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      Corneal Hysteresis in Normal Subjects and in Patients with Primary Open-Angle Glaucoma and Pseudoexfoliation Glaucoma

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          Abstract

          Purpose: To identify differences in corneal hysteresis (CH) between primary open-angle glaucoma (POAG), pseudoexfoliative glaucoma patients (PXSG) and a healthy control group. Methods: In this retrospective study, CH was measured with the Ocular Response Analyzer. 90 subjects were evaluated, 30 subjects in each group. One eye per subject was analyzed. Results: In normal eyes, POAG and PXSG, CH was 9.8 ± 1.6, 9.0 ± 1.9 and 8.0 ± 1.5 mm Hg, respectively. CH was significantly lower in PXSG patients than in POAG (p = 0.042) and normal patients (p = 0.0001), but no significance was found between the POAG and the normal group (p = 0.23). Conclusion: CH differs in the different groups and might be considered in glaucoma evaluation. Further studies with larger sample sizes are needed.

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          Determining in vivo biomechanical properties of the cornea with an ocular response analyzer.

          David Luce (2005)
          To study the results of an ocular response analyzer (ORA) to determine the biomechanical properties of the cornea and their relationship to intraocular pressure (IOP). Reichert Inc., Depew, New York, USA. The ORA (Reichert) makes 2 essentially instantaneous applanation measurements that permit determination of corneal and IOP effects. Measurements of several populations indicate that corneal hysteresis, a biomechanical measure, varied over a dynamic range of 1.8 to 14.6 mm Hg and was only weakly correlated with corneal thickness (r(2)=0.12); this is related to the observation that some subjects with relatively thick corneas have less-than-average corneal hysteresis. Corneal hysteresis changes diurnally, presumably as a result of hydration changes. Keratoconus, Fuchs' dystrophy, and post-LASIK patients demonstrated low corneal hysteresis. The corneal hysteresis biomechanical measure may prove valuable for qualification and predictions of outcomes of refractive surgery and in other cases in which corneal biomechanics are important.
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            Central corneal thickness and corneal hysteresis associated with glaucoma damage.

            Aimee Broman, Karen Bandeen-Roche, N Congdon … (2006)
            We sought to measure the impact of central corneal thickness (CCT), a possible risk factor for glaucoma damage, and corneal hysteresis, a proposed measure of corneal resistance to deformation, on various indicators of glaucoma damage. Observational study. Adult patients of the Wilmer Glaucoma Service underwent measurement of hysteresis on the Reichert Ocular Response Analyzer and measurement of CCT by ultrasonic pachymetry. Two glaucoma specialists (H.A.Q., N.G.C.) reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup-to-disk ratio (CDR), mean defect (MD), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and presence or absence of visual field progression. Among 230 subjects, the mean age was 65 +/- 14 years, 127 (55%) were female, 161 (70%) were white, and 194 (85%) had a diagnosis of primary open-angle glaucoma (POAG) or suspected POAG. In multivariate generalized estimating equation models, lower corneal hysteresis value (P = .03), but not CCT, was associated with visual field progression. When axial length was included in the model, hysteresis was not a significant risk factor (P = .09). A thinner CCT (P = .02), but not hysteresis, was associated with a higher CDR at the most recent examination. Neither CCT nor hysteresis was associated with MD, PSD, or GHT "outside normal limits." Thinner CCT was associated with the state of glaucoma damage as indicated by CDR. Axial length and corneal hysteresis were associated with progressive field worsening.
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              Corneal biomechanical properties in normal, post-laser in situ keratomileusis, and keratoconic eyes.

              Dolores Ortiz, David Piñero, Mohamed Shabayek … (2007)
              To compare the biomechanical properties of normal, post-laser in situ keratomileusis (LASIK), and keratoconic corneas evaluated by corneal hysteresis and the corneal resistance factor measured with the Reichert Ocular Response Analyzer (ORA). Instituto Oftalmológico de Alicante, Vissum, Alicante, Spain. Two hundred fifty eyes were divided into 3 groups: normal (control group), post-LASIK, and keratoconus. The corneal biomechanical properties were measured with the ORA, which uses a dynamic bidirectional applanation process. The main outcome measures were intraocular pressure, corneal hysteresis, and the corneal resistance factor. The control group had 165 eyes; the LASIK group, 65 eyes; and the keratoconus group, 21 eyes. In the control group, the mean corneal hysteresis value was 10.8 mm Hg +/- 1.5 (SD) and the mean corneal resistance factor, 11.0 +/- 1.6 mm Hg. The corneal hysteresis value was lower in older eyes, and the difference between the youngest age group (9 to 14 years) and oldest age group (60 to 80 years) was statistically significant (P = .01, t test). One month after LASIK, corneal hysteresis and the corneal resistance factor decreased significantly, from 10.44 to 9.3 mm Hg and from 10.07 to 8.13 mm Hg, respectively. In the keratoconus group, the mean corneal hysteresis was 7.5 +/- 1.2 mm Hg and the mean corneal resistance factor, 6.2 +/- 1.9 mm Hg. There were statistically significant differences in both biomechanical parameters between keratoconic eyes and post-LASIK eyes (P<.001, t test). The corneal hysteresis and corneal resistance factor values were significantly lower in keratoconic eyes than in post-LASIK eyes. Future work is needed to determine whether these differences are useful in detecting keratoconus when other diagnostic tests are equivocal.
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                Author and article information

                Journal
                Journal ID (publisher-id): ORE
                Journal ID (nlm-ta): Ophthalmic Res
                Journal ID (doi): 10.1159/issn.0030-3747
                Title: Ophthalmic Research
                Publisher: S. Karger AG
                ISSN (Print): 0030-3747
                ISSN (Electronic): 1423-0259
                Publication date Subscription-year: 2011
                Publication date (Print): October 2011
                Publication date (Electronic): 06 April 2011
                Volume: 46
                Issue: 4
                Pages: 187-191
                Affiliations
                Glaucoma Department, St. Eriks Eye Hospital, Karolinska Institutet, Stockholm, Sweden
                Author notes
                *Marcelo Ayala, St. Eriks Eye Hospital, Polhemsgatan 50, SE–112 82 Stockholm (Sweden), Tel. +46 8 672 3507, E-Mail marcelo.ayala@sankterik.se
                Article
                Publisher ID: 326896 Other ID: Ophthalmic Res 2011;46:187–191
                DOI: 10.1159/000326896
                PubMed ID: 21474969
                SO-VID: 69761391-e465-49ca-9dcf-36588d172e85
                Copyright © © 2011 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 20 August 2010
                Date accepted : 14 January 2011
                Page count
                Figures: 2, Tables: 3, Pages: 5
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Pseudoexfoliation glaucoma,Corneal hysteresis,Primary open-angle glaucoma,Ocular response analyzer
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Pseudoexfoliation glaucoma, Corneal hysteresis, Primary open-angle glaucoma, Ocular response analyzer

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