Transcript Slide 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 Purpose: To assess possible keratometric changes after intra-ocular pressure reduction and describe any change observed. 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. 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. Results (table) Significant differences were observed in the follow data (hypotensive group): PIO (Goldman) = 5.45 ± 2.3 mmHg (p=0.00), 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). 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 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 Conclusion: Even though a significant intraocular pressure reduction no keratometry changes were observed in no device used.