Corneal Volume Research Articles

Evaluación de los signos de la pseudoexfoliación en el segmento anterior mediante tomografía de coherencia óptica y cámara de Scheimpflug

ObjectiveTo evaluate different anterior segment parameters in eyes with pseudoexfoliation (PSX), fellow eyes, and controls using optical coherence tomography and a Scheimpflug imaging system. MethodsThree groups were studied: 44 eyes of 44 patients with PSX, 30 clinically unaffected fellow eyes, and 148 eyes of 148 healthy controls. The anterior chamber depth and volume, corneal volume and thickness, pupil diameter and corneal densitometry were measured using a Scheimpflug imaging system (Pentacam, Oculus Inc.; Wetzlar, Germany). The angle width, the length and area of the trabecular meshwork, and the iris thickness were measured using an optical coherence tomography RTVue 100 device (Optovue, Fremont, CA, USA). The presence of PSX deposits was also assessed by OCT. ResultsThere were no differences in the anterior chamber volume or depth in the corneal volume or central thickness (P≥.228). The corneal densitometry was similar between PSX and fellow eyes; however it was greater than in the control group (P<.001). As regards the parameters measured by OCT, there were no differences in the angle width or in the trabecular meshwork size between the 3 groups; however, the iris was thinner in controls (P=.005). In all patients the PSX deposits were correctly visualised by OCT after the identification by biomicroscopy. ConclusionsThere were no differences in the anterior segment biometric measurements between patients with PSX and controls, although the corneal densitometry and iris thickness were greater in the PSX and fellow eyes groups.

Corneal biomechanical data and biometric parameters measured with Scheimpflug-based devices on normal corneas

To analyze the correlations between ocular biomechanical and biometric data of the eye, measured by Scheimpflug-based devices on healthy subjects. Three consecutive measurements were carried out using the corneal visualization Scheimpflug technology (CorVis ST) device on healthy eyes and the 10 device-specific parameters were recorded. Pentacam HR-derived parameters (corneal curvature radii on the anterior and posterior surfaces; apical pachymetry; corneal volume; corneal aberration data; depth, volume and angle of the anterior chamber) and axial length (AL) from IOLMaster were correlated with the 10 specific CorVis ST parameters. Measurements were conducted in 43 eyes of 43 volunteers (age 61.24±15.72y). The 10 specific CorVis ST data showed significant relationships with corneal curvature radii both on the anterior and posterior surface, pachymetric data, root mean square (RMS) data of lower-order aberrations, and posterior RMS of higher-order aberrations and spherical aberration of the posterior cornea. Anterior chamber depth showed a significant relationship, but there were no significant correlations between corneal volume, anterior chamber volume, mean chamber angle or AL and the 10 specific CorVis ST parameters. CorVis ST-generated parameters are influenced by corneal curvature radii, some corneal RMS data, but corneal volume, anterior chamber volume, chamber angle and AL have no correlation with the biomechanical parameters. The parameters measured by CorVis ST seem to refer mostly to corneal properties of the eye.

Association between corneal volume change and corneal biomechanical property before and after small incision lenticule extraction in myopia

Background The relationship between corneal central thickness (CCT) and corneal biomechanical property does not reflect the effective amount of ablated tissue because CCT measures only the change in a single point.Corneal volume (CV) is a representative parameter of corneal morphology, and it can fully reflect corneal thickness and tissue distribution. Objective This study was to investigate the correlation between volumetric corneal changes and corneal biomechanical properties after small incision lenticule extraction (SMILE). Methods A prospective series cases-observational study was carried out.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital, and written informed consent was obtained from each patient prior to entering the cohort.Sixty-seven right eyes of 67 myopia or myopic astigmatism patients who received SMILE in Tianjin Eye Hospital from June 2014 to July 2015 were included in this study.Before and 3 months after surgery, the CV at 3, 3-5, 5-7 and 7-10 mm (CV3, CV3-5, CV5-7, CV7-10) was measured by Pentacam anterior segment analysis system, and corneal hysteresis (CH) and corneal resistance factor (CRF) were obtained by ocular response analyzer (ORA). The changes of CV (ΔCV), CH (ΔCH) and CRF (ΔCRF) were calculated, and the correlations between ΔCV and ΔCH or ΔCRF were analyzed. Results CV3, CV3-5 and CV5-7 values after SMILE were significantly lower than those before SMILE (t=36.24, 20.38, 16.17, all at P< 0.001). The CH values before and after SMILE were (10.06±1.11)mmHg and (8.10±1.05)mmHg (1 mmHg=0.133 kPa), and the CRF values before and after SMILE were (10.40±1.38)mmHg and (6.91±1.19)mmHg, respectively, showing significant reduces after SMILE than before SMILE (t=16.71, 27.41, both at P<0.001). Positive correlations were seen between the CV values at different corneal areas and CH value or CRF value.Moderate positive correlations were found between CV3 and CH or CRF (r=0.571, 0.569; both at P<0.001) before surgery, and 3 months after surgery, a weak positive correlation was seen between ΔCV3 and ΔCH (r=0.394, P<0.001) or a moderate positive correlation between ΔCV3 and ΔCRF (r=0.501, P<0.001). Conclusions The CV value is gradually increased from the central cornea to periphery cornea.The CV change is associated with CH and CRF changes after SMILE, and CV3 probably is a useful parameter for the evaluation of corneal biomechanics after refractive surgery. Key words: Biometry; Cornea; Volume; Corneal biomechanics; Corneal hysteresis; Corneal resistance factor; Small incision lenticule extraction

Role of percent peripheral tissue ablated on refractive outcomes following hyperopic LASIK.

ObjectivesTo determine the effect of hyperopic laser in situ keratomileusis (H-LASIK) on corneal integrity, by investigating relationships between proportionate corneal tissue ablated and refractive outcomes at 3 months.Methods18 eyes of 18 subjects treated with H-LASIK by Technolas 217c Excimer Laser were included in the study. Orbscan II Topography System was used to determine corneal volume and pachymetry 3mm temporally (3T). The volume of corneal tissue ablated was determined from the laser nomogram. Univariate associations between age, treatment, corneal volume, overall proportion of tissue removed, proportion of tissue removed at 3T, residual bed thickness at 3T and refractive outcomes 3 months post-LASIK were examined and independent factors associated with refractive outcomes determined using linear regression models.ResultsAt 3 months post-LASIK, the mean difference to expected refractive outcome was -0.20 ± 0.64 (Range -2.00 to +1.00). In univariate analysis, difference to expected refractive outcome was associated with proportion of tissue removed at 3T (P<0.01, r = -0.605) and total number of pulses (P< 0.05, r = -0.574). In multivariable analysis, difference to expected refractive outcome was associated with the proportion of tissue removed at 3T only.ConclusionSubjects undergoing H-LASIK, may present as either over or under-corrected at 3 months. The proportion of tissue removed at 3T was the single significant determinant of this outcome, suggesting unexpected biomechanical alterations resulting in corneal steepening. Future hyperopic LASIK procedures could consider proportionate volume of corneal tissue removed at 3T in addition to laser nomograms to achieve improved refractive outcomes.

Effect of dry eye on Scheimpflug imaging of the cornea and elevation data

ObjectiveTo evaluate the effect of dry eye on Scheimpflug imaging of the cornea and elevation data. DesignProspective observational study. ParticipantsScheimpflug images of 50 patients with dry eye who were being tested for eligibility for corneal refractive surgery were screened. Twelve eyes of 12 patients with abnormal Belin/Ambrosio enhanced ectasia display (BAD) anterior elevation difference were included in the study. The patients had no history of contact lens wear or any other sign of ectasia. MethodsPeak central corneal densitometry value, corneal volume, pachymetry at the thinnest point, and BAD anterior elevation difference value at the centre of the 9 mm zone were recorded before and after 4 weeks of dry eye treatment. Measurements were compared with the Wilcoxon signed rank test. ResultsThe mean corneal peak densitometry and volume were similar before and after therapy (p = 0.465 and p = 0.441, respectively). The mean anterior elevation difference value at the centre of the 9 mm zone before treatment (6.67 ± 1.72 µm) was significantly higher than the mean post-treatment value (4.00 ± 1.48 µm) (p = 0.002). The mean pachymetry at the thinnest location after treatment (548 ± 11.0) was significantly higher than the pretreatment value (538 ± 8.5) (p = 0.027). ConclusionsBAD anterior elevation differences and pachymetric measurements may be affected by ocular surface or tear film abnormalities associated with dry eye disease. Repeated evaluations after treatment may reveal normal results.

Effects of hemodialysis on corneal and anterior chamber morphometry and intraocular pressure in patients with end-stage renal disease.

To evaluate the effects of hemodialysis (HD) on corneal and anterior chamber morphometry, as well as intraocular pressure (IOP) in patients with end-stage renal disease. Fifty right eyes were examined 30 minutes before and after HD. IOP was measured with a Goldmann applanation tonometer, and Ehlers' formula was used to calculate the corrected IOP values. The central corneal thickness (CCT), corneal volume (CV), keratometric values, anterior chamber depth (ACD), aqueous depth (AQD), anterior chamber volume (ACV), and anterior chamber angle (ACA) in the nasal and temporal quadrants were measured with a Sirius anterior segment analysis system. Blood urea nitrogen levels, body mass, and systolic and diastolic arterial pressure were also measured before and after HD. The mean age was 60.80 ± 13.38 (range: 35-80) years. The mean uncorrected and corrected IOP values decreased from 18.06 ± 3.91 and 18.31 ± 4.83 mmHg to 16.94 ± 3.87 and 16.95 ± 4.74 mmHg after HD, respectively (p=0.011 and p=0.003, respectively). The mean CCT decreased from 536.38 ± 24.73 to 533.18 ± 27.25 µm (p=0.002), and the mean CV decreased from 57.52 ± 3.15 to 55.68 ± 3.55 mm³ (p<0.001) after HD. There were no significant changes in ACD, AQD, ACV, ACA, or the keratometric values (p>0.05 for all values). There were no significant correlations between the ocular and systemic parameters (p>0.05 for all correlations). Uncorrected IOP, corrected IOP, CCT, and CV values decreased after HD, whereas the anterior chamber morphometry values remained similar between the measurements performed before and after HD.

Relationship between anterior segment and optic nerve head parameters in healthy subjects.

To determine the relationship between anterior segment and optic nerve head (ONH) parameters. Two hundred healthy subjects were enrolled in this study. The par-ticipants underwent measurement of anterior segment parameters with a Pentacam Scheimpflug system and imaging of the optic disc with confocal scanning laser ophthalmoscopy. Pearson's correlation coefficient was calculated to assess the associations between ONH and anterior segment parameters. Multivariate regression analyses controlling for age and disc area as confounding factors were also conducted. There were significant negative relationships between optic disc area and corneal thickness (p=0.03, r=-0.217) and volume (p=0.017, r=-0.239). Corneal refractive power was significantly correlated with cup area, rim area, rim volume, and cup/disc ratio (p<0.05 for all). An increase of 1 diopter in anterior corneal refractive power corresponded to a decrease of 0.022 in cup/disc ratio. Rim volume was negatively correlated with anterior chamber depth and anterior chamber volume (p<0.05 for both). A 1-mm3 increase in anterior chamber depth corresponded to a 0.154-mm3 decrease in rim volume. Mean and maximum cup depth measurements were not associated with any of the anterior segment parameters. In nonglaucomatous eyes, the dimensions and shape of the ONH may be related to anterior segment morphology. Therefore, it may be helpful to take anterior segment parameters into consideration in evaluating the OHN.

Normative values and contralateral comparison of anterior chamber parameters measured by Pentacam and its correlation with corneal biomechanical factors

PurposeTo evaluate the normative values of anterior chamber parameters measured by Pentacam and corneal hysteresis (CH) and corneal resistance factor (CRF) measured by Ocular Response Analyzer (ORA) and their relationship. MethodsIn an observational cross-sectional study, patients aged 18–35years were included. Exclusion criteria were history of any intraocular or corneal disease, anomaly or surgery; hyperopic spherical refraction more than +3, and myopic spherical refraction less than −5.00 diopters (D) or cylindrical refraction more than 2.00D. ORA was used to measure CH and CRF. Corneal volume (CV), anterior and posterior Q value (QA and QP), anterior and posterior elevation (AE and PE), central corneal thickness (CCT), corneal thinnest thickness (CTT), anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) were measured with Pentacam. ResultsThis study evaluated 506 eyes of 253 cases (182 females) with a mean age of 28.43±6.36years. The average CH and CRF were 10.07±1.61 and 10.33±1.68mmHg. CH and CRF were not correlated with PQ, AQ, AE and PE. CH and CRF were significantly correlated with CCT (r=0.499, p<0.0001 and r=0.591, p<0.0001 respectively), CTT (r=0.469, p<0.0001 and r=0.593, p<0.0001 respectively) and CV (r=0.443, p<0.0001 and r=0.526, p<0.0001 respectively). ConclusionA significant positive correlation was found between CH and CRF, and CCT, CTT and CV. This study also provided data about wide range normative values of corneal parameters.

Characteristics of higher-order aberrations and anterior segment tomography in patients with pathologic myopia.

To investigate prospectively the characteristics in the higher-order aberrations and anterior segment tomography in patients with pathologic myopia. One hundred and twelve consecutive highly myopic patients (mean age 43.4±9.3years, spherical equivalent of refractive error≥8 D and an axial length≥26.5mm) were studied. Thirty-seven emmetropic individuals (mean age 37.0±14.5years, spherical equivalent of refractive error≤±1 D) were analyzed as controls. The ocular and cornea higher-order aberrations were measured using a Hartmann-Shack wavefront sensor (KR-1W; Topcon Corporation, Tokyo, Japan). The crystalline lens rise, the angle-to-angle, and the white-to-white values were measured using anterior segment OCT (SS-1000; Tomey Corporation, Nagoya, Japan). The mean curvature of the anterior corneal surface, the thickness at the thinnest central corneal point, the location of the central corneal point, the corneal volume, the anterior chamber volume, and the anterior chamber depth were measured using the Pentacam HR (Oculus, Inc., Wetzlar, Germany). The ocular total higher-order aberration for 4-mm pupil, the ocular spherical aberrations, and internal spherical aberration for 6-mm pupil were significantly higher in highly myopic eyes than in the emmetropic controls. The crystalline lens rise was significantly smaller in highly myopic eyes than in the emmetropic controls. The anterior chamber depth and the anterior chamber volume were significantly larger in highly myopic eyes than in the emmetropic controls. Highly myopic eyes had higher-order aberrations than emmetropic eyes because of the increasing internal aberrations.

Corneal Endothelium and Phacoemulsification.

Phacoemulsification has become the most commonly used procedure in cataract surgery owing to the development of new devices and surgical techniques; however, corneal endothelial damage still represents a serious complication. Although several factors are known to cause corneal endothelial damage, effects of irrigating pressure and temperature rise in the anterior chamber should also be considered. Furthermore, free radical formation is another important harmful factor. Ultrasound in aqueous solution induces cavitation, which results in the formation of hydroxyl free radicals that damage the corneal endothelium. The best protection is the use of ophthalmic viscosurgical devices. In addition, the use of H2 gas as an anti-free radical agent in the irrigating solution is discussed. At present, corneal endothelial injury is usually assessed using the limited range of specular microscopy. Corneal volume might be a new parameter with which to assess total corneal endothelial function.

Visual, Topographic, and Pachymetric Effects of Pediatric Corneal Collagen Cross-linking.

To evaluate the effects of pediatric corneal collagen cross-linking (CXL) on corrected distance visual acuity (CDVA), maximum keratometry (Kmax), and other Scheimpflug imaging system parameters during 2 years of follow-up. The records of 29 eyes of 29 pediatric patients who underwent unilateral CXL treatment for progressive keratoconus were reviewed. Changes in CDVA, Kmax, anterior chamber depth, anterior chamber volume, anterior chamber angle, pupil-center pachymetry, apical pachymetry, thinnest pachymetry, corneal volume, and topographic indices (index of surface variance [ISV], index of vertical asymmetry [IVA], index of height asymmetry [IHA], keratoconus index [KI], center keratoconus index [CKI], index of height decentration [IHD], and minimum radius of curvature [Rmin]) were analyzed among baseline and 1 and 2 years after the CXL treatment. Mean CDVA and Kmax significantly improved from baseline at 1 year (-0.17 logMAR, P < .0001; -1.18 diopters [D], P = .012, respectively) and 2 years (-0.21 logMAR, P < .0001; -1.40 D, P = .001, respectively) after the CXL treatment. Anterior chamber parameters, corneal thicknesses, and corneal volume remained unchanged during the period following CXL (P > .05). Five of the seven Scheimpflug topographic indices (including ISV, KI, CKI, IHD, and Rmin) showed significant improvement after CXL between baseline and 2 years (P < .05). In pediatric patients with progressive keratoconus, CXL appears to be effective in improving CDVA, Kmax, and corneal topographic irregularity at 2 years' follow-up. However, long-term effects of CXL should be tested by further studies in pediatric keratoconus. [J Pediatr Ophthalmol Strabismus. 2017;54(2):84-89.].

Scheimpflug image-based changes in anterior segment parameters during accommodation induced by short-term reading.

To analyze the effect of the accommodation on the anterior segment data (corneal and anterior chamber parameters) induced by short-time reading in a healthy, nonpresbyopic adult patient group. Images of both eyes of nonpresbyopic volunteers were captured with a Scheimpflug device (Pentacam HR) in a nonaccommodative state. Fifteen minutes of reading followed and through fixation of the built-in target of Pentacam HR further accommodation was achieved and new images were captured by the device. Anterior segment parameters were observed and the differences were analyzed. Fifty-two healthy eyes of 26 subjects (range 20.04-28.58 years) were analyzed. No significant differences were observed in the keratometric values before and after the accommodative task (p = 0.35). A statistically significant difference was measured in the 5.0-mm-diameter and the 7.0-mm-diameter corneal volume (p = 0.01 and p = 0.03) between accommodation states. Corneal aberrometric data did not change significantly during short-term accommodation. Significant differences were observed between nonaccommodative and accommodative states of the eyes for all measured anterior chamber parameters. Among the parameters of the cornea, only corneal volume changed during the short-term accommodation process, showing some fine changes with accommodation of the cornea in young, emmetropic patients. The position of the pupil and the anterior chamber parameters were observed to change with accommodation as captured by a Scheimpflug device.

Assessment of Corneal Parameters in Patients with Constitutional Thinness Using Scheimpflug Imaging

ABSTRACTPurpose: To assess corneal parameters in constitutional thinness (CT) subjects and to compare them with those of healthy individuals. Methods: Twenty-four CT subjects (BMI < 18.5 kg/m2) and 24 healthy subjects (BMI: 18.5–25 kg/m2) were enrolled in this observational cross-sectional study. All participants were screened for age, gender, and medical history, then underwent a detailed ophthalmological examination. Corneal parameters were evaluated by Scheimpflug imaging. Height and weight of all subjects were measured and body mass index (BMI) was calculated. Results: The mean corneal thicknesses at the apex point, the center of pupil, the thinnest point, and the mean corneal volume were significantly lower in CT patients than those of controls. The mean intraocular pressure (IOP) was significantly lower in CTs than in controls. There was a significant correlation between BMI and IOP, and BMI was significantly correlated with all pachymetric measurements and corneal volume. Conclusion: Corneal thicknesses were significantly thinner in CT subjects compared to those in control subjects. The impact of constitutional thinness on corneal parameters should be further investigated.

Anterior segment characteristics in normal and keratoconus eyes evaluated with a combined Scheimpflug/Placido corneal imaging device

PurposeTo assess the anterior segment parameters of keratoconus (KC) eyes at different stages of the disease by a new Scheimpflug camera combined with Placido disk corneal topography (Sirius, CSO, Italy) in a sample of the Iranian population. MethodsA total of 225 eyes of 225 individuals comprising 41 suspect KC, 40 mild KC, 71 moderate KC, 48 severe KC and 25 normal eyes were assessed for the following parameters: corneal thickness at the apex (CTA), thinnest corneal thickness (TCT), anterior chamber depth (ACD), corneal volume (CV), corneal keratometry (K), corneal asphericity (Q), and corneal elevation in the anterior and posterior surface. Also, the Zernike coefficients for the corneal aberrations including total root mean square (RMS), RMS Coma, RMS spherical aberration (SA), RMS Astigmatism, Baiocchi Calossi Versaci front index (BCVf), and BCV back index (BCVb) were noted for all eyes. Data was analyzed using analysis of variance (ANOVA) and post hoc Bonferroni test for comparison of the means of the five groups. P-value was considered significant if it was <0.05. ResultsThe TCT, CTA and posterior corneal elevation were significantly different between all comparison groups (P < 0.05). ACD values showed inconsistent differences between groups. Mean value of CV in comparing normal eyes vs suspect KC group, normal eyes vs mild KC, and normal eyes vs moderate KC revealed statistically significant change (P < 0.05). Also, weak non-significant positive correlation was demonstrated between K and CV (r = 0.08). There were statistically significant differences in total RMS, RMS coma, BCVf, and BCVb for most groups (P < 0.05). ConclusionPosterior corneal elevation, corneal thickness and high order aberrations are important indices that need to be considered to diagnose different grades of keratoconus.

In Vitro Corneal Tomography of Donor Cornea Using Anterior Segment OCT.

The aim of this study was to establish a tomographic screening method for revealing potential pathologies in corneal donors before keratoplasty so they may be excluded as candidates for corneal transplantation. Donor corneal tomographies were measured in a viewing chamber filled with preservation medium and with the use of a clinical optical coherence tomography (OCT) device. Custom-written software was developed to extract corneal surfaces from the raw data, which were analyzed in the central and peripheral regions. An adaptive nonlinear edge-enhancement algorithm was used to observe scars within the corneal volume. The thickness distribution map was analyzed to detect keratoconus and corneas with extreme topographic irregularities. Measurements were repeated 5 times to assess reproducibility. Eight corneas were investigated: 6 randomly selected intact donors, unsuitable for implantation because of low endothelial cell densities, and 2 keratoconus corneas, excised from patients during corneal transplantation. A major thickness abnormality was detected in one of the intact donor corneas, so it was excluded from further analysis. The keratoconus corneas were clearly evident in optical coherence tomography cross-sectional images, and similarly, they could easily be identified by analyzing the thickness map. Overall, the measurements were reliable and had a Cronbach's alpha coefficient greater than 0.8. Donor corneal examination using sterile viewing chambers was found to be suitable as a pre-keratoplasty advanced screening routine. A proof of concept was demonstrated, which could identify both irregular corneas and those affected by keratoconus.

Comparison of Scheimpflug imaging parameters between steep and keratoconic corneas of Caucasian eyes.

PurposeTo compare the keratometric and pachymetric parameters of healthy eyes with those affected by steep cornea and keratoconus (KC) using Scheimpflug camera.SettingBriz-L Eye Clinic, Baku, Azerbaijan.DesignA cross-sectional study.MethodsIn this study, 49 KC (Amsler–Krumeich stage 1) eyes and 36 healthy eyes were enrolled. A complete ophthalmic evaluation and a Scheimpflug camera scan were performed in every eye included in the study. Tomographic parameters such as parameters from the front and back cornea, maximum keratometry reading (Kmax), corneal volume (CV), anterior chamber volume (ChV), anterior chamber depth (ACD), anterior chamber angle (AC angle), keratometric power deviation (KPD), maximum front elevation (Max FE), and maximum back elevation (Max BE), as well as pachymetric progression indices (PPI), Ambrosio relational thickness (ART), index of surface variance (ISV), index of vertical asymmetry (IVA), center keratoconus index (CKI), index of height asymmetry (IHA), index of height decentration (IHD), and radius minimum (RM) were collected and statistically compared between the two groups.ResultsPPI, ART, ISV, IVA, CKI, IHA, IHD, and RM parameter values were significantly different (P<0.05) between the KC and healthy eyes. There were no significant differences in K mean and Q values of the frontal corneal parameters, as well as in Kmax, AC angle, RM, back, and front astigmatism, between stage 1 keratoconic and normal Caucasian eyes with steep cornea. All other parameters such as K mean and Q values of the back corneal parameters, Max FE, Max BE, ACD, ChV, and CV showed significant differences between the groups (P<0.05 for all).ConclusionScheimpflug imaging is able to detect corneal morphological differences between stage 1 KC eyes and healthy eyes with steep cornea, in Caucasians.

Ocular surface findings in patients with rheumatoid arthritis under methotrexate or biological agent therapy

Purpose: To evaluate the ocular findings in patients with rheumatoid arthritis (RA) treated with disease-modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX) or MTX with biological agents.Methods: One hundred and twelve eyes of 56 patients with RA and treated with MTX or MTX with biological agents were included in the study. Patients were divided into two groups using DMARDs only (group 1) and patients using DMARDs and biologic agents together (group 2). In both groups; Schirmer’s II test, tear film break-up time (tBUT), central corneal thickness (CCT), corneal volume (CV), intraocular pressure (IOP) measurement, and anterior segment and fundus examinations of the eye with slit lamp were carried out. Ocular surface disease index (OSDI) score questionnaire were performed.Results: Thirty-eight patients with a mean age of 53.00 ± 8.19 years were in group 1 and 18 patients with a mean age of 51.00 ± 9.54 years were in group 2. The mean duration of RA was 6.89 ± 7.96 years in group 1 and 5.70 ± 9.00 years in group 2. There was a statistically significant difference between two groups with tBUT, CCT, CV, IOP (p < 0.05) and there was no significant difference with age, sex, disease duration, disease activity, and Schirmer’s II test (p > 0.05). The disease duration showed a significant moderate negative correlation with CCT and CV in group 2 (p < 0.05).Conclusions: Although tBUT values were significantly higher in the combination treatment group, CCT and CV values were significantly lower. Due to the decrease in corneal thickness, IOP was determined to be significantly lower.

Grosor corneal central y conteo de células endoteliales en pacientes sometidos a cirugía de catarata asistida con láser de femtosegundos comparada con cirugía facoemulsificación tradicional

ObjectivesTo compare the endothelial cell count and central corneal volume between the group of conventional phacoemulsification and the femtosecond laser assisted surgery. MethodProspective, comparative, experimental and randomized study of 64 cataract patients who had surgery between May and August of 2013. Patients where randomly choose to have either femtosecond laser assisted surgery (Femto group) or the conventional phacoemulsification (Phaco group). The endothelial cell count was determined by specular microscopy preoperatively, 1 day, 1 week, and 1 month postoperatively. The same process was applied to assess the central corneal volume by measuring it with ultrasonic paquimetry. We included patients with similar cataract density, older than 40 years old and with no corneal pathology. ResultsThe mean age was 66.68±11.74 years in the femto group and 72.2±8.82 on the phaco group. In the multivariable modeling, there were no significant differences in the mean central corneal volume (P=.44) and the endothelial cell count (P=.45). There was not statistical significance difference between the central corneal volume and the endothelial cell count of the conventional phaco and the femto group. ConclusionsThe femtosecond laser-assisted surgery has the same impact in corneal swelling and endothelial trauma that the conventional phaco surgery.

Density of the crystalline lens in obese and nonobese children

To compare crystalline lens density in obese and nonobese children. A total of 40 obese (25 females) and 46 age-sex matched controls (26 females) were included in this prospective study. Children with ocular diseases (except for mild refractive errors), ocular trauma, or surgery and any systemic disorders, including diabetes, were excluded. Lens densitometry (LD), central corneal thickness (CCT), anterior chamber depth (ACD) and corneal volume (CV) were measured by Pentacam HR. Mean participant age was 12.0±1.9 (range, 7.2-18years) in the obese group and 11.7±2.0 (range, 7.5-16.1years) in the control group. The BMI was 29.9±4.5 in the obese group and 18.7±2.5 in the control group (P≤0.05). The vertical, horizontal, and areal lens density measurements were higher in obese group than in controls (P≤0.05). There was a positive correlation between BMI and vertical, horizontal, and areal lens density measurements. The difference in CCT, ACD, and CV was not statistically significant between groups (P≥0.05). There is increased lens density in the obese children compared with controls. Pentacam HR may provide objective data about lens density in children.

Evaluation of the Anterior Segment Parameters of the Patients with Scleroderma

ABSTRACTPurpose: To evaluate corneal parameters of scleroderma (SC) patients by Pentacam-HR.Methods: Twenty-two eyes of 22 SC patients and 33 eyes of 33 control subjects were enrolled. All participants underwent Pentacam (Pentacam-HR, Oculus, Germany) evaluation. Both SC and control groups were divided into two subgroups as dry eye (DE) (Schirmer test with topical anesthesia (STA) ˂5 mm) and without DE (STA ˃5 mm).Results: Pachymetric measurements and mean corneal volume (CV) were significantly lower in the SC group than in the control group (p<0.001). Pachymetric measurements and CV of SC patients with DE were significantly lower than all the other subgroups. Control subgroups with or without DE were similar in pachymetric measurements and CV.Conclusions: The results suggest that SC patients have thinner corneas compared with control subjects. Additionally, coexistence of DE seems to have an additional impact in the thinning of cornea in SC patients.