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Abstract #20926 Published in IGR 10-2
Intraocular pressure measurements following descemet stripping endothelial keratoplasty
Vajaranant TS; Price MO; Price FW; Wilensky JT; Edward DPAmerican Journal of Ophthalmology 2008; 145: 780-786
PURPOSE: The effect of increased corneal thickness after Descemet stripping endothelial keratoplasty (DSEK) on intraocular pressure (IOP) measurement has not been previously studied. It is uncertain if this increase in corneal thickness would artificially elevate IOP reading by Goldmann tonometry [GAT] (Haag-Streit, Konig, Switzerland). Therefore the effect of DSEK-related thick cornea on IOP measurement was investigated using three different techniques. DESIGN: Prospective cross-sectional study. METHODS: Participants were recruited from a single tertiary referral center. Fifty eyes of 38 patients with successful DSEK at least three months prior to testing were evaluated. At the time of the study, none of the participants had clinically detectable corneal edema. IOP was measured with GAT, pneumatonometry, and dynamic contour tonometry (DCT) in an unmasked randomized sequence. Central corneal thickness (CCT) was measured by ultrasonic pachymetry. RESULTS: Mean CCT was 701 ± 68 μm. The mean IOP ± standard deviation (SD) was 15.9 ± 4.9 mmHg for GAT, 20.3 ± 4.5 mmHg for pneumatonometry, and 19.8 ± 4.4 mmHg for DCT. Pneumatonometry and DCT IOP measurements were significant higher than GAT (P < .01). In contrast, the difference between pneumatonometry and DCT readings was not statistically significant (P = .28). The correlations between IOP and corneal thickness were not significant in this cohort (P > .05). CONCLUSIONS: Falsely elevated GAT, as expected in thick corneas, was not demonstrated after DSEK. High IOP reading by GAT therefore should raise suspicion of elevated IOP in DSEK eyes.
Dr. T.S. Vajaranant, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
Classification:
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
