Surgically induced changes of the cornea may not only be characterized by anatomic parameters such as corneal thickness but also by biomechanical parameters such as corneal hysteresis.
Central corneal thickness in patients with OHT was significantly greater, and in patients with NDG significantly lower, compared to control subjects. In defining the desired intraocular pressure in glaucoma patients, in the future CCT measurements should be considered along with intraocular pressure measurement and visual field analysis.
Patients with POAG show an alteration of biomechanical corneal parameters with a significant decrease in corneal hysteresis. A positive correlation between CH and CCT, which was seen in the non-glaucoma group could not be detected in the POAG group.
The postoperative change of refraction depends on multiple factors among which changes of the anterior chamber depths, the corneal refraction, the swelling of the cornea, and the axial length can play a role.
Bimedial rectus belting is an alternative procedure to the faden operation, yielding similar results. Surgically, the procedure is more demanding, as the fixating sutures have to be passed through the sclera twice on either side. However, the integrity of the muscle is maintained and major adhesions with the sclera do not develop. Thus, the muscle can be subjected to recess or resect surgery without touching the anchoring of the belt in the sclera. In addition, revision surgery can be carried out easily with the belt left in place.
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