Abstract
To evaluate changes in central corneal thickness (CCT) following vitrectomy. All consecutive old and new patients referred to glaucoma services for possible secondary glaucoma after vitrectomy and who had undergone corneal pachymetry between July 2013 to June 2020, were included. The eye that developed elevated intraocular pressure (IOP) and was diagnosed clinically as glaucoma after vitrectomy, was labelled as the "affected" eye. The contralateral eye of the patient with normal IOP and no history of vitrectomy was labelled as the "control" eye. The difference in CCT in the affected eye and the contralateral control eye (ΔCCT) and CCT were compared between different age groups. Correlation of CCT in the affected eye with age, diagnosis, type of surgery done, lens status and pre-existing glaucoma was done using multivariate regression analysis. Of 127 eyes of 120 patients (M:F = 85:35), the average CCT in the affected eye was significantly higher than the unaffected contralateral control eye (p<0.0001). The ΔCCT in eyes presenting at an age <25 years was higher (median 582, 497-840) than those that presented later (median 518, 384-755), p <0.0001, with maximum ΔCCT seen in eyes that had undergone vitrectomy at age<12 years. The CCT in the affected eye was significantly higher in aphakic eyes (588±81.6 microns) than in pseudophakic eyes (552±79.03 microns), p = 0.03. On multivariate analysis, age<25 years remained as a significant influencer of CCT in the affected eye (β = -1.7, p<0.001, R2 = 28.3%). Young age group<25 years are more prone to corneal remodelling and CCT changes after vitrectomy.
Highlights
Central corneal thickness (CCT) has been recognized as a significant risk factor for the progression of ocular hypertension to primary open-angle glaucoma in the Ocular Hypertension Treatment Study [1, 2]
The ΔCCT in eyes presenting at an age
Age
Summary
Central corneal thickness (CCT) has been recognized as a significant risk factor for the progression of ocular hypertension to primary open-angle glaucoma in the Ocular Hypertension Treatment Study [1, 2]. Though the role of CCT in glaucoma pathogenesis is debatable, it remains an invaluable tool in routine glaucoma practice [3, 5, 6]. This is especially important in situations where we want to accurately interpret Goldman applanation tonometry (GAT) readings to avoid over or under-treatment of glaucoma [3, 5]. While these changes are commonly encountered after refractive surgeries, its application in glaucoma assumes importance after posterior segment surgeries where post-operative corneal remodelling may cause false diagnosis of raised intraocular pressure (IOP) or secondary glaucoma [3, 4, 7, 9]
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