1. Intraocular Pressure Measurements After Descemet Membrane Endothelial Keratoplasty
- Author
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Antonia M. Joussen, Eckart Bertelmann, Anna-Karina B. Maier, Necip Torun, Caitlin Corkhill, Johannes Gonnermann, Enken Gundlach, Matthias K. J. Klamann, and Milena Pahlitzsch
- Subjects
Adult ,Male ,Intraocular pressure ,medicine.medical_specialty ,genetic structures ,Descemet membrane ,Glaucoma ,Goldmann applanation tonometry ,Cornea ,03 medical and health sciences ,Tonometry, Ocular ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Postoperative Period ,Prospective Studies ,Prospective cohort study ,Descemet Membrane ,Intraocular Pressure ,Aged ,business.industry ,Limits of agreement ,Pneumatic tonometry ,Middle Aged ,medicine.disease ,eye diseases ,030221 ophthalmology & optometry ,Female ,sense organs ,business ,030217 neurology & neurosurgery ,Descemet Stripping Endothelial Keratoplasty ,Tomography, Optical Coherence - Abstract
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.
- Published
- 2016