Original article
Corneal Hysteresis and Intraocular Pressure Measurement in Children Using the Reichert Ocular Response Analyzer

https://doi.org/10.1016/j.ajo.2006.07.058Get rights and content

Purpose

To examine corneal hysteresis in children with normal eyes and congenital glaucoma and assess intraocular pressure (IOP) measurement with the Reichert Ocular Response Analyzer (RORA).

Design

Observational, cross-sectional study.

Methods

setting: Clinical practice. patients: Corneal hysteresis and intraocular pressure (Goldmann correlated [IOPg] and corneal compensated [IOPcc]) were recorded with RORA. IOP was also measured by Goldmann applanation tonometry.

Results

Mean corneal hysteresis of 12.5 mm Hg was recorded in 91 normal eyes of 42 children. It was markedly lower (mean 6.3 mm Hg) in 11 eyes of eight children with congenital glaucoma. No correlation was found between age and corneal hysteresis (r = −0.08). IOPg did not differ significantly from Goldmann applanation tonometry (P = .27). IOPcc was statistically significantly greater than IOPg (P = .014). RORA measurement was not possible in the presence of nystagmus but was possible with applanation tonometry. Cooperation with IOP measurement was much higher with RORA (89.8%) compared with applanation tonometry (78.7%).

Conclusions

Corneal hysteresis in children is similar to that reported in adults. No correlation was found with age. In the presence of nystagmus, IOP measurement was possible with Goldmann applanation tonometry but not RORA. Cooperation with IOP measurement was better with RORA than with Goldmann applanation tonometry.

Section snippets

Methods

This study was granted approval by the Institutional Review Board of the Childrens University Hospital, Dublin, Ireland. Children ranging in age from four to 18 years attending a pediatric ophthalmology clinic were selected for inclusion in the study. These children had healthy corneas and no history of anterior segment surgery. A second group of children with congenital glaucoma was also selected for inclusion. Goniotomy had previously been carried out on all eyes and was the sole surgical

Results

Corneal hysteresis was measured in 91 normal eyes of 42 children (22 boys, 20 girls) ranging in age from four to 18 years. Mean recorded corneal hysteresis was 12.5 ± 1.35 mm Hg (range, 8.2 to 15.7 mm Hg) (Figure). No correlation was found between corneal hysteresis and age (r = −0.08). Mean corneal hysteresis in 11 eyes of eight children with congenital glaucoma was 6.3 ± 1.58 mm Hg (range, 3.1 to 8.5 mm Hg) (Figure). Lowest corneal hysteresis values were recorded from eyes observed clinically

Discussion

Recent advances in technology have enabled in vivo measurement of corneal biomechanics, with the result that this is now the focus of much research interest. RORA has the capability to measure both corneal hysteresis and IOP simultaneously. A jet of air directed at the cornea generates a force-displacement relationship, which is monitored by an electrooptical system. The underlying principles have been described by Luce.1 During a measurement, a precise jet of air is directed at the cornea that

References (4)

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    Previous studies have shown that older patients present lower values of CH and CCT.33,34 Although children present a mean CH of 12.5 mmHg,35 normal adult populations show a mean CH lower than 11 mmHg in all studies.9,20,30 Therefore, it is possible that the effect of aging on glaucoma damage may be partially related to its effect on ocular biomechanical characteristics.

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