Recovery of Corneal Hysteresis After Reduction of Intraocular Pressure in Chronic Primary Angle-Closure Glaucoma

• Published in: American journal of ophthalmology Vol. 147; no. 6; pp. 1061 - 1066.e2
• Main Authors: Sun, Lei, Shen, Meixiao, Wang, Jianhua, Fang, Aiwu, Xu, Aiqin, Fang, Haizhen, Lu, Fan
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-06-2009; Elsevier; Elsevier Limited
• Subjects: Antihypertensive Agents - therapeutic use; Biological and medical sciences; Biomechanical Phenomena; Biomechanics; Chronic Disease; Chronic illnesses; Combined Modality Therapy; Cornea - physiopathology; Drug Therapy, Combination; Elasticity - physiology; Female; Glaucoma; Glaucoma and intraocular pressure; Glaucoma, Angle-Closure - physiopathology; Glaucoma, Angle-Closure - therapy; Hospitals; Humans; Intraocular Pressure - physiology; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Prospective Studies; Recovery of Function; Standard deviation; Surgery; Tomography, Optical Coherence; Tonometry, Ocular; Trabeculectomy; Eye disease; Chronic; Cornea; Reduction; Primary; Ophthalmology; Recovery; Angle closure glaucoma; Hysteresis; Intraocular pressure
• DOI: 10.1016/j.ajo.2009.01.008
• EISSN: 1879-1891
• ISSN: 0002-9394

Purpose To measure corneal hysteresis (CH) in unilateral chronic primary angle-closure glaucoma (CPACG) patients to determine if it was affected by high intraocular pressure (IOP). Design Prospective interventional case series. Methods CH and Goldmann-correlated IOP (IOPg) were obtained with the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Dephew, New York, USA) and central corneal thickness (CCT) was measured by optical coherence tomography. Baseline CH, IOPg, and CCT were measured in 40 CPACG eyes and compared to the fellow eyes and 40 normal controls. Reduction of IOPg in CPACG eyes was achieved medically, followed by trabeculectomy and peripheral iridectomy. Measurements were repeated at 2 and 4 weeks posttherapy. Results IOPg decreased significantly from 31.55 ± 10.48 mm Hg (mean ± standard deviation) before therapy to 11.47 ± 4.71 mm Hg, and CH increased significantly from 6.83 ± 2.08 mm Hg to 9.22 ± 1.80 mm Hg at 2 weeks, with no further changes after that. However, the CH in the treated eyes remained significantly lower compared with that of fellow and normal eyes. Before treatment, CH was negatively correlated with IOPg; however, there was no correlation after treatment. CCT was not affected by the reduced IOPg in the CPACG eyes. Conclusions CH was significantly lower in CPACG patients, and partial recovery occurred after successful IOP-lowering therapy. Alternations affecting corneal biomechanical properties appear to occur during glaucoma development.