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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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[Comparative evaluation of tonometry methods in keratoconus].

S E Avetisov1,2, V V Averich1,3, A V Volzhanin1

  • 1Krasnov Research Institute of Eye Diseases, Moscow, Russia.

Vestnik Oftalmologii
|December 23, 2025
PubMed
Summary
This summary is machine-generated.

Keratoconus (KC) alters corneal biomechanics, affecting intraocular pressure (IOP) measurements. Different tonometry devices show variability, with lower readings indicating poorer corneal health and thickness in KC patients.

Keywords:
corneal biomechanical parametersintraocular pressurekeratoconustonometrytonometry readings

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Corneal Science

Background:

  • Keratoconus (KC) presents chronic corneal changes complicating intraocular pressure (IOP) measurement interpretation.
  • Corneal biomechanical properties and thickness significantly influence tonometry readings.
  • Analyzing tonometric data considering corneal variability is a promising approach for accurate IOP assessment in KC.

Purpose of the Study:

  • To comparatively evaluate tonometric readings from various devices in keratoconus patients.
  • To assess the impact of corneal biomechanical characteristics and thickness on IOP measurements in KC.
  • To determine how different tonometry methods perform in the context of altered corneal properties.

Main Methods:

  • 167 patients (334 eyes) with bilateral KC were analyzed.
  • Subgroups were formed based on corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT) using Ocular Response Analyzer (ORA) and Corvis ST.
  • IOP was measured using pneumotonometry, ORA, rebound tonometry (RT), dynamic contour tonometry (DCT), and Maklakov tonometry.

Main Results:

  • Statistically significant differences in tonometry readings were observed across subgroups (p<0.05).
  • Pneumotonometry and ORA (IOPg) showed the highest variability (39-50%), correlating lower IOP with poorer biomechanics and thinner corneas.
  • Other methods (ORA IOPcc, RT, DCT, Maklakov) exhibited less variability (≤26%).

Conclusions:

  • Alterations in corneal biomechanics in KC lead to underestimation of IOP values, irrespective of the measurement method.
  • Corneal properties significantly impact IOP assessment accuracy in keratoconus.
  • Further research into device-specific performance in KC is warranted.