Since corneal thickness does affect Goldmann applanation tonometry we recommend to use the "Dresden Correction Table" (Tab. ) to achieve the real IOP. Pressure measurements after LASIK are inaccurate because of a change in corneal biomechanics, corneal thickness and curvature and they should be corrected as follows: IOP (real) = IOP (measured) + (540 - CCT)/71 + (43 - K-value)/2.7 + 0.75 mmHg.
The influence of topically applied clonidine 0.125% on ocular hemodynamics was investigated in ten patients with open-angle glaucoma and ten healthy volunteers, using a new, differentiated method. Ocular perfusion pressures were determined by Ulrich's method of oculo-oscillodynamography. Following monocular application of clonidine 0.125% eye drops a clear decrease in systemic blood pressure and a somewhat less pronounced reduction of ocular perfusion pressure was observed in both groups of patients. The reduction in ocular perfusion pressures was higher in the eye after drop application than in the untreated control eye. It must therefore be assumed that clonidine 0.125% eye drops have a local perfusion pressure-reducing effect in addition to their systemic effect.
A new method has recently been suggested for the determination of the outflow resistance in the anterior chamber angle. In this method the intraocular pressure is set to 45 mmHg for 8 minutes. The intraocular pressure is measured after the removal of the suction cup. Values below 7 mmHg are obtained in healthy subjects. Values above 7 mmHg are thought to be indicative for glaucoma. By setting the intraocular pressure to 45 mmHg for the expression of fluid the authors claim to have brought normalization to tonography. We show here in a series of results that we can reproduce the results which have been published by Ulrich et al. For normalization of a tonographic test we need a pressure rise which effects a uniform expression of volume. According to the knowledge presently generally agreed upon a uniform expression of volume is obtained by increasing the intraocular pressure by a constant factor and not by increasing it to a constant level. In 30 healthy volunteers and in 30 glaucoma patients we have increased the intraocular pressure by the constant factor of 1.8. According to our results the glaucoma patients and the healthy subjects can no longer be differentiated. A better differentiation is possible by the initial intraocular pressure. Thus we have shown that the favorable results by ocular pressure tonometry are mainly due to the intraocular pressure before the test. We feel therefore that ocular pressure tonometry should not be incorporated in our diagnostic armamentarium for glaucoma diagnosis.
To date there have been numerous promising publications on collagen cross-linking for keratoconus. The results of this study indicate that collagen cross-linking appears to be an effective therapeutic option for progressing keratoconus. Besides the clinical there are enormous economical and psychosocial benefits. Cross-linking is an out-patient, minimally-invasive, cost-effective treatment with minimal strain for the persons concerned.
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