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白内障手术后角膜生物力学和眼内压的变化。

Changes in Corneal Biomechanics and Intraocular Pressure Following Cataract Surgery.

机构信息

Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan; Moorfields Eye Hospital NHS Foundation Trust and University College London, Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan.

Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan.

出版信息

Am J Ophthalmol. 2018 Nov;195:26-35. doi: 10.1016/j.ajo.2018.07.025. Epub 2018 Jul 30.

Abstract

PURPOSE

To investigate the effects of cataract surgery on corneal biomechanics and intraocular pressure (IOP) measured with the updated Corvis ST tonometer (CST).

DESIGN

Prospective, interventional case series study.

METHODS

This study included 39 eyes of 39 cataract patients. CST measurements were performed at presurgery (Pre) as well as 1 week (1W), 1 month (1M), and 3 months (3M) postsurgery. The following CST parameters were recorded: deformation amplitude max (DA max), DA ratio max 1 mm and 2 mm, integrated radius, stiffness parameter at applanation 1 (SP A1), Ambrosio relational thickness to the horizontal profile (ARTh), Corvis biomechanical index (CBI), central corneal thickness (CCT), noncorrected intraocular pressure (IOPnct), and biomechanically corrected IOP (bIOP). IOP was also measured with Goldmann applanation tonometry and the noncontact tonometer CT-90A. All measurements were compared at each period using the linear mixed model, with and without adjustment for bIOP and CCT.

RESULTS

All IOP measurements decreased over time (P < .01). CCT was increased at 1W and 3M (P < .01), whereas ARTh was decreased at 1W and 1M (P < .01), but returned to its Pre level at 3M. DA max and Integrated radius were increased at 3M (P < .01), whereas SP A1 was decreased at 3M (P < .01). CBI was increased at 1W (P < .01), but returned to its Pre level at 1M.

CONCLUSIONS

IOP and Corneal biomechanical properties are changed after cataract surgery. In particular, SP A1 decreases while DA max and integrated radius increase, even at 3M, suggesting a less stiff cornea.

摘要

目的

研究白内障手术后角膜生物力学和更新后的 Corvis ST 眼压计(CST)测量的眼压(IOP)的变化。

设计

前瞻性、干预性病例系列研究。

方法

本研究纳入了 39 例 39 只眼白内障患者。在术前(Pre)以及术后 1 周(1W)、1 个月(1M)和 3 个月(3M)时进行 CST 测量。记录以下 CST 参数:最大变形幅度(DA max)、最大 1mm 和 2mm 处 DA 比值、整合半径、压平 1 处的刚性参数(SP A1)、与水平轮廓的 Ambrosio 关系厚度(ARTh)、角膜生物力学指数(CBI)、中央角膜厚度(CCT)、非矫正眼压(IOPnct)和生物力学矫正眼压(bIOP)。还使用 Goldmann 压平眼压计和 CT-90A 非接触眼压计测量 IOP。使用线性混合模型比较每个时间段的所有测量值,包括和不包括 bIOP 和 CCT 的调整。

结果

所有 IOP 测量值随时间推移而降低(P <.01)。CCT 在 1W 和 3M 时增加(P <.01),而 ARTh 在 1W 和 1M 时降低(P <.01),但在 3M 时恢复到术前水平。DA max 和整合半径在 3M 时增加(P <.01),而 SP A1 在 3M 时降低(P <.01)。CBI 在 1W 时增加(P <.01),但在 1M 时恢复到术前水平。

结论

白内障手术后 IOP 和角膜生物力学特性发生变化。特别是,即使在 3M 时,SP A1 降低而 DA max 和整合半径增加,提示角膜硬度降低。

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