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Am J OphthalmolApril 202017 citations

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

Taroni Leonardo, Bernabei Federico, Pellegrini Marco, Roda Matilde, Toschi Pier Giorgio, Mahmoud Ashraf M, Schiavi Costantino, Giannaccare Giuseppe, Roberts Cynthia J


AI Summary

Scleral buckling for retinal detachment alters corneal biomechanics, reducing corneal hysteresis. This suggests SB eyes have less compliant corneas, potentially affecting IOP measurement accuracy and glaucoma management.

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.


MeSH Terms

BiometryCorneaElasticityFemaleFollow-Up StudiesHumansIntraocular PressureMaleMiddle AgedPostoperative PeriodRetinal DetachmentRetrospective StudiesScleral BucklingTonometry, Ocular

Key Concepts5

Operated eyes (OEs) that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) showed significantly lower values of corneal hysteresis (9.0 ± 1.8 mm Hg) than fellow eyes (10.1 ± 1.8 mm Hg) (P < .001).

MechanismCohortRetrospective, fellow-eye matched cohort studyn=18 consecutive patients (11 males and…Ch3Ch26

Operated eyes (OEs) that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) showed significantly lower values of corneal resistant factor (CRF) (10.0 ± 2.2 mm Hg) than fellow eyes (10.9 ± 2.2 mm Hg) (P < .001).

MechanismCohortRetrospective, fellow-eye matched cohort studyn=18 consecutive patients (11 males and…Ch3Ch26

Goldmann applanation tonometry (GAT) was significantly lower (18.1 ± 4.9 mm Hg) than corneal-compensated IOP (19.8 ± 4.8 mm Hg) in operated eyes (OEs) that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) (P = .022), but not in fellow eyes.

DiagnosisCohortRetrospective, fellow-eye matched cohort studyn=18 consecutive patients (11 males and…Ch3Ch26

Scleral buckle (SB) for the treatment of rhegmatogenous retinal detachment (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.

MechanismCohortRetrospective, fellow-eye matched cohort studyn=18 consecutive patients (11 males and…Ch3Ch26

The second applanation event (A2) took place earlier in time, and the cornea was moving faster during A2 in operated eyes (OEs) that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) than in the fellow eyes.

MechanismCohortRetrospective, fellow-eye matched cohort studyn=18 consecutive patients (11 males and…Ch3Ch26

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