Changes in corneal properties and its effect on intraocular pressure measurement following phacoemulsification with intraocular lens implantation with or without trabeculectomy

  • Ashim Dey 1 Elite School of Optometry, Chennai 2 Birla Institute of Technology and Science, Pilani, 3 Medical and Vision Research Foundation, Chennai
  • RathiniLilian David Medical Research Foundation, Chennai
  • Rashima Asokan 1 Elite School of Optometry, Chennai 2 Birla Institute of Technology and Science, Pilani, 3 Medical and Vision Research Foundation, Chennai
  • Ronnie George Medical and Vision Research Foundation, Chennai
Keywords: Corneal biomechanics, intraocular pressure, phacoemulsification, trabeculectomy

Abstract

Purpose: To evaluate the changes incorneal biomechanical properties and their effect on pre and postoperative differences in IOP measurement by each tonometer

Design: Observational study.

Methods: The study was done in subjects who underwent phacoemulsification with intraocular lens (IOL) implantation (phaco-IOL) and combined phacoemulsification with IOL implantation and trabeculectomy (phaco-trab). IOP was measured by a single trained examiner using rebound tonometer (RBT), Ocular Response Analyzer (ORA), Goldmann applanation tonometer (GAT), dynamic contour tonometer (DCT), and Tono-Pen. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using ORA, central corneal thickness (CCT) using ultrasonic pachymeter, and corneal curvature (CR) with manual keratometry. All measurements were done one week prior to surgery and after four weeks and six weeks of the two surgeries, respectively. Only the operated eye was included for analysis.

Results: Twenty-nine eyes of 29 normal subjects who underwent phaco-IOL and 23 eyes of 23 glaucoma subjects who underwent phaco-trab were studied. Increase in CCT [10.2 ± 14.86 microns, p = 0.001], decrease in CH [0.82 ± 1.38 mmHg, p = 0.003] and CRF [0.97 ± 1.0 mmHg, p < 0.001] were found post-phaco-IOL, whereas post-phaco-trab decrease in CCT [16.61 ± 15.22 microns, p < 0.001], CRF [2.28 ± 1.93 mmHg, p < 0.001] with increase in CH [0.95 ± 1.89 mmHg, p = 0.03] were noted. Multiple linear regression analysis showed significant associations for change in CH and CRF with change in IOP and not with CCT and CR postoperatively.

Conclusion: Alterations in CH and CRF were associated with changes in IOP measured postoperatively by different tonometers. CH and CRF changes contribute to postoperative changes in measured IOP.

 

Author Biographies

Ashim Dey, 1 Elite School of Optometry, Chennai 2 Birla Institute of Technology and Science, Pilani, 3 Medical and Vision Research Foundation, Chennai

1 Elite School of Optometry, Chennai
2 Birla Institute of Technology and Science, Pilani,
3 Medical and Vision Research Foundation, Chennai

RathiniLilian David, Medical Research Foundation, Chennai

Consultant, Glaucoma Services 

Medical Research Foundation, Chennai

Rashima Asokan, 1 Elite School of Optometry, Chennai 2 Birla Institute of Technology and Science, Pilani, 3 Medical and Vision Research Foundation, Chennai
1 Elite School of Optometry, Chennai 
2 Birla Institute of Technology and Science, Pilani,
3 Medical and Vision Research Foundation, Chennai
Ronnie George, Medical and Vision Research Foundation, Chennai

Consultant, Glaucoma Services 

Director - Research

Medical and Vision Research Foundation, Chennai

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Published
2018-10-23
How to Cite
Dey, A., David, R., Asokan, R., & George, R. (2018). Changes in corneal properties and its effect on intraocular pressure measurement following phacoemulsification with intraocular lens implantation with or without trabeculectomy. Asian Journal of Ophthalmology, 16(1), 35-50. https://doi.org/10.35119/asjoo.v16i1.344
Section
Original Articles