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Corneal hysteresis in post-radial keratotomy primary open-angle glaucoma

  • Glaucoma
  • Published:
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Abstract

Purpose

Corneal hysteresis (CH) is a corneal biomechanical property measured by the ocular response analyzer (ORA). It is associated with primary open-angle glaucoma development, progression, and severity as well as intraocular pressure (IOP) measurement. Decreases in CH and changes in IOP measurements have been described for laser-assisted refractive surgery; however, patients with prior radial keratotomy (RK) have not been examined. We have performed a cohort study examining CH and intraocular pressure measurements (Goldmann applanation and ORA values including Goldmann-correlated and cornea-compensated IOP [adjusted for corneal hysteresis]) in RK patients and myopic controls with POAG.

Methods

Eighty POAG patients (28 RK and 52 myopic controls) were recruited. Central corneal thickness (CCT), prostaglandin analogue (PGA) use, perimetric stage, and history of cataract and glaucoma filtration surgery were assessed through chart review. Participants underwent testing with the ORA (yielding measures of CH, cornea-compensated [IOPcc], Goldmann-correlated IOP [IOPgc], and corneal resistance factor [CRF]), Goldmann applanation, A-scan for axial length (AL), and corneal topography. Slit lamp exam was performed to assess for number of incisions in RK patients.

Results

Adjusting for AL and CCT, CH was significantly lower in the RK group with an estimated difference of 0.8585 mmHg (p = 0.0112). Cornea-compensated intraocular pressure was significantly higher in the RK group after controlling for Goldmann applanation, AL, and CCT (2.35 mmHg difference, p < 0.001). Corneal resistance factor and IOPgc were not significantly different. A correlational analysis did not reveal a significant correlation between numbers of RK incisions and CH.

Conclusions

We report significant differences, with lower CH and higher IOPcc, when comparing eyes with glaucoma and either a history of RK or myopia. These findings may aid in establishing normative decreases in CH with RK and POAG and indicate a possible under-estimation of pressure in RK patients.

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Acknowledgments

We wish to acknowledge Shauna Pritchett, Stevi Riddle, and Megan Vandament for their assistance with data collection, the Translation Research Institute at the University of Arkansas for Medical Sciences for assistance with IRB preparation, and H. Trey Spencer for his assistance with statistical analysis. This work is dedicated to the memory of J. Charles Henry, MD (1954-2016), who played a major role in designing this study but sadly passed away before the completion of the work.

Funding

This research supported in part by clinic and staff utilization at the Little Rock Eye Clinic, the University of Arkansas for Medical Sciences (UAMS) Department of Ophthalmology, Harvey & Bernice Jones Eye Institute, UAMS Translational Research Institute, and Research to Prevent Blindness.

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Authors and Affiliations

  1. Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Joshua S. Hardin & Christopher I. Lee

  2. Little Rock Eye Clinic, 201 Executive Court, Little Rock, AR, 72205, USA

    Lydia F. Lane, Christian C. Hester & R. Grant Morshedi

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  1. Joshua S. Hardin
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Correspondence to R. Grant Morshedi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hardin, J.S., Lee, C.I., Lane, L.F. et al. Corneal hysteresis in post-radial keratotomy primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 256, 1971–1976 (2018). https://doi.org/10.1007/s00417-018-4073-y

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  • DOI: https://doi.org/10.1007/s00417-018-4073-y

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