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Corneal hysteresis helps predict pressure reduction

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WAIKOLOA, Hawaii — Understanding the effects of high and low corneal hysteresis on tonometry measurements can be clinically useful in predicting pressure reduction in patients undergoing selective laser trabeculoplasty, or SLT, according to a speaker at Hawaiian Eye 2019.

“When talking about applanation tonometry, the cornea can be thought of as a shock absorber,” Nathan M. Radcliffe, MD, said.

An eye with a high corneal hysteresis will often show a modest pressure reduction response. An eye with a low hysteresis will show a high pressure reduction response.

“If you are counseling patients on what they can expect from SLT, you now have a little prognostic information, he said. “If you have a patient that doesn’t seem to respond, think of their corneal thickness, corneal biomechanics and hysteresis, if you have it available, it might explain why you aren’t seeing an effect.”

A good shock absorber is going to be an eye with a thick cornea and high hysteresis, Radcliffe said.

“So when you go to applanate, you have to apply more force, which may lead to an abnormally high ocular pressure measurement, and the reverse can be said for an eye with a low hysteresis,” Radcliffe said.

Corneal hysteresis is measured with air jet tonometry and an infrared light, which measures when the eye deforms, when applanation occurs, and as the air jet dies down, when the cornea returns to its normal shape, he said.

The difference between the pressure at which the cornea deforms and the pressure at which it returns to its original shape is corneal hysteresis, he said. – by Abigail Sutton

Reference: Radcliffe NM. Corneal hysteresis in glaucoma. Presented at: Hawaiian Eye; Jan. 19-25, 2019; Waikoloa, Hawaii.

Disclosures: Radcliffe consults with Aerie, Alcon, Allergan, Bausch + Lomb, Beaver Visitec, Ellex, Glaukos, Iridex, Lumenis, New World Medical, Ocular Science, Reichert, Sight Sciences and Shire; is on the speaker’s bureau for Aerie, Alcon, Allergan, Bausch + Lomb, Ellex, Glaukos, New World Medical, Reichert and Sight Sciences and has ownership interests in Ocular Science and Sight Sciences.