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Xu Y, Ye Y, Chen Z, Xu J, Yang Y, Zhang Y, Liu P, Fan Y, Chong IT, Yu K, Lam DCC, Yu M. The Impact of Intraocular Pressure Changes on Corneal Biomechanics in Primary Open-angle Glaucoma. Am J Ophthalmol 2024; 269:216-225. [PMID: 39218382 DOI: 10.1016/j.ajo.2024.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To investigate the relationship between intraocular pressure (IOP) changes and corneal biomechanical properties, determine the quantitative relationship between IOP changes and corneal biomechanical properties in patients with glaucoma and observe the differences among different types of glaucoma when the effects of high-level IOP were excluded. DESIGN Prospective clinical cohort study. METHODS Setting: Institutional. PATIENTS Treatment-naive patients with primary open-angle glaucoma or ocular hypertension (OHT) were included. OBSERVATION PROCEDURES IOP was measured using a Goldmann applanation tonometer. Corneal biomechanics were evaluated using a corneal indentation device and corneal visualization Scheimpflug technology. Medication therapy was used for IOP reduction. Repeated measurements were taken at the baseline visit and each week thereafter within a month. Paired t tests were used to compare IOP and corneal biomechanical metrics before and after IOP-lowering therapy. One-way analysis of variance was employed to investigate potential differences across groups, with a Bonferroni post hoc correction administered for multiple intergroup comparisons. MAIN OUTCOME MEASURES Corneal biomechanical parameters following IOP changes. RESULTS Eighty-one participants (mean age, 41.63 ± 17.33 years) were included in this study. The cohort comprised 20 patients with normal-tension glaucoma (NTG), 47 with high-tension glaucoma (HTG), and 14 with OHT. The baseline corneal stiffness (88.58 ± 18.30 N/m) and corneal modulus (0.71 ± 0.16 MPa) were greater than the post-IOP reduction values (67.15 ± 9.24 N/m and 0.54 ± 0.08 MPa, respectively; P < .001). The relationships between changes in IOP and changes in corneal biomechanical parameters were Δ corneal stiffness = 2.06*ΔIOP+6.47 (P < .001) and Δ corneal modulus = 0.017*ΔIOP+0.051 (P < .001). After IOP reduction, the mean corneal stiffness at the 4th week in the NTG group was significantly lower (60.97 ± 6.36 N/m) than that in the HTG (67.25 ± 9.01 N/m) and OHT (75.62 ± 6.52 N/m, P < .001) groups. Additionally, the stiffness of HTG patients was lower than that of OHT patients (P = .003). CONCLUSIONS Changes in IOP have an impact on corneal biomechanical parameters. Decreases in corneal stiffness and modulus were observed after IOP reduction. When the effect of high-level IOP was excluded, corneal biomechanics varied according to the type of glaucoma. The HTG corneas were softer than the OHT corneas, and the NTG corneas were even softer.
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Affiliation(s)
- Yunzhi Xu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Yiming Ye
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Zidong Chen
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Jiangang Xu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Yangfan Yang
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Yuning Zhang
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Pingping Liu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Yanmei Fan
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - Iok Tong Chong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology (I.T.C., D.C.C.L.), Kowloon, Hong Kong
| | - Keming Yu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China
| | - David C C Lam
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology (I.T.C., D.C.C.L.), Kowloon, Hong Kong.
| | - Minbin Yu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China.
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Jóźwik A, Przeździecka-Dołyk J, Wałek E, Czerniak M, Asejczyk M. Corneal Behavior during Tonometer Measurement during the Water Drinking Test in Eyes with XEN GelStent in Comparison to Non-Implanted Eyes. J Clin Med 2022; 11:jcm11112962. [PMID: 35683350 PMCID: PMC9181234 DOI: 10.3390/jcm11112962] [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: 03/27/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Biomechanics of the cornea have significant influences on the non-contact measurement of the intraocular pressure. The corneal behaviour during tonometry is a fundamental factor in estimating its value. The aim of the study was to analyse the behaviour of the cornea during tonometric measurement with the forced change in intraocular pressure during the water drinking test. Ocular Response Analyser (Reichert) was used to the measurement. Besides four basic parameters connected with intraocular pressure (IOPg, IOPcc) and biomechanics (corneal hysteresis CH and corneal resistance factor (CRF), other parameters representing the behaviour of the cornea during a puff of air were analysed. There were 47 eyes included in the study, including 27 eyes with a XEN GelStent implanted and 20 without it. The eyes of people with monocular implementation were the reference group. The values of analysed parameters were compared before and after 10, 25, 40, and 55 min after drinking the water. The intraocular pressure increased by 2.4 mmHg (p < 0.05) for eyes with a XEN stent and 2.2 mmHg for eyes without a stent (p < 0.05) in the tenth minute after drinking of water. This change caused a decreasing of corneal hysteresis (p < 0.05) without significant changes in the corneal resistance factor (p > 0.05). Corneal hysteresis changed similarly in the reference group and the group with a XEN GelStent. The analysis of additional parameters showed a difference in the behaviour of the cornea in eyes with a XEN GelStent in comparison to the corneas of eyes without a stent. This was particularly visible in the analysis of the cornea’s behaviour during the second applanation, when the cornea returns to its baseline state after deformation caused by air puff tonometry.
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Affiliation(s)
- Agnieszka Jóźwik
- Department of Optics and Photonics, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland; (A.J.); (M.C.); (M.A.)
| | - Joanna Przeździecka-Dołyk
- Department of Optics and Photonics, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland; (A.J.); (M.C.); (M.A.)
- Department of Ophthalmology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland;
- Correspondence:
| | - Ewa Wałek
- Department of Ophthalmology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland;
| | - Magdalena Czerniak
- Department of Optics and Photonics, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland; (A.J.); (M.C.); (M.A.)
| | - Magdalena Asejczyk
- Department of Optics and Photonics, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland; (A.J.); (M.C.); (M.A.)
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