Biomechanical changes in the cornea following cataract surgery: A prospective assessment with the Corneal Visualisation Scheimpflug Technology

Autor:	Sunny S. Li, Stuti L. Misra, Henry B. Wallace, James McKelvie
Rok vydání:	2019
Předmět:	Male medicine.medical_specialty Intraocular pressure Corneal Pachymetry Pseudophakia genetic structures Minimally invasive glaucoma surgery medicine.medical_treatment Scheimpflug principle Visual Acuity Glaucoma law.invention Cornea Tonometry Ocular 03 medical and health sciences 0302 clinical medicine Lens Implantation Intraocular Randomized controlled trial law Ophthalmology medicine Humans Prospective Studies Intraocular Pressure Aged Aged 80 and over Phacoemulsification business.industry Middle Aged Cataract surgery medicine.disease Elasticity eye diseases Confidence interval Biomechanical Phenomena medicine.anatomical_structure 030221 ophthalmology & optometry Female sense organs business 030217 neurology & neurosurgery
Zdroj:	Clinical & Experimental Ophthalmology. 47:461-468
ISSN:	1442-9071 1442-6404
DOI:	10.1111/ceo.13451
Popis:	Importance Intraocular pressure (IOP) is often reduced following cataract surgery. Postoperative changes in corneal stiffness are likely to be at least partly responsible for any reduction in IOP measured with applanation tonometry. Background To determine the effect of cataract surgery and corneal incision size on corneal biomechanics. Design Prospective randomized trial. Participants One hundred prospectively enrolled patients qualifying for cataract surgery. Methods Participants were randomized to clear corneal incisions with a 2.20 or 2.85 mm keratome. Corneal Visualisation Scheimpflug Technology (Corvis-ST) tonometry and dynamic corneal response measurements were obtained preoperatively, and 3 mo postoperatively. Multiple regression analysis was completed using R software. Main outcome measures Corvis-ST biomechanical parameters. Results Ninety-three eyes of 93 patients were included in the final analysis. Mean Corvis-ST biomechanically corrected IOP decreased by 3.63 mmHg postoperatively (95% confidence interval = 2.97-4.35, P ≤ 0.01), and central pachymetry increased by 6.96 μm (4.33-9.59, P ≤ 0.01). Independent of IOP and pachymetry changes, mean (±SE) corneal first applanation stiffness parameter reduced by 9.761 ± 3.729 (P = 0.01) postoperatively. First applanation velocity increased by 0.007 ± 0.002 ms, second applanation velocity increased by 0.012 ± 0.004 ms (P ≤ 0.01), the first applanation deformation amplitude increased by 0.008 ± 0.002 mm (P ≤ 0.01) and the deflection amplitude at highest concavity increased by 0.030 ± 0.069 (P ≤ 0.01). There were no significant differences between different incision size groups. Conclusions and relevance Corneal stiffness is reduced 3 mo following cataract surgery and is associated with falsely low IOP measurements. This finding may be important for glaucoma patients and in particular when assessing the effectivity of minimally invasive glaucoma surgery devices.
Databáze:	OpenAIRE
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