Corneal Crosslinking Biomechanics Evaluated by a Novel and Easily Implemented Differential Tonometry Method

Wang, Mingwu; Berdahl, John P.; McCafferty, Sean

doi:10.1080/02713683.2021.1916039

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Both prisms measure the same IOP in corneas with average properties, therefore, the difference in CATS and GAT IOP (IOP CATS-GAT ) measures those combined corneal biomechanical properties resisting its applanation [33,34]. Significantly increased and sustained differential IOP was demonstrated following corneal cross linking (CXL) for early progressive keratoconus [37]. IOP CATS-GAT measures corneal biomechanical changes due to procedures similar to CXL.…”

Section: Tonometry Affected By Central Corneal Thickness and Corneal ...mentioning

confidence: 99%

Factors Affecting Intraocular Pressure Measurement and New Methods for Improving Accuracy: What Can IOP Tell Us about Glaucoma? How Can Practitioners Improve IOP Utility and Glaucoma Outcomes?

McCafferty¹,

Kilgore²,

Levine³

2023

Glaucoma - Recent Advances and New Perspectives

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An increased awareness of how central corneal thickness (CCT) and corneal material properties such as corneal hysteresis has changed both tonometry accuracy and the resultant understanding of glaucoma risk. New research findings and methods of tonometry provide differing information on the diagnosis and treatment of ocular conditions which should be understood to appropriately incorporate this information into individual patient care. Additionally, a useful re-examination of what IOP can tell us about glaucoma empowers practitioners to improve glaucoma outcomes. All clinically utilized tonometry methods are estimates of true IOP, which is only assessed using direct intracameral techniques. Different described tonometry techniques are associated with their own overall bias and interpatient variability, due most typically to tissue biomechanics.

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Section: Tonometry Affected By Central Corneal Thickness and Corneal ...mentioning

confidence: 99%

Factors Affecting Intraocular Pressure Measurement and New Methods for Improving Accuracy: What Can IOP Tell Us about Glaucoma? How Can Practitioners Improve IOP Utility and Glaucoma Outcomes?

McCafferty¹,

Kilgore²,

Levine³

2023

Glaucoma - Recent Advances and New Perspectives

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The research progress on the molecular mechanism of corneal cross-linking in keratoconus treatment

Yang¹,

Wang²,

He³

et al. 2023

Contact Lens and Anterior Eye

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Dynamics of Corneal Swelling With Hypoosmolar Riboflavin After Induction During Corneal Collagen Crosslinking in Patients With Progressive Keratoconus

Syed,

Yu,

Crespo

et al. 2024

Cornea

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Purpose: To evaluate the rate of corneal swelling induced by hypoosmolar riboflavin in patients with progressive keratoconus (KCN) with corneal thickness <400 µm after the induction phase using riboflavin with 20% dextran during epithelium-off corneal crosslinking (CXL). Methods: Prospective, nonrandomized, single-center consecutive case series. Preoperative assessments included tomography, specular microscopy, and hysteresis. After epithelial debridement, riboflavin with 20% dextran (Photrexa Viscous; Glaukos, Burlington, MA) was applied at 2-min intervals during a 30-min induction phase. Eyes that dehydrated to a minimum corneal thickness (MCT) of <400 µm after induction (postinduction pachymetry) were recruited. Hypoosmolar riboflavin 0.146% (Photrexa; Glaukos) was used every 10 s to induce stromal swelling, with pachymetry performed every 30 s until the MCT was ≥400 µm (postswelling pachymetry). Corneal swelling rate was compared with variables using regression analysis. Results: In 31 eyes of 31 patients, mean postinduction pachymetry was 338.4 ± 28.7 μm. Hypoosmolar riboflavin induced a postswelling pachymetry of 413.4 ± 15.0 μm over a mean of 5.2 ± 3.2 min, and the average stromal swelling rate was 10.3 ± 8.7 μm/30 s. All eyes reached a postswelling pachymetry MCT ≥400 µm and no cases were aborted. Eyes with highly severe KCN (Kmax >70 and Belin/Ambrosio enhanced ectasia display final D score >17) experienced quicker swelling (14.4 ± 12.8 μm/30 s and 14.9 ± 12.4 μm/30 s, respectively; P < 0.05 for both). A thicker postinduction pachymetry was moderately associated with a faster rate of swelling (rs = 0.389; P = 0.030). Conclusions: Hypoosmolar riboflavin 0.146% can be safely employed in thinner corneas, allowing for swelling to ≥400 µm for epithelium-off CXL. Associations between swelling rate, KCN severity, and postinduction pachymetry were determined, allowing for a more accurate prediction of procedure time during CXL.

show abstract

Corneal Crosslinking Biomechanics Evaluated by a Novel and Easily Implemented Differential Tonometry Method

Cited by 3 publications

References 30 publications

Factors Affecting Intraocular Pressure Measurement and New Methods for Improving Accuracy: What Can IOP Tell Us about Glaucoma? How Can Practitioners Improve IOP Utility and Glaucoma Outcomes?

Factors Affecting Intraocular Pressure Measurement and New Methods for Improving Accuracy: What Can IOP Tell Us about Glaucoma? How Can Practitioners Improve IOP Utility and Glaucoma Outcomes?

The research progress on the molecular mechanism of corneal cross-linking in keratoconus treatment

Dynamics of Corneal Swelling With Hypoosmolar Riboflavin After Induction During Corneal Collagen Crosslinking in Patients With Progressive Keratoconus

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