Keratometric Changes in Noninflammatory Corneal Ectasic Diseases After Intraocular Pressure Reduction

1
Keratometric Changes in Noninflammatory Corneal
Ectasic Diseases After Intraocular Pressure
Reduction

• Authors has no financial interest.
• Renata T Kashiwabuchi, Camila Gadelha, Wilson de
  Freitas, Carlos Arce, Mauro Campos
• Federal University of Sao Paulo, Paulista School
  of Medicine Sao Paulo, Brasil

2

• Purpose To assess possible keratometric changes
  after intra-ocular pressure reduction and
  describe any change observed.

3
Methods

• Ten patients 9 bilateral keratoconus and 1
  corneal ectasia after refractive procedure.
• All patients were submitted to the follow exams
  before and after intra-ocular pressure reduction
  
• Corneal Analysis System EyeSy (EyeSys
  Laboratories Incorporation, Houston, Texas, USA),
  
• Pentacam (Oculus, Wetzlar, Germany),
• Corneo-Gage Plus (Sonogage, Cleveland, OH),
• Galilei (Zymer, SMT Swiss Microtechnology AG,
  Port, Switzerland)
• Ocular Respose Analyser (ORA Reichert Ophthalmic
  Instruments, Depew, NY),
• Intra-ocular pressure was measured by Goldman
  applanation tonometer in 90 and 180 axes by
  examiner 1 as well as all exams.

4
Methods

• For each patient one eye was assigned randomly to
  receive hypotensive drugs. Instructions about the
  drops were given to the patients by examiner 2.
• Examiner 1 has no access to details of random
  process.

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Results (table)

• Significant differences were observed in the
  follow data (hypotensive group)
• PIO (Goldman) 5.45 2.3 mmHg (p0.00),
• Pentacan
• Anterior Chamber Depth 3.5 0.3 µm (p 0.04)
• Anterior Chamber Volume 218 42.95 mm3 (p
  0.004),
• ORA data
• IOPcc 8.1 3.1 mmHg (p 0.00),
• IOPg 4.75 2.1mmHg (p 0.00)
• CRF 6.0 0.4 (p 0.01).

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Results (abbreviation)

• IOP (Goldman) Intra ocular pressure assessed by
  Goldman Tonometry
• Km mean simulated K power
• P Pentacan
• Km post posterior corneal power
• ACV Anterior Chamber Volume
• ACD Anterior Chamber Depth
• G Galilei
• IOPcc Corneal Compensated Intra Ocular Pressure
• IOPg Goldman Compensated Intra Ocular Pressure
• CRF Corneal Resistance Factor
• CH Corneal Histeresis

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Before After
PIO (Goldman) 11.9 2.3 mmHg 5.4 2.3 mmHg
Km (EyeSys) Km 47.6 6.6 47.4 6.3
Km (P) 42.9 14.8 46.8 4.8
Km post (P) -5.5 4.6 -6.9 0.8
ACV 229.9 41.5 mm3 218.9 42.9 mm3
ACD 46.84 4.8 µm 46.84 4.8 µm
Km (G) 49.9 7.4 49.7 7.3
Km post (G) -7.5 1.2 -7.4 1.2
IOPcc 15.2 5.8 mmHg 8.1 3.1mmHg
IOPg 12.5 3.6 mmHg 4.7 2.1 mmHg
CRF 8.1 1.0 mmHg 6.0 0.4 mmHg
CH 8.7 2.5 mmHg 9.1 1.2 mmHg
Data from hypotensive group
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• Conclusion Even though a significant
  intra-ocular pressure reduction no keratometry
  changes were observed in no device used.