1
|
Asaoka R, Aoki S, Fujino Y, Nakakura S, Murata H, Kiuchi Y. Comparing Corneal Biomechanic Changes between Solo Cataract Surgery and Microhook Ab Interno Trabeculotomy. J Clin Med 2024; 13:4564. [PMID: 39124830 PMCID: PMC11313163 DOI: 10.3390/jcm13154564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 07/20/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: This study aimed to examine the postoperative changes in the corneal biomechanical properties between solo cataract surgery and solo microhook ab interno trabeculotomy (LOT). Methods: This retrospective case-control study included 37 eyes belonging to 26 patients who underwent solo cataract surgery and 37 eyes belonging to 31 patients who underwent solo µLOT. These two groups were matched according to their preoperative intraocular pressure (IOP), axial length (AL), and age. Corneal Visualization Scheimpflug Technology (Corvis ST) was used to obtain four biomechanical parameters representing the corneal stiffness or corneal deformation at the highest concavity, including stiffness parameter A1 (SP-A1), stress-strain index (SSI), peak distance (PD), and deflection amplitude max (DefAmpMax). These parameters were compared preoperatively and 6 months postoperatively, and between the two surgical groups. Results: Preoperatively, the patients' IOP, age, and AL, as well as their results in four Corvis ST parameters, were similar between the two groups (p > 0.05). No significant difference was observed in SP-A1; however, PD and DefAmpMax were significantly larger, and SSI was significantly smaller postoperatively in the LOT group than in the cataract group. Conclusions: Corneal stiffness was reduced, and the cornea was more deformed with LOT than cataract surgery.
Collapse
Affiliation(s)
- Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-0906, Shizuoka, Japan
- Seirei Christopher University, Hamamatsu 433-8558, Shizuoka, Japan
- The Graduate School for the Creation of New Photonics Industries, Hamamatsu 431-1202, Shizuoka, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Yuri Fujino
- Seirei Christopher University, Hamamatsu 433-8558, Shizuoka, Japan
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-0021, Shimane, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Tsukazaki Memorial Hospital, Himeji 671-1227, Hyogo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, National Center for Global Health and Medicine, Shinjuku 162-8655, Tokyo, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima 739-0046, Hiroshima, Japan
| |
Collapse
|
2
|
Lin FY, Ho RW, Yu HJ, Yang IH, Fang PC, Kuo MT. Impacts and Correlations on Corneal Biomechanics, Corneal Optical Density and Intraocular Pressure after Cataract Surgery. Diagnostics (Basel) 2024; 14:1557. [PMID: 39061693 PMCID: PMC11275892 DOI: 10.3390/diagnostics14141557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/06/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
The study aimed to investigate the extended effects and interrelations of corneal biomechanics, corneal optical density (COD), corneal thickness (CT), and intraocular pressure (IOP) following cataract surgery. Sixteen eyes were analyzed prospectively. The Corneal Visualization Scheimpflug Technology (Corvis ST) device assessed corneal biomechanics, while the Pentacam AxL® (Pentacam) measured COD and CT. Postoperative data were collected around six months after surgery, with a subgroup analysis of data at nine months. The Pearson correlation was used to examine the relationship between surgical-induced changes in corneal biomechanics and COD. At six months, significant postoperative differences were observed in various biomechanical indices, including uncorrected IOP (IOPuct) and biomechanics-corrected IOP (bIOP). However, many indices lost statistical significance by the nine-month mark, suggesting the reversibility of postoperative corneal changes. Postoperative COD increased at the anterior layer of the 2-6 mm annulus and incision site. The changes in COD correlated with certain biomechanical indices, including maximal (Max) deformative amplitude (DA) and stiffness parameter (SP). In conclusion, despite significant immediate postoperative changes, corneal biomechanics, COD, and IOP experienced a gradual recovery process following cataract surgery. Clinicians should maintain vigilance for any unusual changes during the short-term observation period to detect abnormalities early.
Collapse
Affiliation(s)
- Fang-Yang Lin
- Medical Education Department, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 83301, Taiwan;
| | - Ren-Wen Ho
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 83301, Taiwan; (R.-W.H.); (H.-J.Y.); (I.-H.Y.); (P.-C.F.)
| | - Hun-Ju Yu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 83301, Taiwan; (R.-W.H.); (H.-J.Y.); (I.-H.Y.); (P.-C.F.)
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
| | - I-Hui Yang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 83301, Taiwan; (R.-W.H.); (H.-J.Y.); (I.-H.Y.); (P.-C.F.)
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 83301, Taiwan; (R.-W.H.); (H.-J.Y.); (I.-H.Y.); (P.-C.F.)
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 83301, Taiwan; (R.-W.H.); (H.-J.Y.); (I.-H.Y.); (P.-C.F.)
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| |
Collapse
|
3
|
Chen H, Wu S, Tian L, Li Y, Hong J, Wang Y, Xu J. Intraocular pressure measurement and association with corneal biomechanics in patients underwent Descemet's stripping with endothelial keratoplasty: a comparative study. Front Med (Lausanne) 2024; 11:1384694. [PMID: 39071083 PMCID: PMC11272548 DOI: 10.3389/fmed.2024.1384694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Purpose To compare corneal biomechanical properties and intraocular pressure (IOP) measurements in patients who underwent Descemet's stripping with endothelial keratoplasty (DSEK) with those of the follow healthy eyes. Methods In this retrospective comparative study, a total of 35 eyes of 35 patients who underwent DSEK by a single surgeon from 2015.02 to 2019.12 were enrolled along with their fellow healthy eyes. Corneal biomechanical parameters were assessed at least 3 months post-DSEK using Corneal Visualization Scheimpflug Technology (CST). IOP was measured by CST, Goldmann applanation tonometry (GAT), and MacKay-Marg tonometer. Results Central corneal thickness (CCT) and stiffness parameter at first applanation (SP-A1) were significantly increased after DSEK when compared to the fellow eyes. In DSEK eyes, biomechanically-corrected intraocular pressure (bIOP) and MacKay-Marg IOP correlated significantly with GAT IOP measurements, with bIOP showed the lowest IOP values. All the IOP values did not correlate with CCT. However, GAT-IOP and MacKay-Marg IOP showed a positive correlation with SP-A1. Conclusion The corneal stiffness increased after DSEK. Central corneal thickness may have less influence than corneal biomechanics on IOP measurements in eyes after DSEK. Biomechanically-corrected IOP obtained by CST seemed to be lower than other tonometry techniques in DSEK eyes, perhaps because of correction for corneal stiffness, CCT and age.
Collapse
Affiliation(s)
- Huiyu Chen
- Shanghai Eye Diseases Prevention & Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Suqian Wu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Lijia Tian
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yue Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jiaxu Hong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yulan Wang
- Shanghai Eye Diseases Prevention & Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jianjiang Xu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| |
Collapse
|
4
|
Niazi S, del Barrio JA, Doroodgar F, Sanginabadi A, Alinia C, Hashemian SJ, Hashemi H, Alio JL. Biomechanical changes in keratoconus after customized stromal augmentation. Taiwan J Ophthalmol 2024; 14:59-69. [PMID: 38654988 PMCID: PMC11034678 DOI: 10.4103/tjo.tjo-d-23-00155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/01/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE To verify corneal biomechanical changes, poststromal augmentation using myopic small-incision lenticule extraction's (SMILEs) lenticules in advanced keratoconus (KCN) through Corvis ST (Oculus, Wetzlar, Germany). MATERIALS AND METHODS A clinical trial enrolled 22 advanced KCN patients. We implanted lenticules exceeding 100 μ according to a nomogram and evaluated biomechanical factors through Corvis ST at 3-, 6-, and 24-month postimplantation. We examined parameters during the first applanation (A1), second applanation (A2), highest concavity (HC)/max concavity events, and Vinciguerra screening parameters, as recently established criteria derived from the ideal blend of diverse biomechanical and ocular factors and formulated through the application of logistic regression. Regression analyses explored relationships with age, mean keratometry value, thickness, sphere, cylinder, and best-corrected visual acuity. RESULTS Patients were well matched for age, intraocular pressure, and central corneal thickness (CCT). The mean spherical equivalent decreased from -13.48 ± 2.86 Diopters (D) to -8.59 ± 2.17 D (P < 0.007), and mean keratometry decreased from 54.68 ± 2.77 D to 51.95 ± 2.21 D (P < 0.006). Significant increases were observed in HC time (HCT), Radius-central curvature radius at the HC state-, peak distance (PD) during HC state, CCT, first applanation time, and stiffness parameter (A1T and SP-A1), whereas HC deformation amplitude, maximum deformation amplitude ratio at 2 mm, Corvis Biomechanical Index (CBI), integrated radius (IR), second applanation deformation amplitude (A2DA), first applanation velocity and deflection amplitude (A1V and A1DeflA) significantly decreased postlenticule implantation. Multivariable regression revealed age positively correlated with SP-A1 (P = 0.003) and negatively with HC delta Arc length (P = 0.007). Mean K positively correlated with CCT (P = 0.05) and negatively with CBI (P = 0.032). Best-corrected visual acuity positively correlated with HCT (P = 0.044), and the cylinder positively correlated with PD (P = 0.05) and CCT (P = 0.05) whereas negatively with IR (P = 0.025). CONCLUSIONS Stromal augmentation using myopic SMILE lenticules induces significant corneal biomechanical changes in KCN.
Collapse
Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azad Sanginabadi
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Seyed Javad Hashemian
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Jorge L. Alio
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
- Vissum Miranza Alicante, Alicante, Spain
| |
Collapse
|
5
|
Wallace HB, Vellara HR, Gokul A, McGhee CNJ, Meyer JJ. Comparison of Ectasia Detection in Early Keratoconus Using Scheimpflug-Based Corneal Tomography and Biomechanical Assessments. Cornea 2023; 42:1528-1535. [PMID: 36973879 DOI: 10.1097/ico.0000000000003273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/15/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE The aim of this study was to determine the detection of keratoconus using corneal biomechanical parameters only, a corneal tomographic parameter only, and a parameter that combines corneal biomechanical and tomographic indices. METHODS The discriminatory power of the Pentacam Random Forest Index (PRFI), Belin/Ambrósio Enhanced Ectasia Display (BAD-D) index, Corvis Biomechanical Index (CBI), and Tomographic and Biomechanical Index (TBI) to differentiate between normal eyes (n = 84), eyes with very asymmetric corneal ectasia (VAE-E, n = 21), and the fellow eyes without apparent ectasia based on normal tomography (VAE-NT, n = 21) was assessed. Statistical analyses were completed with R software using t -tests, Wilcoxon rank sum tests, and receiver operating characteristic (ROC) curves. The DeLong test was used to compare the area under the ROC curve (AUROC). RESULTS The TBI and PRFI had the highest AUROC when distinguishing between normal and VAE-E corneas (AUROC = 1.00, 95% CI = 1.00-1.00); however, they were not statistically superior to the CBI (AUROC = 0.97, P = 0.27) or BAD-D (AUROC = 1.00, P = 0.34). The TBI (AUROC = 0.92, 95% CI = 0.86-0.98) was superior to CBI (AUROC = 0.78, P = 0.02) and BAD-D (AUROC = 0.81, P = 0.02) when distinguishing between healthy and VAE-NT corneas. At a threshold of 0.72, the TBI had 99% sensitivity, 67% specificity, and 92% accuracy in distinguishing normal and VAE-NT corneas. CONCLUSIONS The TBI is a useful parameter for the screening of subclinical and frank keratoconus in tomographically normal eyes.
Collapse
Affiliation(s)
- Henry B Wallace
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand; and
| | - Hans R Vellara
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand; and
| | - Akilesh Gokul
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand; and
| | - Charles N J McGhee
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand; and
- Department of Ophthalmology, Auckland District Health Board, New Zealand
| | - Jay J Meyer
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand; and
- Department of Ophthalmology, Auckland District Health Board, New Zealand
| |
Collapse
|
6
|
Aoki S, Asaoka R, Fujino Y, Nakakura S, Murata H, Kiuchi Y. Comparing corneal biomechanic changes among solo cataract surgery, microhook ab interno trabeculotomy and iStent implantation. Sci Rep 2023; 13:19148. [PMID: 37932377 PMCID: PMC10628136 DOI: 10.1038/s41598-023-46709-5] [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: 03/10/2023] [Accepted: 11/03/2023] [Indexed: 11/08/2023] Open
Abstract
Minimally invasive glaucoma surgery has expanded the surgical treatment options in glaucoma, particularly when combined with cataract surgery. It is clinically relevant to understand the associated postoperative changes in biomechanical properties because they are influential on the measurement of intraocular pressure (IOP) and play an important role in the pathogenesis of open-angle glaucoma (OAG). This retrospective case-control study included OAG patients who underwent cataract surgery combined with microhook ab interno trabeculotomy (µLOT group: 53 eyes of 36 patients) or iStent implantation (iStent group: 59 eyes of 37 patients) and 62 eyes of 42 solo cataract patients without glaucoma as a control group. Changes in ten biomechanical parameters measured with the Ocular Response Analyzer and Corneal Visualization Scheimpflug Technology (Corvis ST) at 3 and 6 months postoperatively relative to baseline were compared among the 3 groups. In all the groups, IOP significantly decreased postoperatively. In the µLOT and control groups, significant changes in Corvis ST-related parameters, including stiffness parameter A1 and stress‒strain index, indicated that the cornea became softer postoperatively. In contrast, these parameters were unchanged in the iStent group. Apart from IOP reduction, the results show variations in corneal biomechanical changes from minimally invasive glaucoma surgery combined with cataract surgery.
Collapse
Affiliation(s)
- Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-Ku, Hamamatsu City, Shizuoka, Japan.
- Seirei Christopher University, Hamamatsu City, Shizuoka, Japan.
- The Graduate School for the Creation of New Photonics Industries, Hamamatsu City, Shizuoka, Japan.
| | - Yuri Fujino
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-Ku, Hamamatsu City, Shizuoka, Japan
- Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Tsukazaki Memorial Hospital, Hyogo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
7
|
Chen L, Chen X, Li F, Liu Z. Refractive surprise of irregular astigmatism following cataract surgery in two patients with neglected subclinical corneal ectasia: two case reports. BMC Ophthalmol 2023; 23:239. [PMID: 37248492 DOI: 10.1186/s12886-023-02984-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 05/22/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Corneal ectatic diseases are a group of corneal disorder characterized by the steepening and thinning of the cornea. Older people are not a high-risk population for corneal ectatic diseases; due to the lack of typical preoperative topographic manifestations, there is a high possibility that corneal ectasia is undetected. CASE PRESENTATION Two patients with subclinical corneal ectasia and senile cataracts presented with irregular astigmatism after steep-axis incision during cataract surgery. The two cases presented in this case report are rare because both patients experienced tremendous changes in astigmatism after cataract surgery. CONCLUSION This case report may shed some light on astigmatism-correcting steep-axis incisions in cataract surgeries.
Collapse
Affiliation(s)
- Leran Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China
| | - Xiaoyong Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China
| | - Fanshu Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China
| | - Ziyuan Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China.
- Peking University Institute of Laser Medicine, Beijing, China.
| |
Collapse
|
8
|
Li F, Wang K, Liu Z. In Vivo Biomechanical Measurements of the Cornea. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010120. [PMID: 36671692 PMCID: PMC9854753 DOI: 10.3390/bioengineering10010120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
In early corneal examinations, the relationships between the morphological and biomechanical features of the cornea were unclear. Although consistent links have been demonstrated between the two in certain cases, these are not valid in many diseased states. An accurate assessment of the corneal biomechanical properties is essential for understanding the condition of the cornea. Studies on corneal biomechanics in vivo suggest that clinical problems such as refractive surgery and ectatic corneal disease are closely related to changes in biomechanical parameters. Current techniques are available to assess the mechanical characteristics of the cornea in vivo. Accordingly, various attempts have been expended to obtain the relevant mechanical parameters from different perspectives, using the air-puff method, ultrasound, optical techniques, and finite element analyses. However, a measurement technique that can comprehensively reflect the full mechanical characteristics of the cornea (gold standard) has not yet been developed. We review herein the in vivo measurement techniques used to assess corneal biomechanics, and discuss their advantages and limitations to provide a comprehensive introduction to the current state of technical development to support more accurate clinical decisions.
Collapse
Affiliation(s)
- Fanshu Li
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Health Science Center, Peking University, Beijing 100191, China
| | - Kehao Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Engineering Medicine, Beihang University, Beijing 100191, China
| | - Ziyuan Liu
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Health Science Center, Peking University, Beijing 100191, China
- Correspondence:
| |
Collapse
|
9
|
Shokrollahzadeh F, Hashemi H, Yekta A, Ostadimoghaddam H, Khabazkhoob M. Corneal Biomechanical Parameters after 60-Year-Old. J Curr Ophthalmol 2022; 34:284-289. [PMID: 36644461 PMCID: PMC9832466 DOI: 10.4103/joco.joco_201_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 12/09/2022] Open
Abstract
Purpose To determine the distribution of corneal biomechanical parameters in an elderly population. Methods This cross-sectional study was conducted in subjects above 60 years living in Tehran. The participants were selected using multi-stage cluster sampling. Corneal biomechanical parameters were measured in a randomly selected subsample of this population using the Reichert Ocular Response Analyzer (Reichert Ophthalmic Instruments, Inc., Buffalo, NY, USA). Results Of 470 subjects, the data of 420 participants aged over 60 years were analyzed (mean age: 69.3 ± 6.5 years and range: 61-88 years), 363 (86.4%) of whom were male. The mean and standard deviation of corneal hysteresis (CH) and corneal resistance factor (CRF) were 8.37 ± 1.55 mmHg (95% confidence interval [CI]: 8.02-8.72) and 9.06 ± 1.70 mmHg (95% CI: 8.69-9.44), respectively. The mean CH was 8.27 ± 1.54 mmHg in men and 9.25 ± 1.28 mmHg in women, and the mean CRF was 9.00 ± 1.71 mmHg in men and 9.63 ± 1.37 mmHg in women. According to the results of multiple linear logistic regression analysis, CH had a significant association with younger age (β = -0.05, P = 0.032), female sex (β = 1.83, P < 0.001), reduced maximum keratometry (β = -0.22, P = 0.06), and increased anterior chamber volume (β = 0.01, P = 0.007). CRF had a significant correlation with a younger age (β = -0.06, P = 0.02), female sex (β = 1.01, P = 0.05), central corneal thickness (β = 0.02, P < 0.001), and reduced maximum keratometry (β = -0.39, P = 0.010). Conclusion The mean CH and CRF values were low in this sample of the Iranian population aged over 60 years indicating the weaker elasticity of the corneal connective tissue.
Collapse
Affiliation(s)
- Fereshteh Shokrollahzadeh
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran,Address for correspondence: Abbasali Yekta, Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail:
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Wang Y, Cao H. Corneal and Scleral Biomechanics in Ophthalmic Diseases: An Updated Review. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
11
|
Measurement of In Vivo Biomechanical Changes Attributable to Epithelial Removal in Keratoconus Using a Noncontact Tonometer. Cornea 2021; 39:946-951. [PMID: 32355111 DOI: 10.1097/ico.0000000000002344] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE To compare the biomechanical properties of the cornea after epithelial removal in eyes with keratoconus undergoing corneal cross-linking. METHODS Prospective interventional case series at a university hospital tertiary referral center. Corneal biomechanical properties were measured in patients with keratoconus undergoing corneal cross-linking, immediately before and after epithelial debridement by using a dynamic ultrahigh-speed Scheimpflug camera equipped with a noncontact tonometer. RESULTS The study comprised 45 eyes of 45 patients with a mean age of 19.6 ± 4.9 years (range 14-34). The cornea was found to be 23.7 ± 15.7 μm thinner after epithelial removal (P < 0.01). Corneal stiffness was reduced after epithelial removal as demonstrated by a significant decrease of parameters such as stiffness parameter A1 (12.31, P < 0.01), stiffness parameter-highest concavity (2.25, P < 0.01), A1 length (0.13 mm, P = 0.04), highest concavity radius of curvature (0.26 mm, P = 0.01), highest concavity time (0.22 ms, P = 0.04) and an increase in A1 velocity (-0.01 m/s, P = 0.01), A1 deformation amplitude (-0.03 mm, P ≤ 0.01), A1 deflection length (-0.32 mm, P < 0.01), A2 deformation amplitude (-0.03 mm, P = 0.01), and A2 deflection length (-1.00 mm, P < 0.01). There were no significant differences in biomechanical intraocular pressure (0.15 mm Hg, P = 0.78), deformation amplitude (0.03, P = 0.54), maximum inverse radius (-0.01 mm, P = 0.57), and whole eye movement length (-0.02 mm, P = 0.12). CONCLUSIONS Dynamic ultrahigh-speed Scheimpflug camera equipped with a noncontact tonometer offers an alternative method for in vivo measurements of the epithelial layer's contribution to corneal biomechanical properties. Our results suggest that corneal epithelium may play a more significant role in corneal biomechanical properties in patients with keratoconus than previously described.
Collapse
|
12
|
Baptista PM, Ambrosio R, Oliveira L, Meneres P, Beirao JM. Corneal Biomechanical Assessment with Ultra-High-Speed Scheimpflug Imaging During Non-Contact Tonometry: A Prospective Review. Clin Ophthalmol 2021; 15:1409-1423. [PMID: 33854295 PMCID: PMC8039844 DOI: 10.2147/opth.s301179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In recent years, increasing interest has arisen in the application of data from corneal biomechanics in many areas of ophthalmology, particularly to assist in the detection of early corneal ectasia or ectasia susceptibility, to predict corneal response to surgical or therapeutic interventions and in glaucoma management. Technology has evolved and, recently, the Scheimpflug principle was associated with a non-contact air-puff tonometer, allowing a thorough analysis of corneal biomechanics and a biomechanically corrected intraocular pressure assessment, opening up new perspectives both in ophthalmology and in other medical areas. Data from corneal biomechanics assessment are being integrated in artificial intelligence models in order to increase its value in clinical practice. OBJECTIVE To review the state of the art in the field of corneal biomechanics assessment with special emphasis to the technology based on ultra-high-speed Scheimpflug imaging during non-contact tonometry. SUMMARY A meticulous literature review was performed until the present day. We used 136 published manuscripts as our references. Both information from healthy individuals and descriptions of possible associations with systemic diseases are described. Additionally, it exposed information regarding several fields of ocular pathology, from cornea and ocular surface through areas of refractive surgery and glaucoma until vascular and structural diseases of the chorioretinal unit.
Collapse
Affiliation(s)
- Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Renato Ambrosio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, RJ, Brazil
- Department of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil
- Department of Opthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro & Maceió, Brazil
| | - Luis Oliveira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Meneres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Joao Melo Beirao
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| |
Collapse
|
13
|
Advances in Imaging Technology of Anterior Segment of the Eye. J Ophthalmol 2021; 2021:9539765. [PMID: 33688432 PMCID: PMC7925029 DOI: 10.1155/2021/9539765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/05/2021] [Accepted: 02/16/2021] [Indexed: 12/27/2022] Open
Abstract
Advances in imaging technology and computer science have allowed the development of newer assessment of the anterior segment, including Corvis ST, Brillouin microscopy, ultrahigh-resolution optical coherence tomography, and artificial intelligence. They enable accurate and precise assessment of structural and biomechanical alterations associated with anterior segment disorders. This review will focus on these 4 new techniques, and a brief overview of these modalities will be introduced. The authors will also discuss the recent advances in research regarding these techniques and potential application of these techniques in clinical practice. Many studies on these modalities have reported promising results, indicating the potential for more detailed comprehensive understanding of the anterior segment tissues.
Collapse
|
14
|
McGhee CNJ, Zhang J, Patel DV. A perspective of contemporary cataract surgery: the most common surgical procedure in the world. J R Soc N Z 2020. [DOI: 10.1080/03036758.2020.1714673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Charles N. J. McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jie Zhang
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Dipika V. Patel
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|