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Einfluss der stromalen Restdicke nach myoper LASIK auf die Messung des Augeninnendrucks

Applanationstonometer nach Goldmann und dynamischer Konturtonometer

Influence of residual corneal bed thickness after myopic LASIK on intraocular pressure measurements

Goldmann applanation tonometry and dynamic contour tonometry

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Zusammenfassung

Hintergrund

Ziel der Studie war, den Einfluss der kornealen Dicke und stromalen Restdicke nach myoper LASIK-Behandlung auf die Messungen des Augeninnendrucks mit dem Goldmann-Applanationstonometer und dem dynamischen Konturtonometer zu untersuchen.

Material und Methoden

Bei 50 Augen (30 Patienten) wurde der Augeninnendruck mit dem Goldmann-Tonometer und dem dynamischen Konturtonometer vor, 1 und 3 Monate nach myoper LASIK gemessen. Der mittlere korneale Abtrag betrug 71±27 µm. Intraoperativ wurde die Hornhautdicke mithilfe der optischen Kohärenzpachymetrie (Online OCP, 4optics AG) jeweils nach dem Mikrokeratomschnitt und nach dem Ablationsvorgang gemessen.

Ergebnisse

Ein signifikanter Abfall der Augeninnendruckmessungen wurde postoperativ beobachtet, sowohl mit dem Goldmann-Tonometer (−3,7 mm Hg; p<10−6) als auch mit dem dynamischen Konturtonometer (−1,5 mm Hg; p<10−6). Es bestand eine signifikante Korrelation zwischen Abfall der Messungen erhoben mit dem Goldmann-Tonometer und Dicke des Reststromas gemessen vor (r=0,48; p<0,001) und nach (r=0,46; p<0,001) dem Laserabtrag.

Schlussfolgerungen

Nach einer LASIK-Behandlung sind mit dem Goldmann-Tonometer und, wenn auch geringer, dem dynamischen Konturtonometer falsch-niedrige Messwerte zu erwarten. Zusätzlich zur Gesamtdicke der Hornhaut scheint die Restdicke der Hornhaut (gemessen unterhalb der Flaps vor und nach Laserabtrag) eine wichtige Rolle zu spielen.

Abstract

Purpose

The purpose of this study was to compare the influence of residual bed thickness after myopic ablation on intraocular pressure measurements using Goldmann applanation tonometry and dynamic contour tonometry.

Methods

Intraocular pressure using Goldmann tonometry and dynamic contour tonometry was measured in 50 eyes before, 1 and 3 months after LASIK for myopia. LASIK surgery reduced the central corneal thickness by 71±27 µm. During surgery, corneal thickness was measured by optical coherence pachymetry (Online OCP, 4optics AG) prior to flap creation, after flap lifting, and after laser ablation.

Results

Postoperative measurements with Goldmann tonometry were reduced by −3.7 mmHg (p<10−6) and mean measurements with dynamic contour tonometry were reduced by −1.5 mmHg (p<10−6). Differences in measurements with Goldmann tonometry were significantly correlated with thickness of residual bed after ablation, whereas measurements with dynamic contour tonometry were not.

Conclusions

Thickness of residual bed appears to influence readings with Goldmann tonometry more than readings with dynamic contour tonometry after myopic LASIK.

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    L. Muller &  T. Kohnen

  2. Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA

    T. Kohnen

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  1. L. Muller
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  2. T. Kohnen
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Correspondence to T. Kohnen.

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Muller, L., Kohnen, T. Einfluss der stromalen Restdicke nach myoper LASIK auf die Messung des Augeninnendrucks. Ophthalmologe 106, 21–28 (2009). https://doi.org/10.1007/s00347-008-1885-x

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  • DOI: https://doi.org/10.1007/s00347-008-1885-x

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