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Abstract #70656 Published in IGR 18-2

Intraocular Pressure Measurements After Descemet Membrane Endothelial Keratoplasty

Maier AB; Gundlach E; Pahlitzsch M; Gonnermann J; Corkhill C; Bertelmann E; Joussen AM; Klamann MK; Torun N
Journal of Glaucoma 2017; 26: 258-265

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PURPOSE: Intraocular pressure (IOP) elevation occurs regularly after Descemet membrane endothelial keratoplasty (DMEK). This study evaluated the effect of central corneal thickness (CCT) on the IOP after DMEK. PATIENTS AND METHODS: This prospective study recorded the IOP of 46 eyes from 46 patients preoperatively, and then 1 and 3 months after DMEK. IOP measurement was performed by noncontact pneumatic tonometry (NCT), iCare, Goldmann applanation tonometry (GAT), and dynamic contour tonometry (DCT). CCT was analyzed by anterior-segment optical coherence tomography. RESULTS: Mean IOPs as measured by NCT, iCare, GAT, and DCT, respectively, were 14.3, 11.6, 12.7, and 16.0 mm Hg preoperatively; 13.1, 12.6, 12.7, and 16.0 mm Hg after 1 month; and 14.7, 14.5, 12.9, and 17.7 mm Hg after 3 months. There was a correlation of IOP measurements between GAT and NCT (P=0.119), GAT and iCare (P=0.892), and iCare and NCT (P=0.081) after 1 month and between iCare and NCT (P=0.702) after 3 months. Although GAT recorded approximately stable IOP values, NCT, iCare, and DCT tended to measure a higher IOP postoperatively than preoperatively. Preoperatively, correlations between IOP and CCT were not statistically significant for any measurement technique. After 3 months, the IOP measured by NCT and iCare correlated significantly with CCT (P=0.003, 0.041). CONCLUSIONS: Correlation between the different measurement techniques was poor and showed a broad distribution of limits of agreement. Therefore, a change between the 4 techniques during follow-up is not recommended. Nevertheless, all techniques detected the IOP elevation during follow-up, requiring therapy.

Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Germany.

Full article

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Classification:

9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
6.1.1 Devices, techniques (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)

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