[Corneal distortion induced by speculum--studies with computer-assisted corneal topography]

The corneal distortion induced by the presence of an eyelid speculum was analysed by the Videokeratoscope-Eyesys Corneal Analysis System (EYESYS), with a Barraquer type speculum (B group) in 22 normal eyes and with a Kratz-Barraquer type speculum in 38 normal eyes (KB group). The following differences were evaluated in the 2 groups: intraocular pressure (IOP), refractive power, change in astigmatism of the Cravy method, and corneal refractive power before and after the specula were put in the interpalpebral fissure. Significant differences were found in the IOP in the KB group, in spherical equivalent in the B and KB groups, and in corneal refractive power in the B groups. Then the 38 eyes of the KB group were divided into two groups by the average level of proptosis and the average difference of IOP, and the corneal refractive power of the two groups was compared by statistical analysis. Significant difference was found in the direction of 0 degree/ 180 degrees in the group with higher than average proptosis and in the direction of 90 degrees/ 270 degrees in the group with higher than average difference in IOP. Multiple regression analysis suggested that higher grades of proptosis were related with steeper vertical meridians and that wider palpebral fissures were associated with steeper horizontal meridians. Multiple regression also showed that the speculum did not cause corneal distortion with the proper relation between level of proptosis and width of the palpebral fissure.