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巩膜扣带术后对孔源性视网膜脱离的角膜生物力学反应改变。

Corneal Biomechanical Response Alteration After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment.

机构信息

Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.

Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.

出版信息

Am J Ophthalmol. 2020 Sep;217:49-54. doi: 10.1016/j.ajo.2020.03.054. Epub 2020 Apr 10.

Abstract

PURPOSE

To compare the corneal biomechanics of eyes that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) with those of fellow eyes (fellow eyes) and to further investigate the effects of SB on intraocular pressure (IOP) values.

DESIGN

Retrospective, fellow-eye matched cohort study.

METHODS

A total of 18 consecutive patients (11 males and 7 females) treated with SB for RRD in 1 eye were enrolled. Goldmann applanation tonometry was used to measure IOP. Biomechanical properties of the cornea were investigated by using the Ocular Response Analyzer (ORA) (Reichert Instruments) for the calculation of corneal resistant factor (CRF), corneal hysteresis, Goldmann-correlated IOP, and corneal-compensated IOP. Customized software was used for analysis of the ORA infrared and pressure signals, and a significance threshold was set to a P value of .05.

RESULTS

Operated eyes (OEs) showed significantly lower values of corneal hysteresis and CRF than fellow eyes (9.0 ± 1.8 vs 10.1 ± 1.8 mm Hg, respectively; P < .001; 10.0 ± 2.2 vs 10.9 ± 2.2 mm Hg; P < .001). GAT was significantly lower than corneal-compensated IOP in OEs (18.1 ± 4.9 vs 19.8 ± 4.8 mm Hg, respectively; P = .022) but not in fellow eyes. The second applanation event (A2) took place earlier in time, and the cornea was moving faster during A2 in the OEs than in the fellow eyes.

CONCLUSIONS

SB for the treatment of RRD affects corneal biomechanical response, likely due to a less compliant sclera that limits corneal motion and reduces energy dissipation, reflected in a lower corneal hysteresis. This has potentially meaningful clinical implications as the accuracy of the measurement of IOP values may be affected in these eyes.

摘要

目的

比较行巩膜扣带术(SB)治疗孔源性视网膜脱离(RRD)后的患眼和对侧眼(对侧眼)的角膜生物力学,并进一步研究 SB 对眼压(IOP)值的影响。

设计

回顾性、配对的同眼队列研究。

方法

共纳入 18 例(男 11 例,女 7 例)接受 SB 治疗的 1 只眼 RRD 患者。使用 Goldmann 压平眼压计测量 IOP。使用 Ocular Response Analyzer(ORA)(Reichert 仪器)测量角膜的生物力学特性,计算角膜阻力因子(CRF)、角膜滞后、Goldmann 相关 IOP 和角膜补偿 IOP。使用定制软件分析 ORA 红外和压力信号,并将显著性阈值设置为 P 值<.05。

结果

手术眼(OE)的角膜滞后和 CRF 值明显低于对侧眼(分别为 9.0±1.8 和 10.1±1.8mmHg;P<.001;10.0±2.2 和 10.9±2.2mmHg;P<.001)。OE 的 GAT 明显低于角膜补偿 IOP(分别为 18.1±4.9 和 19.8±4.8mmHg;P=.022),但对侧眼则不然。第二次压平事件(A2)发生得更早,OE 中的角膜在 A2 期间运动得更快。

结论

RRD 的 SB 治疗会影响角膜生物力学反应,这可能是由于较不顺应的巩膜限制了角膜运动并减少了能量耗散,反映在较低的角膜滞后。这可能具有重要的临床意义,因为这些眼的 IOP 值测量的准确性可能受到影响。

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