer preoperatively and 1, 7, and 30 days postoperatively. The central and peripheral corneal thicknesses; incision width, length, and architecture; corneal hysteresis (CH); and corneal resistance factor (CRF) were computed to identify new parameters influencing corneal optical changes that determine the final refractive result. RESULTS The study enrolled 40 patients (40 eyes). The SIA and HOAs were significantly lower after microincision surgery (≤ 2.2 mm) than after small-incision surgery (2.75 mm) (both P<.01). The CRF was significantly reduced with a direct corneal incision compared with a constructed incision (P<.01). Multivariate analysis showed that SIA was correlated not only with incision width (P<.05) but also with preoperative CH (P<.01). Corneal 3rd-order trefoil depended on incision width (P<.01). CONCLUSIONS In addition to the well-known influence of incision size on SIA, CH also modulates optical changes. The biomechanical features of the cornea should be taken into account preoperatively to better predict the refractive outcomes of cataract surgery.
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Gros-Otero J, Pérez-Rico C, Montes-Mollón MA, Gutiérrez-Ortiz C, Benítez-Herreros J, Teus MA. Effects of pterygium on the biomechanical properties of the cornea: a pilot study. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2013; 88:134-138. [PMID: 23597642 DOI: 10.1016/j.oftal.2012.06.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/01/2012] [Accepted: 06/26/2012] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To investigate the changes induced by a pterygium or its surgical removal on the biomechanical properties of the cornea and to determine factors that might affect these parameters. METHODS This prospective pilot interventional, non-randomized, observer-masked study included 20 eyes of 20 patients with a unilateral primary pterygium (pterygium group) and 19 fellow healthy eyes (control group). The bare sclera technique with one-minute application of 0.02% mitomycin C intraoperatively was performed in all cases. The follow-up period was one month. The preoperative and postoperative biomechanical properties of the cornea were measured using the Reichert ocular response analyzer (ORA). RESULTS The corneal hysteresis (CH) decreased significantly (P<.01) in eyes with a pterygium compared to the control eyes, while surgery did not significantly change the CH compared to preoperatively. There were no significant changes in the corneal resistance factor or the central corneal thickness. CONCLUSIONS Primary active pterygium (grades 1 or 2) induce a reduction of corneal biomechanical features. Further studies are needed in populations, with longer follow-ups and bigger pterygium that may involve wider keratectomy to confirm our results.
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Affiliation(s)
- J Gros-Otero
- Servicio de Oftalmología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
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Uthoff D, Hebestedt K, Duncker GIW, Spörl E. [Influence of corneal biomechanical properties on myopic regression after laser in situ keratomileusis]. Ophthalmologe 2013; 110:41-7. [PMID: 23329119 DOI: 10.1007/s00347-012-2633-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Laser in situ keratomileusis is a safe and accepted method for correcting myopia. The operational results in terms of accuracy as well as the subjective acceptance of patients for corrections to - 8 D are now considered to be promising (Seiler, Refraktive Chirurgie der Hornhaut, 2000); however, postoperative results show individual patient problems in long-term stability. It is believed that the preoperative condition of the cornea (e.g. thickness, biomechanical properties) could have an influence on postoperative problems such as myopic regression. METHOD This study included a total of 46 eyes from 25 patients. At 3 months postoperatively, 15 patients (19 eyes) showed a SEQ of -0.50 D or more. Within this group, 11 patients (15 eyes) developed a regression (regression group) within the first 3 postoperative months. The remainder of the total group did not show any regression (stability group). The subjects of this study were on average 33 ± 8 years (stability group) and 31 ± 7 years old (regression group). The corneal thickness was tested and refractive error, visual acuity (BCVA/UCVA) and intraocular pressure was measured. In addition, the corneal hysteresis (CH) and corneal resistance factor (CRF) were determined. RESULTS The mean preoperative spherical equivalent refraction was -3.14 D ± 1.41 D (SE) in the stability group and - 6.47 D ± 1.40 D (p = 0.001)in the regression group. Also, the postoperative spherical equivalents were statistically significant different (p < 0.05). In contrast, the mean preoperative corneal thickness showed no differences in both groups (p = 0.96) (stability group 563 ± 36 µm and regression group 563 ± 28 µm). CONCLUSIONS The aim of the study to detect a possible causal relationship between myopia regression after LASIK and the biomechanical properties of the cornea and corneal thickness could not be clearly identified.
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Affiliation(s)
- D Uthoff
- Augenklinik Bellevue, Lindenallee 21, 24105 Kiel.
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Abstract
PURPOSE To evaluate the relative influences of several demographic, ocular, and systemic parameters on corneal hysteresis (CH). METHODS This is a prospective, observational, cross-sectional study using subjects recruited from consecutive Albuquerque VAMC eye clinic patients. We classified eligible subjects as primary open-angle glaucoma (POAG), ocular hypertension, glaucoma suspect, or normal. We used the Ocular Response Analyzer, Pascal Dynamic Contour Tonometer, and Goldmann applanation tonometer to obtain intraocular pressure (IOP), CH, corneal resistance factor, and ocular pulse amplitude values. We also obtained corneal curvature, central corneal thickness (CCT), axial length, retinal nerve fiber layer thickness, clinical cup/disc ratio (CDR) estimates, and standard automated perimetry metrics (mean defect, pattern standard deviation). We gathered glycosylated hemoglobin (A1C) data through chart review. Multivariate regression analyses were used to determine independent relationships between CH and the other parameters. RESULTS Three hundred seventeen eyes in 317 subjects were studied (116 POAG, 87 ocular hypertension, 47 glaucoma suspect, and 67 normal). In univariate regression analysis, CH varied directly with CCT (β = 0.39, p < 0.001), corneal curvature (β = 0.16, p = 0.01), corneal resistance factor (β = 0.57, p < 0.001), A1C (β = 0.15, p = 0.01), mean defect (β = 0.29, p < 0.001), and retinal nerve fiber layer (β = 0.31, p < 0.001). Factors inversely related to CH were age (β = -0.22, p < 0.001), IOP (β = -0.29, p < 0.001), ocular pulse amplitude (β = -0.11, p = 0.04), CDR (β = -0.34, p < 0.001), and pattern standard deviation (β = -0.29, p < 0.001). CH was lower in POAG compared with the other diagnostic groups. In multivariate analysis, CH was independently associated with age, IOP, CCT, A1C, glaucoma diagnosis, and CDR. Of these factors, CCT and IOP demonstrated twice as much influence on CH compared with the other four factors. CONCLUSIONS Although this study identified six separate variables that independently influence CH values, the overall r value indicates that these variables together only explain 40% of CH variability. These results suggest that other significant sources of variability exist and deserve investigation.
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Kandarakis A, Soumplis V, Karampelas M, Koutroumanos I, Panos C, Kandarakis S, Karagiannis D. Response of corneal hysteresis and central corneal thickness following clear corneal cataract surgery. Acta Ophthalmol 2012; 90:526-9. [PMID: 21232083 DOI: 10.1111/j.1755-3768.2010.02078.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the effect of routine phacoemulsification in corneal viscoelastic properties determined by corneal hysteresis (CH) and central corneal thickness (CCT) and to explore the impact of phaco energy on the above parameters. METHODS Forty-one eyes of 41 patients undergoing cataract surgery were enrolled in this prospective study. CH and CCT were measured preoperatively, 1 day and 1 week postoperatively. CCT measurement was performed using a non-contact optical pachymeter followed by ocular response analyzer (ORA) examination. Intraoperatively ultrasound time, average phaco power and effective phaco time (EPT) were recorded. RESULTS Mean CH was 10.05±1.86 mmHg preoperatively, 8.25±1.85 mmHg 1 day and 9.12±1.37 mmHg 1 week postoperatively (p<0.001). The mean CCT was 534±37.33 μm preoperatively, 592.22±46.34 μm 1 day and 563.21±49.84 μm 1 week postoperatively (p<0.001). CCT and CH were statistically significantly correlated preoperatively (p=0.01, r=0.396). This correlation was not sustained on the first postoperative day (p=0.094, r=0.265) and was re-established 1 week postoperatively (p=0.002, r=0.568). On the first postoperative day, the CCT increase was positively correlated with EPT (p=0.009, r=0.404), which was not found between CH change and EPT. CONCLUSION Structural corneal alterations following cataract surgery resulted in a statistical change in CH and CCT. These two parameters responded in a different manner that clearly demarcates their different nature. On the first postoperative day, CCT increase was correlated at a statistically significant level with intraoperative EPT. This correlation was not found with CH reduction. Other factors, besides cornea oedema or phacoemulsification energy, could be responsible for this CH modification.
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Combining corneal hysteresis with central corneal thickness and intraocular pressure for glaucoma risk assessment. Eye (Lond) 2012; 26:1349-56. [PMID: 22878449 DOI: 10.1038/eye.2012.164] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To determine whether adjusting corneal hysteresis (CH) values for central corneal thickness (CCT) and intraocular pressure (IOP) improves its capability to differentiate primary open-angle glaucoma (POAG) from ocular hypertension (OH). METHODS This prospective, observational, cross-sectional study included 169 eyes of 169 subjects with a diagnosis of POAG (n=81) or OH (n=88). We utilized the Ocular Response Analyzer (ORA), Pascal Dynamic Contour Tonometer (DCT), Goldmann applanation tonometer (GAT), and ORA ultrasound pachymeter to obtain CH, IOP, and CCT values. Correlational, regression, and t-test analyses were conducted before and after the sample was divided into low, intermediate, and thick CCT subgroups. RESULTS In the full sample, CH and CCT were moderately correlated (r=0.44, P<0.001). Although both were related to diagnosis in univariate regression analysis, only CH was independently related to glaucoma diagnosis in multivariate analysis. After the sample was divided into CCT tertiles, CH was significantly lower in POAG vs OH eyes within all three CCT subgroups, and CH was the only multivariate variable that differentiated POAG from OH in each CCT subgroup. Moreover, the relationship between CH and diagnosis was more robust within the CCT subgroups compared with the full sample, suggesting that integrating CCT into CH interpretation is beneficial. Adjusting CH for IOP did not aid diagnostic precision in this study. CONCLUSION Our findings suggest that combining CH and CCT for glaucoma risk assessment improves diagnostic capability compared to using either factor alone. Conversely, adjusting CH for IOP provided no clear clinical benefit in this study.
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Seymenoğlu G, Uzun Ö, Başer E. Surgically Induced Changes in Corneal Viscoelastic Properties After 23-Gauge Pars Plana Vitrectomy Using Ocular Response Analyzer. Curr Eye Res 2012; 38:35-40. [DOI: 10.3109/02713683.2012.707269] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Terai N, Raiskup F, Haustein M, Pillunat LE, Spoerl E. Identification of Biomechanical Properties of the Cornea: The Ocular Response Analyzer. Curr Eye Res 2012; 37:553-62. [DOI: 10.3109/02713683.2012.669007] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Huang C, Zhang M, Huang Y, Chen B, Lam DSC, Congdon N. Corneal Hysteresis Is Correlated with Reduction in Axial Length After Trabeculectomy. Curr Eye Res 2012; 37:381-7. [DOI: 10.3109/02713683.2011.620729] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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de Freitas Valbon B, Ventura MP, da Silva RS, Canedo AL, Velarde GC, Ambrósio R. Central Corneal Thickness and Biomechanical Changes After Clear Corneal Phacoemulsification. J Refract Surg 2012; 28:215-9. [DOI: 10.3928/1081597x-20111103-02] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 08/30/2011] [Indexed: 11/20/2022]
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Corneal biomechanical properties and intraocular pressure measurement in Marfan patients. J Cataract Refract Surg 2012; 38:309-14. [DOI: 10.1016/j.jcrs.2011.08.036] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 07/06/2011] [Accepted: 08/18/2011] [Indexed: 11/22/2022]
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Kopito R, Gaujoux T, Montard R, Touzeau O, Allouch C, Borderie V, Laroche L. Reproducibility of viscoelastic property and intraocular pressure measurements obtained with the Ocular Response Analyzer. Acta Ophthalmol 2011; 89:e225-30. [PMID: 20738262 DOI: 10.1111/j.1755-3768.2010.01957.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To analyse the reproducibility of corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) obtained with the ocular response analyzer (ORA). METHODS This is a prospective study, nonmasked, of eight successive examinations with the ORA device in 60 normal eyes. Using 30 eyes (one eye per subject), the reproducibility was assessed by comparing the first series of four examinations to the second four and by calculating the within-subject coefficient of variation. The correlation and difference with the fellow eye were analysed, respectively. RESULTS The mean values were 10.7 ± 1.8 mmHg, CRF; 10.6 ± 1.6 mmHg, CH; 15.9 ± 3.9 mmHg, IOPg and 16.2 ± 3.7 mmHg, IOPcc. The reproducibility was significantly different for CRF (5.2 ± 5.9%), CH (7.3 ± 8.6%), IOPg (7.7 ± 6.7%) and IOPcc (10.1 ± 8.0%); p < 0.001. Considering the reproducibility, CRF correlated with CH (rs = 0.55; p < 0.001) and showed to be independent of IOPg and IOPcc. The score spread was best for CRF (2.6 ± 1.5 mmHg; 24.0%) compared to IOPg (4.3 ± 1.5 mmHg; 28.1%) and CH (3.1 ± 1.7 mmHg; 29.9%) and worst for IOPcc (5.5 ± 2.5 mmHg; 34.4%). The lowest difference with the fellow eye was observed for CRF (5.0%; p = 0.09). The correlation with the fellow eye was high, especially for IOPcc and CRF (rs > 0.9; p < 0.001) followed by IOPg and CH (rs > 0.8; p < 0.001). CONCLUSION The ORA device provides reproducible information on viscoelastic properties of the cornea in normal eyes notably CRF and CH. IOPcc was less reproducible. Four measurements per eye were necessary to reach a 10% precision and six for 5%.
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Affiliation(s)
- Robert Kopito
- Quinze-Vingts National Ophthalmology Hospital, Department of Ophthalmology, Paris, France
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Kamiya K, Shimizu K, Ohmoto F, Amano R. Evaluation of corneal biomechanical parameters after simultaneous phacoemulsification with intraocular lens implantation and limbal relaxing incisions. J Cataract Refract Surg 2011; 37:265-70. [DOI: 10.1016/j.jcrs.2010.08.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 08/10/2010] [Accepted: 08/25/2010] [Indexed: 11/25/2022]
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Kotecha A, Oddone F, Sinapis C, Elsheikh A, Sinapis D, Sinapis A, Garway-Heath DF. Corneal biomechanical characteristics in patients with diabetes mellitus. J Cataract Refract Surg 2010; 36:1822-8. [PMID: 21029887 DOI: 10.1016/j.jcrs.2010.08.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 06/15/2010] [Accepted: 06/15/2010] [Indexed: 12/18/2022]
Abstract
PURPOSE To compare the corneal biomechanical properties in eyes of patients with diabetes mellitus and in those of subjects without diabetes mellitus. SETTING Hospital eye clinic. DESIGN Comparative case series. METHODS Corneal hysteresis (CH) and corneal response factor (CRF) were measured in diabetic patients and nondiabetic subjects using the Ocular Response Analyzer. Central corneal thickness (CCT) and intraocular pressure (IOP) were also measured. Differences in corneal biomechanical properties were determined using a 1-way analysis of variance. Interassociations between ocular and diabetic parameters were also evaluated. RESULTS Sixty-one eyes of 61 diabetic patients and 123 eyes of 123 nondiabetic subjects were evaluated. The CRF was significantly greater in the eyes of diabetic patients (mean difference, 1.09 mm Hg; 95% confidence interval [CI], 0.49-1.69; P = .001). There were no significant differences in CCT or CH between groups (CH: mean difference, 0.38 mm Hg; 95% CI, -0.21 to 0.97 mm Hg; P = .21; CCT: mean difference, 0.13 μm; 95% CI, -10.6 to 10.8 μm; P =.98). Corneal hysteresis and CRF were weakly correlated with blood glucose concentration (slopes: CH: 0.28; 95% CI, 0.03-0.50; P = .03; CRF: 0.27; 95% CI 0.02-0.49; P = .04). In a multiple regression analysis, the effects of blood glucose concentration were reduced and age and CCT became significant predictors of CH and CRF. CONCLUSIONS The eyes in diabetic patients displayed altered corneal biomechanics that may be related to blood glucose concentration. Further studies are required to establish the effects of long-term poor glucose control on corneal biomechanical properties and how this might affect the diabetic patient's response to refractive surgery procedures.
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Affiliation(s)
- Aachal Kotecha
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
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Time Course of Corneal Biomechanical Parameters After Phacoemulsification With Intraocular Lens Implantation. Cornea 2010; 29:1256-60. [DOI: 10.1097/ico.0b013e3181d9284b] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ogbuehi KC, Almubrad TM. Evaluation of the intraocular pressure measured with the ocular response analyzer. Curr Eye Res 2010; 35:587-96. [PMID: 20597645 DOI: 10.3109/02713681003698871] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Comparison of the magnitude and repeatability of the intraocular pressure (IOP) measured with the Ocular Response Analyzer (ORA) to that measured with the Goldmann tonometer. METHODS Two sets of IOP measurements were made, for 89 eyes of eighty-nine subjects, approximately 1-week apart. Goldmann tonometry was performed subsequent to non-contact tonometry, in which the order of measurement was randomized between the ORA and the Topcon CT80 non-contact tonometer (CT80). Each method was assessed twice for intrasession repeatability. The limits of agreement between each non-contact pressure and that measured with the Goldmann tonometer were assessed once per session. The level of statistical significance was 0.05. RESULTS The mean differences between the ORA-corneal compensated, Goldmann-correlated, and CT80-IOP (ORA-IOPcc; ORA-IOPg and CT80-IOP) versus the Goldmann IOP were -0.3 +/- 2.7 mmHg (mean +/- SD), -0.3 +/- 2.2 mmHg and -0.3 +/- 2.1 mmHg, respectively for session 1 and 0.3 +/- 3.0 mmHg, 0.2 +/- 2.2 mmHg, and -0.5 +/- 2.2 mmHg, respectively, for session 2. The repeatability coefficients were +/- 5.3 mmHg, +/- 4.2 mmHg, +/- 2.5 mmHg, and +/- 1.9 mmHg, respectively for ORA-IOPcc, ORA-IOPg, CT80-IOP, and Goldmann IOP in session 1 and +/- 3.8 mmHg, +/- 3.6 mmHg, +/- 1.6 mmHg, and +/- 1.9 mmHg, respectively for session 2. CONCLUSION The repeatability indices for the ORA were poorer than those with the Goldmann tonometer and the CT80 in both sessions. However, the average IOP measured with the ORA did not vary significantly from those measured with the other two tonometers in either session. The ORA provides valid, repeatable measures of IOP.
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Affiliation(s)
- Kelechi C Ogbuehi
- Department of Optometry and Vision Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Corneal Biomechanical Properties and Intraocular Pressure in High Myopic Anisometropia. Eye Contact Lens 2010; 36:204-9. [DOI: 10.1097/icl.0b013e3181e4a60a] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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