Changes In Central Corneal Thickness Research Articles

Comparison of endothelial cell loss in diabetic patients after conventional phacoemulsification and femtosecond laser-assisted cataract surgery

PurposeThis study aims to comparatively evaluate the morphological changes of the cornea after phacoemulsification (PHACO) and femtosecond laser-assisted cataract surgery (FLACS) without intercurrences in patients with type 2 diabetes mellitus.MethodsA total of 95 diabetic patients with moderate cataracts (N2 + and N3+), 47 undergoing PHACO and 48 undergoing FLACS, were selected randomly for the study. Surgeries were performed by a single surgeon between July 2021 and December 2021. Cumulative dissipated energy (CDE) and total balanced saline solution (BSS) data were obtained at the end of each surgery. Changes in corneal endothelial cell density (ECD) and central corneal thickness (CCT) at three months postoperatively were investigated.ResultsAfter three months, evidence is lacking between groups in the CCT measures; the difference was neither statistically nor clinically relevant. However, for ECD, a significant and clinically significant difference was found; if all patients were treated with laser, the mean ECD would be 423.55 greater (RSE: 86.09; p-value < 0.001; 95% CI: 254.81–592.29) than the ECD potential means of 1656.423 among the conventional group (RSE: 74.90; p-value < 0.001; 95% CI: 1509.62–1803.23).ConclusionsDiabetic patients under treatment with moderate cataracts may predispose themselves to a more significant loss of endothelial cells after conventional phacoemulsification than femtosecond laser-assisted cataract surgery.Trial registrationIt was registered at The Brazilian Registry of Clinical Trials (ReBEC) with the code RBR-6d8whb5 (UTN code: U1111-1277-6020) on 17/05/2022.

Early Visibility of Cellular Aggregates and Changes in Central Corneal Thickness as Predictors of Successful Corneal Endothelial Cell Injection Therapy.

(1) Background: Cell injection therapy is an emerging treatment for bullous keratopathy (BK). Anterior segment optical coherence tomography (AS-OCT) imaging allows the high-resolution assessment of the anterior chamber. Our study aimed to investigate the predictive value of the visibility of cellular aggregates for corneal deturgescence in an animal model of bullous keratopathy. (2) Methods: Cell injections of corneal endothelial cells were performed in 45 eyes in a rabbit model of BK. AS-OCT imaging and central corneal thickness (CCT) measurement were performed at baseline and on day 1, day 4, day 7 and day 14 following cell injection. A logistic regression was modelled to predict successful corneal deturgescence and its failure with cell aggregate visibility and CCT. Receiver-operating characteristic (ROC) curves were plotted, and areas under the curve (AUC) calculated for each time point in these models. (3) Results: Cellular aggregates were identified on days 1, 4, 7 and 14 in 86.7%, 39.5%, 20.0% and 4.4% of eyes, respectively. The positive predictive value of cellular aggregate visibility for successful corneal deturgescence was 71.8%, 64.7%, 66.7% and 100.0% at each time point, respectively. Using logistic regression modelling, the visibility of cellular aggregates on day 1 appeared to increase the likelihood of successful corneal deturgescence, but this did not reach statistical significance. An increase in pachymetry, however, resulted in a small but statistically significant decreased likelihood of success, with an odds ratio of 0.996 for days 1 (95% CI 0.993-1.000), 2 (95% CI 0.993-0.999) and 14 (95% CI 0.994-0.998) and an odds ratio of 0.994 (95% CI 0.991-0.998) for day 7. The ROC curves were plotted, and the AUC values were 0.72 (95% CI 0.55-0.89), 0.80 (95% CI 0. 62-0.98), 0.86 (95% CI 0.71-1.00) and 0.90 (95% CI 0.80-0.99) for days 1, 4, 7 and 14, respectively. (4) Conclusions: Logistic regression modelling of cell aggregate visibility and CCT was predictive of successful corneal endothelial cell injection therapy.

Ten-Year Changes in Vision, Refractive Error, and Corneal Thickness After Descemet Stripping Automated Endothelial Keratoplasty for Fuchs Endothelial Corneal Dystrophy.

The goal of this study was to determine changes in best-corrected visual acuity (BCVA), refractive error, and central corneal thickness (CCT) during the first decade after Descemet stripping automated endothelial keratoplasty (DSAEK). Outcomes of all consecutive eyes undergoing DSAEK for Fuchs endothelial corneal dystrophy (FECD) were reviewed; eyes with untreatable comorbidities before DSAEK were excluded. DSAEK was performed through a temporal incision and all eyes were pseudophakic postoperatively. Changes in BCVA, manifest spherical equivalent, manifest cylinder (vector analysis), and CCT were assessed by using generalized estimating equation models. BCVA improved between 6 months (0.18 ± 0.12 logarithm of the minimum angle of resolution (logMAR); Snellen equivalent, 20/30) and 5 years (0.10 ± 0.10 logMAR; 20/25; n = 74, P < 0.001) and then remained stable at 10 years (0.09 ± 0.10 logMAR, n = 48, P = 0.22). There was a myopic shift of -0.20 ± 0.51 D between 6 months and 5 years (n = 65, P = 0.002) that remained stable at 10 years (-0.09 ± 0.44 D; 20/25; n = 34, P = 0.33). Manifest cylinder drifted with-the-rule between 6 months and 5 years (n = 65, P < 0.001) and between 5 and 10 years (n = 34, P < 0.001). CCT was stable between 6 months (672 ± 57 μm) and 5 years (677 ± 55 μm, n = 67, P = 0.47), but increased at 10 years (702 ± 60 μm, n = 39, P = 0.001). Excellent BCVA can be achieved during the first decade after DSAEK for FECD, although improvement seems to plateau after 5 years. Changes in manifest refractive error were not clinically significant. The gradual increase in CCT was consistent with longer-term changes found after other types of keratoplasty.

Central Corneal Thickness and Intraocular Pressure Changes Post- Phacoemulsification Surgery in Glaucoma Patients with Cataract

To compare the changes of central corneal thickness (CCT) and intraocular pressure (IOP) post-phacoemulsification between cataract patients with and without pre-existing glaucoma. A prospective cohort study of 86 patients with visually significant cataract: 43 with pre-existing glaucoma (GC group) and 43 without pre-existing glaucoma (CO group). CCT and IOP were evaluated at baseline (pre-phacoemulsification), as well as at 2 hours, 1 day, 1 week and 6 weeks post-phacoemulsification. The GC group have significantly thinner CCT pre-operatively (p = 0.003). There was a steady increase of CCT with the highest peak at 1 day post-phacoemulsification, followed by a steady decline of CCT and back to baseline at 6 weeks post-phacoemulsification in both groups. The GC group demonstrated a significant difference in CCT at 2 hours (mean difference 60.2 μm, p = 0.003) and 1 day (mean difference 70.6 μm, p = 0.002) post-phacoemulsification, compared to the CO group. There was a sudden increase in IOP at 2 hours post-phacoemulsification measured by GAT and DCT in both groups. This was followed by a gradual reduction of IOP, with significant reduction at 6 weeks post-phacoemulsification in both groups. However, there was no significant difference in IOP between the two groups. IOP measured by GAT and DCT showed strong correlation (r &gt; 0.75, p &lt; 0.001) in both groups. There was no significant correlation between GAT-IOP and CCT changes; nor between DCT-IOP and CCT changes in both groups. CCT changes post-phacoemulsification in patients with pre-existing glaucoma were similar, in spite of having thinner CCT pre-operatively. IOP measurement was not affected by CCT changes in glaucoma patients post-phacoemulsification. IOP measurement using GAT is comparable with DCT post-phacoemulsification.

Development and validation of an intuitive biomechanics-based method for intraocular pressure measurement: a modal analysis approach

BackgroundCurrent intraocular pressure (IOP) measurements based on non-contact tonometry are derived from statistics-driven equations and lack biomechanical significance, which often leads to under-estimation in post-refractive surgery cornea. This study aims to introduce and validate modal analysis-derived intraocular pressure (mIOP) as a novel method generated through Legendre-based modal decomposition of the anterior corneal contour; it provides an accurate and intuitive IOP measurement from an energy-based perspective.MethodsThis retrospective study included 680 patients. Healthy participants were divided into reference (n = 385) and validation (n = 142) datasets, and the others underwent either femtosecond-assisted laser in situ keratomileusis (FS-LASIK, n = 58) or transepithelial photorefractive keratectomy (TPRK, n = 55). Corneal curvature of the right eyes was extracted from raw serial cross-sectional images of the cornea generated by Corvis ST, a noncontact tonometer with a high-speed Scheimpflug-camera. Legendre expansion was then applied to the corneal curvature to obtain the modal profiles (i.e., temporal changes of the coefficient for each basis polynomial [modes]). Using the reference dataset, feature selection on the modal profiles generated a final mIOP model consisting of a single parameter: total area under curve (frames 1–140) divided by the area under curve of the rising phase (frames 24–40) in the fourth mode, i.e. the M4 ratio. Validation was performed in both the healthy validation and postoperative datasets. IOP-Corvis, pachymetry-corrected IOP, biomechanically corrected IOP, and mIOP values were compared. For the FS-LASIK and TPRK groups, pairwise postoperative IOP changes were analyzed through repeated measures analysis of variance, and agreement was examined through Bland–Altman analysis. Using a finite element analysis based three-dimensional model of the human cornea, we further compared the M4 ratio with the true intraocular pressure within the physiological range.ResultsThe M4 ratio-based mIOP demonstrated weak to negligible association with age, radius of corneal curvature, and central corneal thickness (CCT) in all validation analyses, and performed comparably with biomechanically corrected IOP (bIOP) in the refractive surgery groups. Both remained nearly constant postoperatively and were not influenced by CCT changes. Additionally, M4 ratio accurately represented true intraocular pressure in the in silico model.ConclusionsmIOP is a reliable IOP measurement in healthy and postrefractive surgery populations. This energy-based, ratio-derived approach effectively filters out pathological, rotational, misaligned movements and serves as an interpatient self-calibration index. Modal analysis of corneal deformation dynamics provides novel insights into regional corneal responses against pressure loading.

Outcomes of primary surgical treatment of medically recalcitrant post-keratoplasty glaucoma with transscleral cyclophotocoagulation.

To report the outcomes of slow-coagulation continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) in post-keratoplasty glaucoma refractory to medical therapy. Medical records of 47 patients (mean age of 70.7 ± 15.7 years and follow-up of 13.9 ± 7.1 months) were retrospectively enrolled. All patients had the diagnosis of secondary glaucoma after penetrating keratoplasty (PKP; n = 28) or Descemet's stripping automated endothelial keratoplasty (DSAEK; n = 19) with no previous history of incisional glaucoma or TSCPC surgeries. Study participants underwent slow-coagulation CW-TSCPC (1250-milliwatt power and 4-second duration). A statically significant reduction of IOP from 31.8 ± 8.0 mmHg preoperatively to 16.9 ± 9.0 mmHg postoperatively was noted (p < 0.001). Similarly, the number of glaucoma medications decreased from 4.0 ± 1.0 to 2.7 ± 1.4 (p < 0.001). The overall success rates at 12 and 24 months were 68.1% and 66.0%, respectively, with no difference in success rates between post-PKP and post-DSAEK subgroups (p = 0.836). No significant changes in VA or central corneal thickness (CCT) were observed (p = 0.345 and 0.311, respectively). One (3.3%) patient had a graft rejection. The majority of the complications noted during this study were mild and transient. Our study suggests that slow-coagulation TSCPC may be a safe and efficient surgical glaucoma treatment modality in patients with medically uncontrolled post-keratoplasty glaucoma.

Effects of Long-Term Wear and Discontinuation of Orthokeratology Lenses on the Eyeball Parameters in Children with Myopia.

Objective: To evaluate the effects of long-term wear and discontinuation of the orthokeratology lenses (Orth-K) on the biological parameters of eyeballs in children with myopia. Methods: In this prospective study, a total of 308 subjects with myopia were randomized to receive Orth-K (n = 154) or single vision spectacles (SVS) (n = 154) for 12 months followed by a 1-month withdrawal period. The axial length (AL), the central corneal thickness (CCT), the anterior chamber depth (ACD) and the central lens thickness (CLT) were assessed at the baseline, 6 months, 12 months, and 13 months (1-month after lens withdrawal). Results: A total of 279 subjects completed the 13-month follow-up (142 in Orth-K group and 137 in SVS group). No statistical difference was noted in AL, CCT, ACD and CLT between the two groups at the baseline (all p > 0.05). However, compared with the baseline, the AL from the two groups became elongated 12 months after wearing Orth-K or SVS. The increase of AL in Orth-K group was 0.22 ± 0.11 mm, significantly smaller than 0.35 ± 0.08 mm in SVS group (p < 0.05). In addition, CCT in Orth-K group was 544.26 ± 11.69 µm at 12 months, significantly thinner than 550.49 ± 12.13 µm in SVS group (p < 0.05). Interestingly, the change in CCT between the baseline and 1-month after withdrawal of the lens was not statistically different in either group (all p > 0.05). Furthermore, at 12-months, CLT in Orth-K group was 3.35 ± 0.21 mm, significantly thicker than 3.31 ± 0.15 mm at baseline and thicker than 3.30 ± 0.05 mm in SVS group at 12 months (all p < 0.05). Lastly, ACD was not statistically different between Orth-K and SVS groups at any time point (p > 0.05). Conclusion: Orthokeratology lenses can effectively retard axial elongation, reversibly reduce CCT, increase CLT in myopic children, but have no obvious effect on ACD, indicating that Orth-K may significantly retard myopia without noticeable myopia rebound after interruption of Orth-K.

Transpalpebral intraocular pressure measured by Diaton tonometer before, 1 week, and 1 month after transepithelial photorefractive keratectomy in young myopic Saudi patients and its determinants.

To present changes in transpalpebral intraocular pressure (tpIOP) in eyes after transepithelial photorefractive keratectomy (TPRK) in myopic Saudi patients and its determinants. This one-armed cohort included the myopic eyes of Saudi adolescents treated with TPRK in 2020-2021. The difference in tpIOP before surgery, 1 week after surgery, and 1 month after surgery using Diaton was the main outcome. Central corneal thickness (CCT), myopia grade, gender, age, and corneal epithelial thickness before surgery were independent factors. Matched-pair analysis was conducted. The determinants of tpIOP post-TPRK were studied. Our cohort included 193 eyes of 97 participants (25.6 ± 5.8 years). Mild, moderate, and severe myopia were present in 93, 79, and 21 eyes, respectively. tpIOP was 22 mmHg or more in 5 and 8 eyes at 1-week and 1-month follow-up, respectively. The change in tpIOP ranged from - 7.00 to + 11.0 mmHg at 1 week and - 8.0 to + 26.0 mmHg at 1 month. The median change of CCT at 1 month was 59 μ. Change in tpIOP was not correlated with change in CCT at 1 month (r = -0.107, Pearson P = 0.14). Change of tpIOP was significantly correlated to spherical equivalent (SE) before surgery (matched-pair P < 0.001). SE (Mann-Whitney U P = 0.02) and tpIOP (Mann-Whitney U P = 0.02) before TPRK were significantly correlated to tpIOP >22 mmHg after TPRK. The changes in tpIOP following refractive surgery correlate to the refractive status of the eye and tpIOP before surgery.

Comparison of Changes in Corneal Thickness and Curvature After Myopia Correction Between SMILE and FS-LASIK.

To comparatively investigate the changes in corneal thickness and curvature between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Data were collected preoperatively and postoperatively at 1 week, 1 month, and 3 months, including central corneal thickness (CCT), midperipheral corneal thickness (MPCT), peripheral corneal thickness (PCT), central keratometry (CK), midperipheral keratometry (MPK), and peripheral keratometry (PK), using a dual rotating Scheimpflug analyzer. At 1 week postoperatively, changes in CCT, MPCT, PCT, and PK were significantly greater in the SMILE group than in the FS-LASIK group (P = .003 for CCT and < .001 for MPCT, PCT, and PK), but no significant inter-group differences were found between changes in CK and MPK (P = .883 and .513, respectively). CCT, MPCT, and PK values showed a similar increase in both groups, but significantly more increase in PCT and significantly less increase in CK and MPK was observed in the SMILE group from 1 week to 3 months after surgery. At 3 months postoperatively, CCT and MPCT were significantly thinner in the SMILE group than in the FSLASIK group (P = .018 and .022, respectively), and there was no significant difference in PCT, CK, MPK, and PK between the two groups. SMILE caused significantly more corneal thinning at the center, midperiphery, and periphery, and more corneal flattening at the periphery, compared to FS-LASIK. A different pattern of corneal remodeling was observed between the two surgeries during the 3-month follow-up period. [J Refract Surg. 2023;39(1):15-22.].

Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study

Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study

Correlation between postoperative central corneal thickness and endothelial changes after cataract surgery by phacoemulsification in diabetic patients

Correlation between postoperative central corneal thickness and endothelial changes after cataract surgery by phacoemulsification in diabetic patients

Comparison of pachymetry values during crosslinking with different riboflavin solutions

Objectives: To compare the effect of two different riboflavin solutions we use in the accelerated crosslinking (CXL) process on the pachymetry value. Materials and Methods: Patients who had accelerated CXL treatment with dextran-free riboflavin solution due to progressive keratoconus were retrospectively screened. Thirty-seven eyes of 27 patients (group 1) treated with Hydroxyl Propyl MethylCellulose (HPMC) and 0.1% riboflavin containing solution and 29 eyes of 23 patients (group 2) treated with D-alpha-tocopheryl polyethylene-glycol 1000 succinate (VE-TPGS) and 0.1% riboflavin containing solution were compared in terms of pachymetry changes during treatment. Results: In groups 1 and 2, the mean age was 23.92 ± 5.66 and 23.30 ± 4.89, respectively. Mean age, gender, initial keratometry values, mean central corneal thickness (CCT) before and after epithelial debridement did not differ significantly between the two groups. The CCT measured after riboflavin instillation was 453.22 ± 37.48 μ in the group 1 and 479.34 ± 38.54 μ in the group 2. After instillation of riboflavin, according to the initial CCT, there was an average thinning of 21.57 ± 16 μ in the group 1 and 18.72 ± 22.13 μ thickening in the group 2. According to the CCT measured after epithelial debridement, a thickening of 20.70 ± 21.77 μ in the group 1 and 62.76 ± 21.65 μ in the group 2 was observed. The rate of change of CCT after riboflavin instillation of significant differences existed between both groups. (p&lt;0.001). Conclusion: VE-TPGS, which is utilized to increase the cornea's permeability to riboflavin tissue during crosslinking treatment, significantly increases the corneal thickness compared to HPMC and provides a safer tissue thickness for ultraviolet A.

Effect of Topical Prostaglandin Analogue Therapy on Central Corneal Thickness: A Systematic Review.

To investigate whether prostaglandin analogue (PGA) eyedrops have a significant effect on central corneal thickness (CCT), we conducted a systematic search of literature published from 2000 to 2021. Among the studies conducted on topical PGA therapy in open-angle glaucoma or ocular hypertension patients over 18 years old, prospective studies with CCT change as an outcome were included. A single-arm meta-analysis was conducted to assess the overall effect on CCT, and subgroup analysis according to exposure time of PGA eyedrops was also performed. We counted the number of articles that reported on severe events (CCT reduction of 25 μm or more) and obtained their proportion. The methodological quality was assessed by the McHarm tool. Twenty-two reports of prospective studies were selected. The results of the single-arm meta-analysis showed very high heterogeneity. Still, in subgroup analysis, when PGA was used for more than 6 months, heterogeneity was low, and a significant decrease in CCT was observed. Severe events were reported in two reports and occurred in 3.8% to 14.8% of participants. PGA eyedrop use may cause a clinically significant CCT decrease, requiring CCT follow-up.

Goldmann and modified Goldmann tonometry measuring intraocular pressure changes in eyes which underwent myopic laser in situ Keratomileusis and photorefractive keratectomy

PurposeCompare intraocular pressure (IOP) measured by a standard Goldmann applanation tonometer prism (IOPg) and a modified correcting applanation tonometer surface Goldmann prism (IOPc) before and after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).MethodsGoldmann tonometry was analyzed in a retrospective, cross-sectional study, using both GAT and modified-GAT prisms pre-operatively and at the 3 month post-operative appointment on 120 eyes (64 patients) who received LASIK (n = 58) or PRK (n = 62). Demographics, central corneal thickness (CCT), manifest refraction and corneal curvature (CC) data was collected at each visit as well as surgical parameters, including maximum ablation depth.ResultsMean paired IOP following LASIK decreased by − 3.28 ± 3.2 mmHg measured by IOPg and − 1.93 ± 3.3 mmHg by IOPc (p ≤ 0.0001). Mean paired IOP following PRK reduced by − 1.92 ± 3.6 mmHg measured by IOPg and − 1.06 ± 3.6 mmHg by IOPc (p ≤ 0.0001). Increased LASIK ablation depth and post-procedural change in CCT trended toward a statistically significant reduction in IOPg (p = 0.07,p = 0.12), but not IOPc (p = 0.18,p = 0.32). PRK ablation depth was not associated with a reduction in IOPg or IOPc.DiscussionThe modified Goldmann (IOPc) prism measured less of an IOP reduction following LASIK and PRK compared to the standard (IOPg) prism, and the IOP reduction with both prisms was associated with the degree of myopic correction.What is already known and the residual queryCorneal refractive surgery generally demonstrates significant postoperative Goldmann IOP reductions. Presumably, this is due to corneal biomechanical changes for which a newer method of Goldmann IOP measurement may be able to compensate.What this study addsA modified, corneal conforming Goldmann prism demonstrates significantly less IOP reduction following myopic LASIK and PRK compared to the standard flat Goldmann prism.How this study might affect research, practice or policyA newer, modified Goldmann prism may help detect glaucoma and OHT at an earlier stage in patients which have undergone LASIK or PRK. The findings corroborate predicted corneal biomechanical changes following the most common corneal refractive procedures.

Predictive models for IOPs measured with NCT, GAT, and ORA among patients undergoing SMILE.

Purpose: To develop predictive models for the intraocular pressure (IOP) of patients undergoing small incision lenticule extraction (SMILE) procedures, measured with a noncontact tonometer (NCT), Goldmann applanation tonometry (GAT), and an ocular response analyzer (ORA). Methods: In this prospective study, a total of 104 eyes (-6.23 ± 2.06 diopters) of 52 patients (24.38 ± 4.76years) undergoing SMILE procedures were included. The intraocular pressure was measured (IOPNCT with NCT, IOPGAT with GAT, and IOPcc and IOPg with ORA) before surgery and at postoperative 6months. Information on age, preoperative and attempted spherical equivalent (SE), ablation depth, preoperative values and postoperative changes in central corneal thickness (CCT), K1, K2, Km, corneal hysteresis (CH) and corneal resistance factor (CRF) values was collected in order to predict IOPs. Results: All surgeries were uneventful. At postoperative 6months, the efficacy and safety index were 1.04 ± 0.15 and 1.08 ± 0.18, respectively. Significant decreases were detected in postoperative IOPNCT, IOPGAT, IOPcc, and IOPg compared to preoperative values (all p < 0.001). No relationship was found between any IOP and ablation depth, attempted SE, and preoperative SE, as well as CCTdifference (all p > 0.05). Predictive models for IOPs were constructed to predict preoperative values, and R 2 values were 67.5% (IOPNCT), 64.5% (IOPGAT), 78.7% (IOPcc), and 82.0% (IOPg). The prediction band of IOPNCT and IOPGAT was 7.4-15.1mmHg and 8-16mmHg, respectively. Conclusion: Predictive models for IOP measurements after SMILE procedures can be helpful in clinical practice.

Corneal tissue changes following short-term soft contact lens wear of different materials.

To study the effect of different soft contact lens (CL) materials during short-term wear on corneal tissue. Twenty-two healthy participants wore both silicone hydrogel (MyDay, CooperVision) and hydrogel soft CLs (Biomedics 1day extra, CooperVision) for 8 h per lens. In each session, Scheimpflug images were captured before and immediately after CL removal. Images were analysed using the densitometry distribution analysis, a technique from which two parameters, α (corneal transparency) and β (corneal homogeneity), were estimated. In addition, the central corneal thickness changes after CL wear and the influence of the CL material on corneal transparency were evaluated. The β parameter (homogeneity) increased by 5% after wearing both CL materials (paired t-test, p< 0.001). However, the α parameter (transparency) only increased in half of the participants. No material was found to be more determinant in causing the corneal densitometry changes. Statistically significant but not clinically relevant changes in corneal thickness were observed. Biomarkers of corneal tissue integrity (α and β) were affected by short-term soft contact lens wear. The observed changes in corneal transparency and homogeneity were not clinically relevant but support the importance of participant-material biocompatibility.

Corneal Tonometric and Morphological Changes in Patients with Acromegaly.

(1) Purpose: This study aimed to investigate the changes in Reichert Ocular Response Analyzer (ORA) parameters, corneal endothelium parameters, central corneal thickness (CCT), and intraocular pressure (IOP) before and after the transsphenoidal resection of pituitary adenoma in patients with acromegaly. (2) Methods: This was a single-center, prospective, interventional study. Twenty patients with newly diagnosed acromegaly were examined before and 19 ± 9 months after transsphenoidal resection. The participants underwent a comprehensive ophthalmological examination including pneumatic IOP (IOP air puff), Goldmann applanation tonometry (IOP GAT), CCT measured using the iPac pachymeter (CCTUP), IOP value corrected for CCTUP using the Ehlers formula (IOPc) ORA measurements included corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg). CCT from non-contact specular microscopy (CCTNSM), the number of endothelial cells (CD) per mm2, and average cell size (AVG) were determined with non-contact specular microscopy. (3) Results: A statistically significant decrease was observed in CCTUP (p = 0.007), and IOP air puff (p = 0.012) after surgery. Moreover, we noted a statistically significant increase in CD (p = 0.001), and a statistically significant decrease in AVG (p = 0.009) and CCTNSM (p = 0.004) after surgery. A statistically significant decrease was also observed in IOPg (p = 0.011), CH (p = 0.016), and CRF (p = 0.001) after surgery. The mean value of IOP GAT and IOPc was lower after the surgery. However, the difference was not statistically significant. (4) Conclusions: Our study revealed significant changes in biomechanics, corneal endothelium, CCT and IOP after pituitary adenoma resection in patients with acromegaly. It proves that the eye might be sensitive to long-term overexposure to growth hormone (GH) and insulin-like growth factor-1 (IGF-1). We suggest that disease activity be taken into consideration on ophthalmological examination.

Hydro-implantation versus Visco-implantation of Intraocular Lenses and Fluid Load Effect on Corneal Endothelial Cells after Uneventful Phacoemulsification

AIM: The purpose of the study was to study the effect of implantation method and fluid load (aspiration time, aspiration volume) on corneal endothelium in uneventful phacoemulsification surgeries. METHODS: This study was a prospective and interventional study involved 77 eyes, 50−81 years, divided into three groups according to implantation method (on Saline, Healon, or Methylcellulose). Specular microscope analysis of corneal endothelial parameters: Cell density (CD), central corneal thickness (CCT), coefficient of variation (CV), and Hexagonality (HEX) were done before and 3 months after surgery. RESULTS: A total of 77 eyes with cataracts were studied, and there was a significant increase in CCT and CV with a decrease in CD and HEX in all three groups. On comparing the same parameters between the three groups, there were insignificant differences regarding CCT and HEX changes. Although there was a significant change in CD, the highest loss was in the Healon group (median −0.138), followed by the Saline group (median −0.118), and the lowest was in the Methyl group (median −0.075). There was a significant change in CV, showing the highest increase in the Healon group (median 0.16129) followed by the Saline group (median 0.13307) and the lowest in the Methyl group (median 0.1266). There was a non-significant change in all corneal parameters among cases in each group with different aspiration volumes and times. CONCLUSION: Endothelial cell loss was lowest with Methyl followed by saline, and highest with Healon implantation. Fluidics had an insignificant effect in the three groups. Saline implantation was comparable to Healon, with an insignificant difference in CD loss.

Comparison of Visual Acuity, Refractive Status, Intraocular Pressure, Central Corneal Thickness, RNFL Thickness and Disc Changes Between Patients with Primary Open Angle Glaucoma and Primary Angle Closure Glaucoma - A Retrospective Observational Study

Aim and objective: To compare visual acuity, refractive status, intraocular pressure, central corneal thickness, RNFL thickness and disc changes between patients with primary open angle glaucoma and primary angle closure glaucoma Materials and methods: A retrospective study conducted over a period of 6 months with a sample size of 172 eyes from 100 patients. Various parameters including Pachymetry, IOP and gonioscopy were performed. Result: POAG is more in prevalence in the age group of 45- 60 and more in males than females. In general, POAG groups were predominantly myopic and have a thinner central corneal thickness average 534±24.6µm and leading to effects in Intraocular pressure. PACG is more prevalent among males than females in contrary to our reference and it is common in the age group 40-60yrs. PACG’s were more predominantly Hyperopic and having thicker CCT on an average of 544±25.7 µm. Conclusion: This study concludes that more rapid glaucomatous changes is seen in the patients with POAG than PACG. These patients should be screened carefully and provided more diagnostic and preventive management. Keywords: Primary open angle glaucoma, Primary angle closure glaucoma, Central corneal thickness, RNFL thickness.

Central Corneal Thickness Changes in Diabetic Retinopathy. A Prospective Observational and Correlative Study

Generally, there is a delay of 4 to 7 years in the diagnosis of type 2 diabetes and about 20% of patients would have already developed some micro vascular complications at the time of diagnosis. To study the central corneal thickness (CCT) variation and correlate with grades of diabetic retinopathy in an adult South Indian population. The study was conducted on 184 eyes each of T2DM patients of duration more than 5 years. 98 males (53.26%) &amp; 86 females (46.73%) were recruited. After recording age, sex and duration of diabetes, fundus examination was done. CCT measurements were determined using Ultrasonic Pachymetry. Diabetic retinopathy was classified based on ETDRS (Early diabetic retinopathy study) and mean CCT values of each group were correlated and statistically analysed using SPSS software Version 17. Out of 184 subjects recruited, 72 patients were with no diabetic retinopathy (NDR), 107 patients were with non-proliferative diabetic retinopathy (NPDR) and 5 patients were with proliferative diabetic retinopathy (PDR). The mean CCT of no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) were found to be 526.14μm, 533.98μm and 555.20μm respectively. CCT was found to be thicker for diabetics with proliferative diabetic retinopathy compared to those with no retinopathy; the difference was not statistically significant (p=0.16). Uncontrolled diabetics (HbA1c &gt;7%) had thicker corneas compared with diabetics with good control which was statistically significant (p=0.003). CCT was higher in diabetics having duration &gt; 10 years than with duration &lt;10 years but was not statistically significant (p=0.117).