Usefulness of Measuring Corneal Stiffness in Predicting the Reduction of Intraocular Pressure With Microhook Ab Interno Trabeculotomy.

PURPOSE: To investigate the predictive factors for intraocular pressure (IOP) after microhook ab interno trabeculotomy (TLO).

METHODS

We included 147 eyes of 97 glaucoma patients who underwent TLO. We recorded the following preoperative parameters: systemic parameters (age, height, body mass index, systolic blood pressure, diastolic blood pressure, and history of smoking), blood examination scores, ocular parameters (preoperative Goldmann applanation tonometry [GAT]-IOP, central corneal thickness, type of glaucoma, and preoperative use of anti-glaucoma eyedrops), and Ocular Response Analyzer (ORA) parameters (corneal resistance factor [CRF], corneal hysteresis, corneal-compensated intraocular pressure). We analyzed the preoperative parameters associated with postoperative GAT-IOP. Subsequently, similar analysis was performed using a corneal visualization Scheimpflug technology instrument (Corvis ST) parameters, instead of the ORA parameters. Postoperative GAT-IOP was measured after 12 months from TLO.

RESULTS

When ORA parameters were used, preoperative high hemoglobin (Hb), high C-reactive protein (CRP), use of brimonidine tartrate, and high CRF were significant risk factors for postoperative high GAT-IOP, in addition to type of glaucoma. When Corvis ST parameters were used, preoperative high serum Hb, high serum CRP, usage of brimonidine tartrate, high biomechanical intraocular pressure, high stress-strain index, and low time to maximal displacement of whole eye movement were significant risk factors for postoperative high GAT-IOP.

CONCLUSIONS

ORA and Corvis ST measurements suggested that stiff cornea was a risk factor for high postoperative GAT-IOP after TLO, in addition to preoperative high Hb, high CRP, and the use of brimonidine tartrate.

TRANSLATIONAL RELEVANCE: Stiff cornea is a risk factor for high postoperative intraocular pressure after trabeculotomy.