Abstract
Changes in the cornea can influence outcomes in patients with primary open-angle glaucoma (POAG). We aimed to evaluate the relevance of changes in corneal biomechanics and intraocular pressure (IOP) in patients undergoing non-penetrating deep sclerectomy (NPDS) with the Esnoper V2000 implant® (AJL Ophthalmic S.A., Gasteiz, Spain). We included 42 eyes of 42 patients with POAG scheduled for NPDS with the Esnoper V2000 implant. Biomechanical properties were measured by Ocular Response Analyzer® G3 (ORA; Reichert Inc., Depew, NY, USA). Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) were measured the day before surgery and on day 1, 7, and 30 and 2 and 3 months after surgery. CH initially increased, fell below the presurgical value at 30 days after the surgery, and increased again at 2 and 3 months. CRF, IOPcc, and IOPg decreased on the first day after surgery, then followed a trend of increasing but stayed below pre-surgery levels. All values reached statistical significance. While observed changes in corneal biomechanics after NPDS and Esnoper V2000 implant were significant, more studies are needed if we are to understand their influence on corneal biomechanics and their clinical relevance in POAG.
Highlights
Glaucoma represents one of the main underlying causes of irreversible blindness worldwide, with the most frequent type being primary open-angle glaucoma (POAG) [1,2]
The purpose of this study was to evaluate changes in the parameters of corneal biomechanics (CH and corneal resistance factor (CRF)) and intraocular pressure (IOP) (PIOg and PIOcc) in patients with POAG undergoing non-penetrating deep sclerectomy (NPDS) surgery associated with Esnoper V-2000 implant® (AJL Ophthalmic S.A., Gasteiz, Spain)
IOP is the only risk factor in the development and progression of glaucomatous optic neuropathy that can be treated at the present time
Summary
Glaucoma represents one of the main underlying causes of irreversible blindness worldwide, with the most frequent type being primary open-angle glaucoma (POAG) [1,2]. The main risk factor for disease progression, and the only one we can influence, is intraocular pressure (IOP); for this reason, its detailed study, along with the corneal properties (both structural and biomechanical) that can affect its measurement, is essential [3,4,5,6]. The resistance of the cornea to flattening by contact tonometry was the most determining factor to influence the differences in IOP between tonometers [6,10]. One of the most recent is the Corvis® ST (OCULUS Optikgeräte GmbH, Wetzlar, Germany). It is a classical non-contact tonometer combined with an ultra-fast Scheimpflug camera capable of giving more reliable IOP measurements and of analyzing biomechanical properties of the cornea and its dynamic deformation [12]
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